With the glow of Christmas holidays and the new year squarely in the rearview mirror, many people have been talking about hitting the COVID-19 wall: where the dwindling adrenalin of dealing with lockdowns, masks, social distancing — the list goes on — meets the thought of months more of the same.
There is help, though, and according to those helping run the mental health system in Prince Edward Island, more people are reaching out for it.
"We have seen an increase since the pandemic has hit, definitely through our intake services and also through our Community Mental Health walk-in clinics," said Star Milton, a clinical social worker with Community Mental Health, who works as an intake screener. She's the voice you'll hear if you call Community Mental Health in the Summerside area, at the Prince County Hospital.
"When it comes to mental health, there's shame, there's fear, there's so many different emotions," Milton said. "It can be scary for people, especially the way they're brought up — some are brought up not to share or ask for that support."
The most common complaint is anxiety and depressive symptoms or struggling with motivation, Milton said.
Do you know how to find help on P.E.I.? Here's a guide to walk you through the process — and Milton reminds people, there is no wrong way to enter the system.
Single point of access coming later in 2021
An important note: in his state-of-the-province address Monday night, Premier Dennis King said some time this year, the province will introduce a single point of access for mental health and addictions services on P.E.I.: a 24-hour phone line, seven days a week, "where a real human being answers the phone and helps to navigate the process of getting the appropriate treatment," he said.
The province also plans to establish a P.E.I. Centre for Mental Wellbeing, an organization funded by but independent of government, that will work with community organizations like the Canadian Mental Health Association, PEERS Alliance, the Boys and Girls Club, and others to create a co-ordinated network of services available for Islanders when they need them.
"The centre will get off the ground immediately, with a founding board of high-performing leaders from across our province who will build a solid foundation for the centre to be fully operational by fall 2021," King said.
Until then, here's how to find the help you need.
Those in crisis can call the Island Helpline 24 hours a day, seven days a week at 1-800-218-2885.
You can also call P.E.I.'s Mental Health and Addictions Information Line weekdays 8 a.m. to 4 p.m. They may redirect you to a Community Mental Health office.
Call Community Mental Health
"Community Mental Health is exactly where to start," for those struggling with anxiety or depressive symptoms, Milton said. You can call 8 a.m. to 4 p.m. weekdays.
There are different toll-free phone numbers for Community Mental Health offices across P.E.I.: find the complete list for Souris, Montague, Charlottetown, Summerside, O'Leary and Alberton here.
You do not need a referral from a doctor, Milton stresses: you can refer yourself. Your family doctor, nurse practitioner or an ER doctor can also refer you, as could a member of a school wellbeing team.
What happens when you call? An administrator will take your name and phone number, then an intake worker like Milton will call back as quickly as possible — she said in Summerside, callbacks usually happen within 48 hours.
The intake worker has a series of questions about how they can help so they can direct clients to the appropriate resource. That call can take anywhere from 10 minutes to an hour, Milton said.
"What I'm looking for is to see how people's daily functioning [is]," Milton said. "Their daily functioning might be a little bit interrupted, where others it might be significantly interrupted."
She'll ask how you've been sleeping and whether your appetite has changed, if you've been having psychotic symptoms or delusions, changes in memory, whether you have past trauma or are using alcohol or drugs. Addictions can be co-occurring with anxiety and depression, she noted.
One of the questions will be whether you have access and coverage through your employer for counselling, like an employee assistance program. Most government employees on P.E.I. have access to a list of mental-health professionals, as do employees of some large private companies. Some people don't realize this help is available, Milton said. However, she stressed that even if you are covered, everyone is welcome to use the free public services offered by CMH.
Go to a free walk-in clinic
Another excellent way to seek help is simply show up at a Community Mental Health walk-in clinic offered across P.E.I., Milton said. The clinics went from in-person to over the phone during the early part of the pandemic, but now they can be either, depending on your preference. Some people do not have transportation to get to a walk-in clinic, or their mental health may present a barrier.
The clinics are free, and you don't need an appointment.
In Charlottetown, walk-in clinics are five days a week at two different locations. In Montague, clinics are Thursdays only, and are twice a week in Summerside. Here's the complete list of walk-in clinics, locations and times.
Once Milton has done an intake interview, she triages the information — that means she decides where to send callers next, for help.
