First, when we work with the women who contact us through the alliance, we can see that much more remains to be done in terms of post-partum follow‑up care.
We recently recorded a podcast with a woman who said that post-partum follow‑up care for the mother doesn't exist. During the post-partum period, her child had 10 follow‑up visits with the pediatrician. Yet, at every meeting with the pediatrician, the mother was, as she put it, dying inside. She really wanted someone to ask her how she was doing, but the question never came up. She considered broaching the topic, then changed her mind. She thought that she would be deemed a bad mother for focusing on herself rather than on her child.
All this to say that the issue isn't straightforward. Having already worked in various areas, such as Gaspésie, I can see that we have plenty to do in terms of the first level of intervention. Research and clinical studies show that we must give people access to resources, while providing these resources with a type of seal of approval from the province.
For example, I'm involved in creating an initiative that will be implemented in Quebec in the coming months. Basically, when we provide a service, we give it a type of departmental seal of approval. At every prenatal visit, right from the start, we bring up the fact that services are available to women should they experience any difficulties during their pregnancy. We can then combine this, for example, with the ECHO telementoring model.
I haven't yet brought up other studies that we carried out and another initiative that we implemented to give people an additional tool. This tool involves Internet access, but also a follow‑up with a mentor such as a nurse or a social worker for people who found the first level of intervention too basic and insufficient and who needed something more.
If necessary, we can then refer some people to psychiatric services. By providing the services at the first two levels of intervention, we can probably solve many problems. We have seen this in school settings. I work a great deal on level 3 interventions. With level 1 and 2 interventions, we can address about 70% of cases that would otherwise require a psychiatric consultation. The leaves us with 30% of people who will actually need to see a psychiatrist. This will automatically lighten the workload of these specialists.
When I talked about reorganization, this was also a factor to some extent. We must look closely at all the cases currently referred to level 3 to see whether these people could receive care at levels 1 and 2. This would lighten the load on the health care system, while meeting the needs of the more isolated communities that you referred to.