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Mental health counsellor denied essential worker status, accommodations

For the past 10 years, Raymond Pidzamecky, a social worker and mental health counsellor, has been travelling to various communities across the territories to provide support under Health Canada’s Indian Residential School, MMIWG and Day School programs. 

Typically, Pidzamecky spends three-and-a-half weeks assisting clients in Fort Simpson, Norman Wells, Yellowknife, Inuvik and elsewhere. He then flies back to his hometown in Northern Ontario for one week before returning to the North.  

Raymond Pidzamecky, a contractor with Health Canada, has been providing in-person mental health counselling appointments for four months with proper public health measures in place. He will now have to complete a 14-day isolation period before counselling clients. He worries the changes may incite relapse.
photo courtesy of Raymond Pidzamecky.

In March, Pidzamecky was directed to leave the NWT as the pandemic lockdown was coming into effect. In August, he was again permitted to return to the North to provide counselling services face-to-face.

As social workers are considered an essential service, Pidzamecky was able to offer in-person appointments for his clients, as long as proper face coverings were worn and proper distancing measures followed.

On Nov. 20, Pidzamecky was notified he would no longer be permitted to work with clients in the first 14 days of his arrival in the territory. 

As locum doctors and nurses continue to cross borders and immediately perform their duties as essential workers, Pidzamecky is asking why mental health workers are not granted the same concessions. 

Without mental health services, he fears clients “are at risk for feeling alone or abandoned,” and “might relapse.” 

“It doesn't look like they are acknowledging or appreciating our value, that we're just as important to the welfare of NWT citizens as doctors and nurses,” he said.

With Covid-19 cases rising steadily in the south, Health Minister Julie Green said the chief public health officer (CPHO) “has a lower tolerance for risk.”

While the government is prepared to grant exemptions for essential service workers, including social workers and mental health counsellors, Green said “there is a concern with counsellors coming in from high-risk areas and requesting to go directly to smaller communities, and then engaging in in-person counselling with vulnerable populations.” 

Permissions for work exemptions are decided using a risk assessment tool, which looks at where the individual is coming from, which communities they are going to, the population they are working with, the nature of the work, the delivery of service and any risk mitigation measures that can be applied. 

“It would be preferable if people from high-incidence zones could provide virtual care, or conduct in-person counselling after completing their self-isolation,” Green said. “Our first response is to look for ways to (provide care) remotely, but if they must be face-to-face, we have to protect communities.”

Pidzamecky appealed the decision and was again denied. In order to service his clients with appointments in December, Pidzemecky, who planned to travel back to Ontario on Nov. 25, is now staying in the territory until Dec. 21 to avoid the 14-day isolation.

Health Minister Julie Green said the GNWT recognizes mental health counselling as essential services, but that public health must be a priority in decision making.
GNWT image

He said telehealth options pose a number of logistical and privacy difficulties. Clients may fear being overheard by other household members, especially if they are living with their abuser, he said by way of example.

From an administrative standpoint, Pidzamecky points to limited internet connection and high costs of cellphone minutes as other obstacles for virtual counselling. He said clients who lack printers and scanners also create challenges for getting referral documents that patients need to receive care. 

Since Pidzamecky is a contractor with Health Canada, and not an NWT employee or resident, he would have to cover the cost of his own isolation stay – about $3,000 each rotation. It becomes “kind of a tough decision,” he said.

Green said the GNWT recognizes “that mental health services are essential and important during a pandemic,” but that they “also need to make decisions based upon the risk to public health.”