Quebec and Ontario introduce new COVID mental health tests for pharmacists

Quebec’s new COVID rules took effect Jan. 1, adding a third test to the standard mix of vitals like blood pressure and pulse. Now pharmacists must ask people with COVID symptoms to complete an additional “sentinel” test of six minutes to see if they have a mental condition like anxiety, bipolar disorder or schizophrenia.

In Ontario, the health minister, Helena Jaczek, announced Tuesday that pharmacists who determine that a person needs a sentinel test can then prescribe a prescription for a medication, including NALT, Abilify and Claritin, that specifically contains naltrexone.

Those who have a psychiatrist or psychologist can have a letter from their doctor providing consent to the new tests, but Jaczek said in a news conference that pharmacists will have more power to order this test, especially for high-risk people. Currently, only limited remits can allow pharmacists to order a sentinel test for symptoms of COVID or CUBIT, based on preliminary information from their provider.

Pharmacists will be able to also order PET scans and electroencephalograms as part of their tests for COVID, Jaczek said.

The province’s Health Quality Council, which regulates pharmacists, will also be responsible for regulating sentinel tests.

Dr. Gil McGowan, president of the Ontario Medical Association, said the association would rather pharmacists had remained under the province’s regulatory umbrella. But with the new province-wide testing requirements, he thinks the information gathered can only be a positive thing.

“We already know there are lots of people with COVID and we know that many of them have psychiatric illness,” McGowan said. “So this is just another tool available to give people this information that might save their lives.”

In addition to Toronto, OMACs in London, Waterloo, and Brockville will also be tested. However, drug companies in Canada — unlike those in the U.S. — are not currently required to collect information about COVID, though McGowan said he believes that should change.

Liam Cameron, regional president for NALT, said while he is not able to specifically comment on the Ontario cases, he believes there is a need for and expectation for Ontario and surrounding areas to have some of the highest rates of schizophrenia and bipolar disorder in the world.

“Certainly, at the global level, treatment guidelines in places like California have called for a combined evaluation that would include a sentinel trial,” Cameron said. “I think that the test should be a priority here because we have a lot of people in this region with schizophrenia and that is certainly a challenging disease to treat.”

According to Statistics Canada, Ontario has the highest rate of schizophrenia in the world, with 7 percent of Canadians at risk of having the illness. The prevalence rate in the region is 10 percent.

With more than 850,000 people living with schizophrenia in Canada, Ontario and surrounding areas may have the highest rate of the disorder, Cameron said, but with the right medication, a person can live a full life.

“We know that with intervention the mental health of people with schizophrenia can be dramatically improved,” Cameron said. “So I think we’re going to be able to save lives with this test.”

You can read more on the province’s latest measures to prevent suicides here.

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