Islanders can also find information on self-help and accessing the mental-health system through the online resource Bridge the gapp, a directory of resources Island-wide for adults and children. It can point Islanders to services such as peer support groups, to a huge library of articles on mental health, and to free online courses offered by Canada's Centre for Addiction and Mental Health (CAMH). This is yet another point of entry to the system, said Milton.
Community Mental Health clinicians do not prescribe drugs, Milton said, since there is no doctor or nurse practitioner on staff. She said anyone looking to discuss or access medication should talk to their family doctor or NP, go to a medical walk-in clinic or access a virtual appointment with a doctor through the telemedicine provider Maple, at getmaple.ca.
You've reached out, what's next?
If someone is experiencing anxiety and depressive symptoms, there are many different things the system can offer, Milton assures.
She might refer them to one of the free programs offered by the Strongest Families Institute. Getting that set up takes only about a week, Milton said.
Strongest Families has a group of online programs launched in 2015 by two psychiatry professors at Dalhousie to help Atlantic Canadian children, and now adults too, suffering from behaviour problems and anxiety. The Strongest Families website claims its programs have a 91 per cent success rate.
ICAN is the only Strongest Families program aimed at adults suffering from anxiety, and began in 2019. It's a free eight-week program that includes videos, relaxation audio, a daily anxiety tracker and weekly telephone support from a coach.
"I tell people if they're still struggling after they finish those programs ... we can offer more," Milton said.
Group or individual therapy
You may be offered the ChangeWays program, an in-person group that uses cognitive behavioural therapy (CBT). Program trainers include nurses, social workers, psychologists and occupational therapists. They're done in small group settings and one is begun every few months, or more often if there is high demand, Milton said.
Some may not be willing to participate in group therapy, and Milton said that's OK.
"We try to meet them where they're at," she said, noting more people are using this option and "A lot of people ... are really seeing the benefits of doing group services."
Community Mental Health also offers individual therapy with a clinician such as a registered nurse, psychologist or someone with a master's in social work (MSW). Milton said wait-lists for that differ in every P.E.I. office. Again, it is triaged, or based on urgency: if someone needs to be seen immediately, they are. Others may have to wait a bit, depending on the load of urgent cases.
Milton said it is important to know that at any time if Islanders are waiting for treatment and their symptoms worsen, they can and should phone back Community Mental Health and be re-triaged.
"I know it's probably so tough and they have to be so brave, and they're already so vulnerable coming through intake," she said. "But they need to call back if things are getting worse ... so we can reassess for intake. Which we have done."
Islanders should also know that if they are waiting for treatment, they are welcome to drop in to a walk-in clinic any time — they can indicate they are on a wait-list, and get support until they can begin a course of therapy, Milton said.
How will therapy help?
Once you're assigned a clinician, you will get an appointment to come in person or talk on the phone. That clinician will decide your course of treatment on a case-by-case basis.
A common treatment is CBT, talk therapy that helps a patient understand how cognition, emotion and behaviour interact.
"I've seen a lot of people calling for the first time saying 'I've had some past trauma and I've put it on the shelf, it's been fine, it's never come out and disrupted my daily function,' but all of a sudden it's exploded a little bit, and they need to unpack it and figure it out," Milton said.
What happens if you are assigned a clinician and you don't think they are helping you, or you clash?
"Sometimes we need to have those tough conversations, ask for what you need," Milton said. "Have a talk about it. Maybe the clinician can adjust something ... change how they are approaching things."
Some people do quit and don't come back.
"We hear that all the time from clinicians," Milton said. CMH will send a letter to the patient and try to get them to re-engage.
"If you are not ready now, just come back, it's totally OK," she said. "We are here to support Islanders."
She notes that Community Mental Health teams can also be deployed in larger-scale or group crisis situations, as they were for residents after the fire at Le Chez-Nous seniors' home in Wellington in January and the tragic drowning deaths of two teens in western P.E.I. last September.
For youth cases who have tried a first-line treatment such as group or individual therapy, but who continue to struggle, a more intensive program called Insight may be recommended, Milton said. It's a day-treatment program for about four months that offers help for 13- to 18-year-olds with significant and persistent primary mood, anxiety, and/or psychotic disorders. You can't self-refer to Insight, but rather come through Community Mental Health.
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