While we are talking openly about mental illnesses and addictions now more than ever – there has been far less public discussion about how difficult it is to access services for mental health.

As a result of a campaign to raise awareness about mental illnesses the number of people seeking help in Emergency Department and outpatient clinics has dramatically increased. We continue to witness public tragedies involving untreated mental illness – often with horrible repercussions for the individual, their families, and the communities where they live.

Primary care physicians have difficulty accessing psychiatrists in many jurisdictions. 
Poor access to psychiatrists could lead to the conclusion that there are not enough psychiatrists to meet the needs of the population.  A recent study, indicates that regions with higher psychiatrist supply would have better access to care and more timely care after psychiatric discharge.

• Per Psychiatrists organization within Ontario’s mental health system, there is a fairly steady level of unmet need no matter how many psychiatrists practice in a region
• Instead of more psychiatrists, do we need to clarify the role of a psychiatrist in a publicly funded system to ensure that access to specialist care is equitable and based on need?
• In a publicly funded system, how should psychiatrists’ roles be defined in order to provide as much specialist care to as many high-needs individuals as possible in the most cost-effective way?

Paul Kurdyak MD PhD FRCPC
Director, Health Systems Research
Social and Epidemiological Research
Centre for Addiction and Mental Health

Lead, Mental Health and Addictions Research Program
Institute for Clinical Evaluative Sciences
Assistant Professor, Department of Psychiatry and Institute for Health Policy, Management and Evaluation
Faculty of Medicine, University of Toronto