Describe Psychiatric Shortage in Rural Canada

Psychiatric Shortage in Rural Canada
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Institution of Affiliation
Abstract
Very alarming reports and findings over the last couple of years show a trend in which the number of psychiatrists is decreasing in Canada. The findings pose a great negative impact on the mental health care of the patients in the county. A good example is the report by the Ontario Psychiatrists, titled Ontario Needs Psychiatrists: Ontario psychiatry shortage contributing to Canada's mental health crisis, there is a shortage of about 350 psychiatrists across Ontario only, and the shortage across the whole country could grow to about 45 percent by the year 2030. Putting into consideration the integral nature of the psychiatrists and their work, their availability and numbers is a great talking point in the world of mental health care. It’s because of it that there have been various brainstorming to try and find a solution, i.e. the people who can fill that gap. One of the groups of people who are seen as the right people to fill the gap is the Psychiatric Mental Health Nurse Practitioners (PMHNP). This paper will seek to provide a discussion of the state of psychiatrists’ availability currently in Canada, the shortage, the impact of the shortage, how and if possible the Psychiatric Mental Health Nurse Practitioners (PMHNP) can cover the shortage, as well as any related information to subject of discussion. The method used by this paper will be the reading and analyses of information from various sources, as well as interviews, form the various resourceful persons. This paper seeks to answer the question of whether the Psychiatric Mental Health Nurse Practitioners (PMHNPs) can fill the gap.
Psychiatric/ Mental Health Care Provider Shortage In Remote, Rural Canadian Setting - Can Psychiatric Mental Health Nurse Practitioners Fill The Gap?
Introduction
The dynamics in demographical conditions, because of the fact the majority of the active psychiatrists are approaching retirement, problems of recruitment as well as lack of incentives in the practice, are the greatest contributors to the few numbers of psychiatrists in rural Canada. The chairperson of the coalition of Ontario Psychiatrists alludes that “the demand for care of the psychiatrists continues to exceed the supply of the clinically active psychiatrists” CITATION Can051 \l 1033 (Canada, 2005). This means that the number of active psychiatrists is not growing at the same rate as that of the people who are in need of the care by these professionals. Proper treatment of mental health issues needs a team approach which includes the need for the special skills of the psychiatrists.
It is because of the growing need for the mental health care that the services of the psychiatrists increasingly becoming so critical. It, therefore, points out to the fact that the world is increasingly becoming filled with challenges which are so difficult to solve, which has contributed to the increased stress levels, depressions as well as general mental disorders. With an increased number of such health mental disorders, it is one of the major reasons for the reason why there is a shortage of psychiatrists in rural Canada CITATION Can051 \l 1033 (Canada, 2005).
Another reason for the shortage is the fact that there has been a relatively slow increase in the number of active psychiatrists and practicing in Canada due to various reasons such as recruitment challenges and lack of incentives. These and many more explain the shortage of professionals CITATION Can05 \l 1033 (Association, 2005). Therefore this topic is important in addressing the manner in which such a gap can be addressed after a careful assessment of the causes of the gap and what exactly can be done to fill the gap by the Psychiatric Mental Health Nurse Practitioners (PMHNP) and above all, if they can be able to fill the gap in the best way possible.
The psychiatrists are an important part of the mental health world, especially in Canada. From the reports indicate that the ratios of the psychiatrist to per population is expected to fall by 14% from 1: 7200 to 1: 8400 by the year 2030, with the rural areas of Canada expected to be the most hit. Albeit the shortage of psychiatrists which is being witnessed in Canada in the present times, the vacancies of studying psychiatry remain to be one of the highest in the country CITATION Rut01 \l 1033 (Chambers, Boath, & Wakley, 2001).
In addressing the challenge, various radical interventions have to be put in place to ensure that the trend above is controlled in the shortest possible time period, so as to guarantee quality mental health care provision in the country. One of the most touted groups of professionals who have been identified as suitable a group of people to fill the gap are the Psychiatric Mental Health Nurse Practitioners (PMHNP) CITATION Ste11 \l 1033 (Trenoweth, Docherty, Franks, & Pearce, 2011).
The Psychiatric Mental Health Nurse Practitioners (PMHNP) are also a group of people who are very important to patient care owing to their services and the close contact they usually have with the patients They are one of the groups who are the closest to any patients and the mental disorder patients just like other patients they can easily be accessed and attended to by the Psychiatric Mental Health Nurse Practitioners (PMHNP) . It is, therefore, the reason why they are viewed as potential fillers of the gap. The finding of this paper in the proceeding parts will help to answer this question, i.e. if the Psychiatric Mental Health Nurse Practitioners (PMHNP) can fill the gap of shortage of psychiatric professionals in rural Canada.
There are various models which can be used to address the question and which can be used further to discuss various issues of the topic. Such models include for instance the boost strapping model and the Nuremberg funnel model.
