Pembroke Regional Hospital Cuts Back Services

[The Bread Guy]

This from the Canadian Press, shared in accordance with the "fair dealing" provisions, Section 29, of the Copyright Act.

Hundreds of soldiers from Canadian Forces Base Petawawa who sought counselling at a nearby hospital in eastern Ontario must get help elsewhere.

The Pembroke Regional Hospital says it can no longer afford the adult outpatient service that saw more than 400 soldiers a year seeking treatment outside the military health system.

Individual counselling has been dramatically scaled back with the retirement this year of four social workers who are not being replaced. Marital sessions are no longer offered.

Soldiers had received free counselling for anger, stress, depression and relationship problems.

The program's end comes amid an emotional public debate about whether troops are getting the support they need. Frontline counsellors say many soldiers still won't use beefed up military mental health programs for fear of tarnishing their careers.

Others simply won't admit they have a problem.

Bernadette Wren, the Pembroke hospital's director of mental health services, said there were no dedicated funds for outpatient counselling. It was a service provided "sort of out of the goodness of the hospital's heart," she explained.

Staff must focus on growing needs among the most severe and chronically ill patients, she said in an interview.

"If we had more funding, I would happily continue to provide the service."

Local social workers have stepped in to offer counselling, but Wren said more help is needed.

The cumulative stress of repeated tours in Afghanistan "is a big concern," she said. "I think the military needs to get better at ... supporting and helping people recognize the signs and symptoms."

Troops need more mental preparation for the reactions they may face once the relentless intensity of surviving a war zone has waned, Wren said.

"Flashbacks, nightmares, anxiety attacks, depression.

"We have a huge bunch of people that are impacted by these tours. And I think there just needs to be more (help) all the way around."

The Department of National Defence has stepped up support for traumatized troops in recent years while it tries to reduce the stigma of mental breakdown. The number of those wrestling with mental demons is significant.

A military survey two years ago suggested almost six per cent of 8,222 soldiers who'd recently returned from Afghanistan — about 500 troops — had symptoms of post-traumatic stress disorder or major depression.

What was once derided as shell shock or battle fatigue is now referred to specialized mental health services on larger bases. It's also treated at operational trauma and stress support centres in Halifax, Ottawa, Edmonton, Esquimalt, B.C. and Valcartier, Que.

Ottawa committed $98 million to hire another 218 mental health staff by March 2009 — a timeline that had to be extended because psychiatrists, psychologists and social workers are in such high demand.

The recent growth of military acceptance and recognition of stress disorders is "remarkable," said Celine Thompson, director of military family services for National Defence.

Her office oversees 41 military family resource centres in Canada, the U.S. and Europe.

"The shift has just been amazing," Thompson said in an interview. And the help is needed, she said.

"There has always been the risk of injury or death," she said of service in the Canadian Forces. Afghanistan, a mission that has claimed the lives of 152 soldiers, has escalated the potential of both physical and mental injury, she added.

"They're coping with things that they've never seen before. Definitely, there's going to be a residual impact of that.

"And we're told that there may actually be a spike later on, that we're probably not seeing all that we need to see right now. So we're just being ever vigilant in trying to manage the cases as they come up."

Military family resource centres offer everything from child care to crisis intervention and discrete referrals for treatment, Thompson said. Some counselling is provided depending on local funding, but there are plans to introduce national mental-health support programs in 2011.

Penny Fitzpatrick, a support worker at My Sister's Place, a shelter for abused women near CFB Borden about an hour north of Toronto, says such changes are overdue.

"The military women, over and over, tell me they're told that there's no services and no support for them," she said. "They're being referred off base all the time.

"It's quite atrocious, really," Fitzpatrick said of what she called "a huge gap" in services for families affected by the fallout of Afghanistan and other missions.

 

[George Wallace]

People in the Pembroke area saw this coming back when the Ontario Government of the day, closed down the better equiped and more modern of the two hospitals in Pembroke, keeping for some (political) reason the hospital that was run by the Grey Nuns. 

One of the worse hospitals in Ottawa was saved through 'political interference' as well. 

This is an indication that we are not getting our monies worth from the Health Care System in Ontario, and that we have too much outside influences to corrupt the system that is supposed to be providing us with medical attention as required. 

 

[GAP]

400 soldiers a year seeking treatment outside the military health system.

