Thanks. That's a great question.
I should say that the number one issue identified was mental health issues during that recent meeting. The number two issue was human resources, the shortage of family doctors and pediatricians, and that's part of the access issue. There are a number of potential solutions.
One of them is that the youth hub model of delivery of mental health care might be further expanded. I work in a rural area once a month, where there's a nurse practitioner and several workers who are trained in the delivery of psychological therapy, cognitive behavioural therapy. So perhaps a more effective use of physicians' time in partnership with colleagues in a youth hub model could be explored and grown.
The second thing is that the physicians who are out there should be perhaps better trained to manage mental health issues. I think funding for continuing professional development opportunities might be a way to address the shortages in mental health care. In Manitoba, for example, the CanREACH program is funded, is subsidized. If there are programs like that that can be subsidized then we can get better and more efficient and refer less, and fewer people end up in the emergency department.
In terms of addressing human resource issues, we need to train more physicians. The demographic is there are a lot of us retiring. I hope to go for another five years or so but I would like to see the young folks get out there, perhaps with a little bit of additional curricula with regard to mental health training. For example, the family medicine program is expected to change from a two-year program to a three-year program over the next five to 10 years, recognizing increasing complexity. If mental health care competencies can be a greater part of their curricula, that's another way to deal with that.
In terms of additional training for pediatrics, in the last 10 years at SickKids, we've had a program called community pediatrics, which is an additional year of training to teach the skills needed out in the community in pediatrics. The curriculum is heavy on mental health care delivery.
There are a number of different ways of doing it but we need to train some more generalists, we need to train them better, we need to use them more effectively, perhaps in a youth hub model. I think until we address the human resource issue and the efficiency of the system, we're going to be struggling.