Challenges facing child psychiatry in Quebec at the dawn of the 21st century

Abstract

Objectives: This study aimed to identify hospital resources by region, determine human resources by type of service and region, and describe how services generally operate in child psychiatry within the province of Quebec. Methods: Data collection took place from May to October 2001. We sent a semistructured questionnaire to all child psychiatry service heads. We collected human resource data and produced organizational charts based on the responses obtained. These charts were forwarded to each of the participating services for validation. We grouped Quebec's 18 social health regions into 3 categories: central (4 regions with 606 370 youths), adjoining (4 regions with 589 750 youths), and peripheral (10 regions with 368 635 youths). Results: The response rate was 100%. We identified 35 child psychiatry services: 13 in the central regions, 9 in the adjoining regions, and 13 in the peripheral regions. Overall, we identified 177 short-stay beds, 476 places in day or evening hospitals, and 113 places in day or evening centres. Most of these resources were located in the central regions. Quebec had 138.2 full-time equivalent (FTE) child psychiatrists (69.8% in the central regions) and 706 FTE professionals. At March 31, 2001, 4285 youths were waiting for services. Conclusions: We observed a shortage of child psychiatrists and professionals, regardless of the norm used. Adjoining and peripheral regions should have access to a minimal range of human and hospital resources in child psychiatry.