If this is the case, there is justification for the cost of setting up their own unit....

 

[Armymedic]

The other issue not mentioned in the article is that neither the civilian hospitals, not the military has been very successful in attracting additional qualified medical professionals to come work in the Upper Ottawa Valley. There is still a sharp family practitioner shortage, and the new Petawawa Family clinic has been relegated to a walk-in clinic for the want of a permanent MD. The base is also having difficulty attracting psychologists and social workers to work on contract.

If this was Edmonton, Valcartier, or either naval base, all located in close proximity to a large urban center, this would not be an issue.

BTW, Shilo has similar problems getting people in.

 

[riggermade]

It has not been relegated to a walkin clinic....there are two full time doctors and one who does one day a week plus the nurse practioners....the walkin clinic is in the building but is not the responsibility of the PCFHC and is open when hey have doctors that come to the area to run it

 

[Gunner98]

If this is the case, there is justification for the cost of setting up their own unit....

"Free counselling" - really bad business case development!

My conservative estimates:

400 soldiers x 10 hours X 180/hr = $720,000  (Normally a soldier is authorized for 10 sessions to begin with)

4000 treatment hours = 4000/2000 minimum 2 providers required

Psychologist, psychiatrist or social worker - even if they were paid $200,000 per year - the hospital would be making $320,000 in revenue.

This leads me to believe there is more to the story than is being reported.

Shared in accordance with the "fair dealing" provisions, Section 29, of the Copyright Act.

Toronto Star article is somewhat different:

Troops who sought counselling at hospital near CFB Petawawa must look elsewhere
Published On Sun Nov 14 2010 Marianne Takacs, Staff Reporter


http://www.thestar.com/news/canada/article/890744--troops-who-sought-counselling-at-hospital-near-cfb-petawawa-must-look-elsewhere

Ottawa needs to step in to prevent the shutdown of a hospital mental health counselling service used by hundreds of soldiers a year at the home base to which many troops return from Afghanistan, opposition critics say.

“This is another example where our veterans are being overlooked,” said Liberal veterans affairs critic Kirsty Duncan on Sunday. “There must be a plan to address their needs. If the hospital is unable to provide the services that they’ve come to depend on the federal government must find a solution or ensure alternatives are in place.”

Pembroke Regional Hospital says it can no longer afford the adult outpatient service that provided counselling for anger, stress, depression and relationship problems to more than 400 soldiers a year from Canadian Forces Base Petawawa.

Bernadette Wren, the hospital’s director of mental health services, said there were no dedicated funds for outpatient counselling. It was a service provided “sort of out of the goodness of the hospital’s heart,” she explained. “If we had more funding, I would happily continue to provide the service.”

This loss of a service for soldiers at the Pembroke hospital is the latest of the many trials facing some returning troops. A team of Star reporters recently spent three months talking with wounded soldiers in Germany and across Canada to prepare a special series of reports on their experiences. They found many of those injured physically and/or mentally in Afghanistan have had to continue to fight at home with bureaucrats and the military to get their needs met by a patchwork of federal programs.

NDP defence critic Jack Harris and Liberal Senator Colin Kenny said the federal government should pay for the hospital program itself if that’s what it takes to keep it running.

‘What needs to happen is the feds need to step up to it right away and make sure that there is no break in service,” Kenny said, “and then if they want to have a squabble with Queen’s Park later on, have at it.”

Even though hospital funding is a provincial responsibility, he noted, the soldiers in this situation suffered psychological injuries overseas and those injuries “are not that readily foreseeable by provinces” when they are deciding how to fund health care.

“The dumbest thing that could happen would be to have a federal-provincial argument and leave these people in the lurch until that’s resolved,” Kenny said.

‘I’m surprised to hear Ottawa is not working more closely with the Pembroke hospital to make sure the financial resources are there,” said Harris, noting CFB Petawawa is a large base that many soldiers come back to from Afghanistan. He said there appears to be an overall lack of resources and understanding on the part of the federal government when it comes to dealing with mental health issues facing returning troops.

‘I think it’s fair to say that we’re approaching a crisis really in terms of looking after returning soldiers,” Harris said, adding the situation is made particularly troubling by Prime Minister Stephen Harper’s recent decision to keep Canadian soldiers in Afghanistan past the original 2011 withdrawal date to train that country’s local military. “The more rotations they do the more opportunity for and prevalence of post-traumatic stress disorder-type reactions you’re going to get.”

