An interesting issue that rarely gets discussed is the mentally challenged population’s experience in the healthcare system. These patients continue to get care that does not meet their needs, even in a government-run system like Canada's, where one in every 11 visits to ER is for a mental-health issue. So is one in every seven hospital admissions, and, because these patients stay much longer, they account for an astounding one-third of all hospital time.
Andre Picard captures this frustration in his article for Canada's Globe and Mail from all sides of the equation, including patients, caregivers and advocates.
[Patients with mental health problems] can wait years for a bed in a long-term care facility or a spot in supportive housing, so they end up as detested “bed blockers” or sometimes on the streets. In the community, family doctors do the bulk of treatment by default, but they are rarely equipped to deal with the complexity of care required by patients with severe depression, bipolar disorder or schizophrenia. Often, they just prescribe drugs.
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“The system is in chaos,” said Donald Milliken, former president of the Canadian Psychiatric Association and a practitioner with nearly 40 years of experience. "The fundamental trouble is not necessarily a lack of money or a shortage of beds but a lack of organization."
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What many patients need is stability – a place to live, a basic income, assistance with daily activities, monitoring of their medication. When these are not available, illness can flare up and hospital visits follow.
“Hospitals are just trying to ‘deal' with this – and I use that word in its most Spartan sense,” said Pamela Fralick, executive director of the Canadian Healthcare Association. She said health-care professionals are compassionate people, but “these are cuts that can't be sutured in hospitals.” Also, while most people recover from bouts of mental illness, a minority of cases are simply intractable.
Picard exemplifies one center that has taken on the task of meeting the challenging needs of this community, the The Archie Courtnall Centre. One notably success is the increased privacy that patients experience.
The centre is a big bright place with a dozen La-Z-Boy chairs and four short-stay beds where psychotic or suicidal patients can remain until a crisis passes. “This is a safe place, where patients get treated with respect,” said Rivian Weinerman, the site chief for psychiatry.
In particular, there is more privacy than in the general ER waiting room, where a person weeping uncontrollably, muttering loudly about conspiracies, going through withdrawal, or wearing leg irons and handcuffs is bound to draw a lot of unwanted attention.
Highlighting that something as easy as providing additional privacy in the waiting room could go a long way, the question begs to be asked “In what other ways can hospitals and other centers become friendlier for mentally challenged patients?”
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