Objectives and Hypothesis
The main objectives of this research include:
* To identify whether or not there is a shortage of psychiatrists in rural Canada
* To quantify the shortage of the psychiatrists
* To qualitatively analyze the shortage
* To assess the impact of the shortage of psychiatrists in rural Canada
* To identify if the Psychiatric Mental Health Nurse Practitioners (PMHNP) can fill the gap
* To discuss the suitability of Mental Health Nurse Practitioners (PMHNP) to fill the gap and their exact contribution towards filling the gap
* To identify other techniques which can be used to assist the Mental Health Nurse Practitioners (PMHNP) to fill the gap
* To find out the general and specific contribution of nurses Mental Health Nurse Practitioners (PMHNP) in filling the gap.
The hypothesis of the study
Substantive hypothesis: Psychiatric Mental Health Nurse Practitioners (PMHNP) can fill the gap of shortage of psychiatrists in Rural/ remote Canadian setting.
Vs.
Null hypothesis: Psychiatric Mental Health Nurse Practitioners (PMHNP) cannot fill the gap of shortage of psychiatrists in Rural/ remote Canadian setting.
Literature Review
It is undoubtedly true psychiatrists that hold an integral part in the society today. Owing to the increased number of challenge in the modern world, the state of the mental health has continued to be put under constant and severe pressure to solve a couple of things which partly explains the origin of stress, depression and any other form of mental related problems CITATION Rut01 \l 1033 (Chambers, Boath, & Wakley, 2001)from their research on the state of mental health of the people especially in Canada, they note that at least 1 in every 4 people go through some form of mental disorders at least for some period of time, at some point in their lives in Canada. This, therefore, explains the need for proper mental health care to the Canadians and to the rest of the people.
There are various forms of treatments available for the mental disorders which one may go through, however Incayawar, Wintrob, Bouchard, & Bartocci (2009) state and explain that, close to two thirds of the people with any form of mental disorders never get to seek any assistance from the psychiatrist, and this explains probably the reason why being a psychiatrist has not been such appealing i.e. it’s not a hotcake job, which in a way according to the authors, does explain the contribution to the growing trend of shortage of psychiatric professionals in Canada and in the world today.
In order to address the shortage, Luxton (2015) suggests that the Psychiatric Mental Health Nurse Practitioners (PMHNP) are a better group of people who can fill the void. They describe the Psychiatric Mental Health Nurse Practitioners (PMHNP) as an “ideal” group of people due to their “closeness” to the patients. They are always at the place where the patient is in the hospital bed or even within the hospital premises, and their closeness to the patients makes them have a better understanding of what the patients need, they develop the good rapport with the patients and together with the expertise which they have, they easily can fill the gap according to the authors.
Trenoweth, Docherty, Franks, & Pearce, (2011), agree with the suggestions noting that the Psychiatric Mental Health Nurse Practitioners (PMHNP)  have got what it requires to properly provide the required services which the psychiatrists do provide and therefore they easily can fill the shortage in Canada. In theorizing their work, in the book, the authors do allude that despite the fact that in fundamental terms the psychiatrists do provide the required good mental healthcare to the mental disorder patients, because they have been trained specifically on that, the Psychiatric Mental Health Nurse Practitioners (PMHNP) and experts in psychological issues have the capability to provide care for such patients and they are required in the subfield to manage properly the patients who are given referrals to them so as to get special care and treatment to their conditions.
Further, Trenoweth et al. ( 2011) note that it is evident that the mental disorder patients are always in need of urgent care and a special type of professional services which the Psychiatric Mental Health Nurse Practitioners (PMHNP) are also capable of offering. The authors note that the Psychiatric Mental Health Nurse Practitioners (PMHNP) can offer training, support as well as supervision to the patients through the use of the services of various non-specialists.
In order for the Psychiatric Mental Health Nurse Practitioners (PMHNP)  to effectively undertake the services of a psychiatrists CITATION Ste11 \l 1033 (Trenoweth, Docherty, Franks, & Pearce, 2011)note that they need the support of various stakeholders such as health planners, policy researchers as well as government officials. The above can provide the required data, policies of operations as well as the various estimates and information which can be used in the discharge of services to the people.
Despite the suggestions by some stakeholders and scholars that the Psychiatric Mental Health Nurse Practitioners (PMHNP)  can provide proper care and treatment just as the psychiatrists do, CITATION Mar09 \l 1033 (Incayawar, Wintrob, Bouchard, & Bartocci, 2009)in their research have looked into the danger of having them in the mental disorder field, I.e. to take over the duties of the specialists in the field i.e. psychiatrists.
They further do echo the fact that the mental disorder patients usually need some sort of special attention from a qualified person who has a broad experience in the matter to do with mental health care provision. The experts must have the ability to understand clearly the root cause of the mental disorder problems, the ability to relate to the problem, the ability to offer more personalized attention and care, with the highest possible degree of cordialness which at the end of the day can help the mental disorder patients. In support of the statement, CITATION Kat11 \l 1033 (Fierlbeck, 2011)does concur with the statement that the type of attention and care which the mental disorder patients is a bit unique, and therefore not only should the quantity of the Psychiatric Mental Health Nurse Practitioners (PMHNP)factor play a role in it, but also most importantly, the quality of the nurses is of great importance in the proper treatment of the patients.