The Canadian Forces “will have to look into” the situation at the Pembroke hospital and will likely respond Monday, said Department of National Defence spokesperson Jennifer Eckersley. “The CF take mental health very seriously and work to ensure appropriate health care resources are available to all members. We have several mental health professionals on staff at CFB Petawawa, in addition to staff in Ottawa that can augment as required.”

Among those the Star reported on in its series was Cpl. Steve Davidson, who struggled with psychological problems after a roadside bomb near Kandahar City killed two of his comrades and grievously injured another. He’s currently stationed at Petawawa and was not among those receiving counselling at the Pembroke hospital, but did receive care from a military psychiatrist and a civilian psychologist.

“I do think it’s extremely important for those kinds of programs to be in place, absolutely,” Davidson said Sunday. “When the vets come home, when they need help, they need to get it and that’s all there is to it.” He said he was helped “enormously” by the mental health counselling he received through the military. “It’s brought me back from where I was when I got back from tour to the man that I am today.”

A military survey two years ago suggested almost six per cent of 8,222 soldiers who’d recently returned from Afghanistan had symptoms of post-traumatic stress disorder or major depression.

CFB Petawawa did not respond to requests for information.

With files from the Canadian Press

 

[George Wallace]

The maddening thing for me, is that Service Members in Ontario are obliged to pay into the Ontario Health Care system, even though they are not supposed to use OHIP (this is in ref to the Service member, not their family).  With the money with which the CF is supporting OHIP, the funding should be directed where it is needed; in this case, to the services such as those being provided by the Pembroke hospital.

 

[mariomike]

Psychologist, psychiatrist or social worker - even if they were paid $200,000 per year

Probably a lot less than that.
"Make your contribution to our Toronto Emergency Medical Services and join us as a Staff Psychologist.":
"Salary: $89,707.80 - $111,202.00 annually":

http://wx.toronto.ca/inter/hr/jobs.nsf/b95d1630385b57cd8525668200523188/43d7a24a8b12d794852576ef006a5d96?OpenDocument

 

[The Bread Guy]

Probably a lot less than that.
"Make your contribution to our Toronto Emergency Medical Services and join us as a Staff Psychologist.":
"Salary: $89,707.80 - $111,202.00 annually":

http://wx.toronto.ca/inter/hr/jobs.nsf/b95d1630385b57cd8525668200523188/43d7a24a8b12d794852576ef006a5d96?OpenDocument

I'd go with the Simian Turner's higher figure, since we're talking about an underserviced area having to attract specific professionals - as someone else said ....

If this was Edmonton, Valcartier, or either naval base, all located in close proximity to a large urban center, this would not be an issue. BTW, Shilo has similar problems getting people in.

 

[mariomike]

I'd go with the Simian Turner's higher figure, since we're talking about an underserviced area having to attract specific professionals - as someone else said ....

$200,000 ? ....

Closing Date: March 31, 2011
Department of National Defence
Psychologist
Locations: Various locations at CF bases across Canada.
Salary: $68,255 to $79,574
https://psjobs-emploisfp.psc-cfp.gc.ca/psrs-srfp/applicant/page1800?toggleLanguage=en&psrsMode=1&poster=137564

I checked the Sunshine List for Pembroke Regional Hospital. No psychologists made it.

Compare that to Toronto: ( an over-serviced area for brain specialists if there ever was one  )
Salary: $89,707.80 - $111,202.00 annually
That is not private practice. It is working for T-EMS as a psychologist.
Ref: Reply #7
Closing date: April 20, 2010.

Edit to add

"Individual counselling has been dramatically scaled back with the retirement this year of four social workers who are not being replaced."

No psycholigists at Pembroke Regional Hospital made the Sunshine List.
The only mental health professional at Pembroke Regional Hospital who made the Sunshine List was the Director of Mental Health Services, quoted in the original article.

Social Workers:

DND
Social Worker
Salary: $63,056 to $73,511
https://psjobs-emploisfp.psc-cfp.gc.ca/psrs-srfp/applicant/page1800?toggleLanguage=en&psrsMode=1&poster=131655
Closing Date: January 31, 2011

 

[Gunner98]

Don't tell me you are still wondering why they have difficulty attracting takers for these jobs?  A PhD-trained psychologists charges $180/hr in a private practice.

