wait times for psychiatric services

I've been invited to make a presentation to my local university medical school about wait times for in-community psychiatric resources. It makes me wonder what kind of experiences you friends on the forum have of your own.

First it might be good to inform us of the procedure where you are and then your experience.

In Canada, one gets a psychiatrist on the referral of their family physician. The wait time is supposed to be no more than 4 weeks but it is taking 3-4mos in my region.

What are your experiences (this is outpatient services, not being assigned a doctor as an inpatient as a result of hospitalization).

thx

When I paid out of pocket ($90) I was able to get a p-doc appointment within days. With insurance I've had to wait between 6 weeks and 3 months.

Rcat in ontario wait time is 8 months to 18 months depending on the size of area and how many pdocs are available.. Not a uncommon to wait a year. Pdoc is a referral from gp. You go on a list.

I am hearing about similar wait times elsewhere in Canada. So, I suppose I should be lucky I only waited 3mos. I've the story again and again of people revolving through the emergency room during each psychiatric event on account of them having no other services to attend to them.

[At any one time - in Saskatoon - the psychiatric emergencies account for 6% of the emergency department. That doesn't sound like much but 6% of say 200 patients is 12. That's far too many people falling through the crack each day - and that doesn't account for the homeless or those who choose to ignore their events or have gone undiagnosed].

I'm also hearing the same story of people whose family physicians attempt to medicate persons during the waiting period with often the wrong medication.

This should be good. I'd be interested to know how different the process is in different parts of the US. I wrote a post about my experiences during the last two years which have involved having private health insurance, having no health insurance, and then being approved for Social Security disability and getting health coverage with that.

After I finished writing it, I realized that I sounded so complicated that I could barely understand it myself.

I'll just say that my current psych meds provider is a physician assistant, not a psychiatrist, and the wait time for my initial appointment was about three weeks.

I go to a mental health agency which leans towards serving patients without health insurance or with Medicaid or Medicare. It offers psychological assessment and testing, individual and group psychotherapy, meds management visits, and social worker case managers for those with mental illness severe enough to need them.

It also has crisis management teams to help people avoid inpatient hospitalization unless it's absolutely necessary.

As far as referral, for psychiatric services, my state uses a "mental health clearing house" type organization to make referrals for people with no insurance or with Medicaid.

When I had private health insurance, I could "self-refer" to a mental health provider on my list of approved doctors. The particular health insurance I had, though, reimbursed so poorly for outpatient meds management visits that I could only see a nurse practitioner at the psych providers group that I went to.

I haven't been able to see a psychiatrist for meds management for about the last ten years and my treatment has suffered for it.

(Although I really like the PA I see now - I like PAs in general. I don't think I've ever seen a poorly-trained one.)

Thats what my gp did. She tried to help but made things worse. Her words "I get 7 hours class time on psych meds. Pdocs get 7 years. Im only giving a calculated guess!" Made me feel really fantastic (sarcasm intended)

Wow, I am so fortunate to have free healthcare here (tho therapists and psychologists exist for user pay)

in England, you simply phone the family practitioner/GP/doctor, get an appointment, if you can, and they'll give you pills that day.

if you want to see a psychiatrist or a therapist, the rules say you should be seen within six weeks, but this is usually 3-4 months, on average, if you're considered mild-to-moderate. If you want anything more than an evaluation/diagnosis, such as therapy, you'll be lucky if you get any. CBT, etc: you could be waiting 18 months, if you ever get it. Most people don't.

We have a chronic underfunding issue in mental health services in England, and the NHS has devised a new form of out-patients services called "Recovery Colleges" (or campus). Basically, you can self refer to access services: art classes, creative writing stuff, laughter therapy, comedy classes, etc, and a "peer support programme" in an attempt to provide some type of service, but there is still no real therapy offered, just ways to waste your time and fill up the day and keep you connected to other people.

voluntary sector services try to fill the gap, and there are a few no/low cost counselling (Rogerian) schemes, but they have long waiting lists.

In terms of crisis: mental health services in England are currently running at 100% occupancy in some areas, and bed managers are, every morning, trying to work out who's the least sick person on the ward they can discharge to free up a bed. Where I am in England, if someone goes AWOL from their ward, their bed WILL be slept in that night by an emergency patient -- it's that bad.

In my area (suburban NE USA) if you have good private insurance, and if you aren't trying to get a particular specialist, you can be seen quite quickly, in a matter of weeks.

If you have no insurance or Medicaid/Medicare and need the county mental health clinic, the wait can be 4-6 months.

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I'm in South USA and on SSDI(disability)

I tried for over a year to get help though my insurance, dropped out of life and stayed in my apt for about 9-10 months then went to the PES(psych emergency services) was seen that day after arriving at 7am...waiting for 5 hours, went home with meds

Went back a few weeks later got med adjustment

Few weeks later signed up to get services though the county(something I had been avoiding because of previous experience with them)

They gave me a paper telling me the level of services I was eligible for(high)
got an appointment with Pdoc for 2 months later

A few weeks later tried to go to a PHP though my insurance got to go about 7 days then told not need it by the insurance

A crisis worker was assigned by the county pdoc because the other services weren't starting

few weeks later was in a open hospital though the county

about a month later was given appointment with Pdoc and a case worker who sees me at home, I couldn't use the other services because of transportation problems and lack of interpreters.

In all from first going to PES it took about 4-5 months to get constant Pdoc appointments and case worker. The county services changed a lot from last time and are very decent with good Pdocs.

What a waste of time. This conference will accomplish nothing. I doubt many psychiatrists at the conference will go back to their practices and implement any of the ideas that arose in the dialogue. Basically it was a paid day off for 150 psychiatric professionals and senior level bureaucrats. It was really frustrating as more visiting was going on that brainstorming.

I'm sorry to hear that the conference was a bust, rcat. That's very frustrating.