The author further agrees with the fact that there is the shortage of psychiatrists in Canada, the shortage needs to be filled as soon as possible, the challenges the Psychiatric Mental Health Nurse Practitioners (PMHNP) can face when dealing with the work and the possible solutions to that. He states that there is a need for the Psychiatric Mental Health Nurse Practitioners (PMHNP) to be given proper training on the psychiatry duties so that they can fill the gap effectively, although they state that there is a need for proper care so as to ensure that the wrong people are not tasked with the delicate duty of dealing with the mental disorder patients. They, therefore, call for a delicate balance between filling the gap and using the correct people to fill the gap so as to ensure that ultimately the gap is filled albeit the fact that the psychiatry professionals are not adequate in Canada.
When talking about the general shortage of psychiatrists in Canada, CITATION Rut01 \l 1033 (Chambers, Boath, & Wakley, 2001)do allude that the shortage has made the situation worse, which compels the mental health patients to wait for many weeks or even months before they can secure appointments to meet the psychiatrists. It means that if a person has a burning and agonizing problem, which requires an urgent solution from the psychiatrists, they may only end up doing something so bad, because of the problem, whereas the problem could have been solved much early. In order to deal with the same, the authors from their research do propose strongly that the Psychiatric Mental Health Nurse Practitioners (PMHNP)can properly fill the gap and therefore their services ought to be fully utilized in mental health care.
So as to enable the nurses PMHNPs to step in and undertake the duties of the psychiatrists whenever there are shortages, Chambers, Boath, and Wakley (2001) reiterate that there may be some limiting factors which need to be dealt with before the Psychiatric Mental Health Nurse Practitioners (PMHNP)s can undertake the work for instance the amendment of the laws. They note that in the present state the laws as they are for instance in Canada, they do limit the effectiveness of the services of the PMHNPs in their bid to provide the mental health care. The authors even quote from a report published by the American Psychiatric Nurses Association which recommends strongly for the granting of more powers for the psychiatric nurses in Canada. Further the authors above, the psychiatric nurses are divided into the registered and the advanced practice nurses. It takes a minimum of more than a year of practice to certify a psychiatric nurse and they must have at least more than 1500 hours of practice in the field of mental health care.
In regard to the training, which the psychiatry nurse do receive, Davis (2011), notes that the psychiatry Psychiatric Mental Health Nurse Practitioners (PMHNP)s are trained on how to diagnose diseases, to provide medication and additionally to give psychotherapy to the patients. Therefore in his view, the nurse practitioners can properly fill the void/ gap of the Psychiatric Mental Health Nurse Practitioners (PMHNPs). He only reiterates the need for them to have teamwork, to build trust with the patients, among many other attributes which can enable them to be an ideal supplement for the psychiatric services in Canada.
The above works by the authors all do present an argument which encompasses, the realization and quantification of the need to have services of the Psychiatric Mental Health Nurse Practitioners (PMHNPs)in psychiatry, their suitability, what they need as well as all the other necessary and relevant discussion which can assist in proving the hypothesis of the study of this paper.
Conceptual Framework
110426598425Shortage of psychiatrists in rural Canada and quantificationShortage of psychiatrists in rural Canada and quantification
31718255207000
210629526035Impact of the shortageImpact of the shortage
31851606985
105854581915Need for the supplementary services of other professionals Need for the supplementary services of other professionals
3190875438150
316801532131077279555880Identification of nurse practitioners as ideal people to fill the gapIdentification of nurse practitioners as ideal people to fill the gap
53483898389Analysis of where nurse practitioners are an ideal group to fill the gap/ assessment of their suitabilityAnalysis of where nurse practitioners are an ideal group to fill the gap/ assessment of their suitability
3158490283845
936625228600Recommendation or rejection of nurses as an ideal groupRecommendation or rejection of nurses as an ideal group
3168015201930
466725193040Further recommendation if the nurses are rejected by the paper as an ideal group of people to supplement the psychiatrists 0Further recommendation if the nurses are rejected by the paper as an ideal group of people to supplement the psychiatrists
Definition of Terms
* Conceptual- Relating to a certain concept being discussed
* Psychiatrist-a medical doctor specialized in providing mental health
Research Methods
Research Design
This paper will use the statistical method of correlation method to test the data and information which will be tested in the research. Data from the various sources will be collected, organized and analyzed properly with the target being to get the most accurate as possible set of results.
Correlation method will be used to test if there are any significant differences which exist between any two or more groups of people being tested in the research. The variances between group variability and within group variability will be studied. Other, methods which can be used in the study to provide more details of the results for the research include the Kolmogorov and t...