Hospital-based psychologists' salaries range from $100-120,000, http://www.fin.gov.on.ca/en/publications/salarydisclosure/2010/hospit10.html - just Ctrl F - Psych

Hospital-based psychiatrists' range $160-270,000 - Ctrl F Psychiatrist

 

[The Bread Guy]

Don't tell me you are still wondering why they have difficulty attracting takers for these jobs?  A PhD-trained psychologists charges $180/hr in a private practice.

Hospital-based psychologists' salaries range from $100-120,000, http://www.fin.gov.on.ca/en/publications/salarydisclosure/2010/hospit10.html - just Ctrl F - Psych

Hospital-based psychiatrists' range $160-270,000 - Ctrl F Psychiatrist

I've heard second-hand that GP's in community clinic settings are getting ~$300K/year - such is the state of the underserviced area bidding war.

 

[riggermade]

No surprise that there is no support from the militry or VA in this matter.  Military should be stepping up and paying the professionals to work on the base with these soldiers.
VA doesn't even have a doctor in the Petawawa area whichis rediculous.  I had to travel to North Bay to see a doc

 

[mariomike]

Hospital-based psychologists' salaries range from $100-120,000, http://www.fin.gov.on.ca/en/publications/salarydisclosure/2010/hospit10.html - just Ctrl F - Psych

The Sunshine List only shows psychologists who earn over 100K. Not many were listed.

Here is one from a school board in Toronto:
SALARY RANGE $63,640.81 to $92,246.49
http://www.tcdsb.org/administration/E-Bulletin/September%2014,%202009/Job%20Posting%20-%20Psychology%20%20APS%202009-11.pdf

Canadian Security Intelligence Service
$70,770 to $86,120 per year
http://www.csis-scrs.gc.ca/crrs/pprtnts/2008-0029-eng.asp

 

[Fishbone Jones]

Compare that to Toronto: ( an over-serviced area for brain specialists if there ever was one  )
Salary: $89,707.80 - $111,202.00 annually

Obviously paid what they're worth, and, obviously, not very successful in their treatment ;D

 

[mariomike]

Obviously paid what they're worth, and, obviously, not very successful in their treatment ;D

I was thinking the same thing. 

In regards to cost, the staff psychologist ( now on our third - that was the job call ) was hired almost 30 years ago. She is a member of the department and her practice is limited to Toronto paramedics. She is available 24/7 for operational incidents. I have no idea how many she treats, but there are about 850 paramedics in Toronto.

Edit to add:
"Hospital denies report that program cuts will affect troops":
http://ottawa.ctv.ca/servlet/an/local/CTVNews/20101115/OTT_Pembroke_Hospital_101115/20101115/?hub=OttawaHome

"Between April 2009 and March 2010, five soldiers were given counseling, according to the hospital. Since April 2010, less than five soldiers have used the program."

"The Canadian Press originally reported that more than 400 soldiers a year sought counseling at the Pembroke hospital."








 

 

[GAP]

Military base to open new clinic to help soldiers
Published On Mon Nov 15 2010
Article Link
Bruce Campion-Smith Ottawa Bureau chief

OTTAWA—One of Canada’s biggest military bases is getting a new centre to help treat soldiers suffering post-traumatic stress disorders and other mental health issues.

The new “operational trauma and stress support centre” is due to open in the coming months at CFB Petawawa, said Commodore Hans Jung, commander of the Canadian Forces health services group and the military surgeon general.

In fact, many of the services are already being provided to assist soldiers on the busy base, which has seen repeated deployments to Afghanistan.

“We’re really ramping up,” Jung said of the 32-member clinic, which will offer services as varied as counselling in psychiatry, psychology and social work.

“They have the full capability,” Jung said.

The move comes as the hospital in neighbouring Pembroke reorganizes its mental health treatment programs. Pembroke Regional Hospital is doing away with some adult counselling, a small “legacy” program that has since been replaced by other resources at the hospital and in the community, said Pierre Noel, president and chief executive officer of the facility.

In addition to civilian patients, the program has also treated a handful of soldiers as well — about five a year, not 400 as some media reports claimed on the weekend.

“Very few soldiers have made use of that program,” Noel said. “There is very comprehensive and robust mental health services to the military up on base Petawawa.”

Jung insisted that any soldiers needing help will not be left in the lurch.
More on link