Free Press sources say staff at Winnipeg's mental health center are overwhelmed by chronic staffing shortages and the number of patients in serious crisis and are calling for more resources and safety.
Staff at the Health Sciences Center's 24-hour crisis center have been concerned for their safety and that of patients for years, but Shared Health hasn't done enough, officials said. .
“We want to help the patient, but we don't even think it's safe for the patient to be there,” one medical worker said. “We are understaffed almost every day, and the urgency (of patients in crisis) is higher than ever.”
“We want to help our patients, but we don't even think it's safe for them to be there.” – Staff, Shared Health
Staff and security guards have been attacked and threatened by some patients.
The official said long wait times and many clients have been “grounded” at the city center facility, which is not a safe facility and does not provide involuntary psychiatric evaluations. There are also not enough locked rooms or isolation rooms for waiting patients.
If a patient leaves voluntarily, staff are instructed to call 911 and not physically stop them.
In 2021, Trevor Farley, then 37, allegedly murdered his parents and stabbed nursing supervisor Candice Szkwarek at Stephen Oaks General Hospital after leaving the crisis center despite being incarcerated. The court heard the case.
After Farley was found not criminally responsible in October, Szkwarek said further steps needed to be taken to prevent people deemed a danger to themselves or others from leaving the center. Stated.
Mike Diehl / Free Press Mental Health Crisis Response Center located at 817 Bannatyne Avenue.
Other concerns were raised after an at-risk youth self-harmed inside the facility on May 11. Officials told the Free Press that the man died the next day after inflicting self-harm in the hospital ward while recovering from surgery.
The man's death is considered a serious incident and will be subject to an internal investigation.
The official said concerns about resources and safety have been raised repeatedly regarding shared health. They believe bureaucracy and budgets stand in the way of change.
Staff say they are burnt out, frustrated and morale is low.
The facility, located on HSC's campus, opened in 2013 as a central access point for adults in crisis. Patients cannot be hospitalized, but may be detained while awaiting transfer to a psychiatric facility.
Officials say the facility doesn't meet today's needs due to an increase in the number of people seeking help, a high level of urgency, a lack of staff, and only one locked room that must be supervised when occupied. That's what it means.
“(Some patients) wait for days before being taken to the hospital,” the official said. “The center no longer has the resources to operate and has almost become an emergency center.”
“(Some patients) wait days to be taken to the hospital. The center has almost become an emergency center because it no longer has the resources to operate.” – Source
They added that they cannot refuse people who seek help.
Standard operating procedures state that the center must register a maximum of two clients at a time on Form 4 (Application for Involuntary Psychiatric Evaluation), but not more than three clients. Officials said it is common for there to be.
Officials say the center is understaffed at night, and psychiatrists are not available 24 hours a day, 365 days a year. They added that despite requests for at least two security guards, there is usually one security guard present at all times.
“When a client comes in, part of the screening question is whether they have thoughts of killing someone, and many say yes,” the source said. “It's very scary.”
Mandatory overtime is another concern.
“When a client comes in, part of the screening question is whether they are thinking of killing someone, and many will say yes.It’s so scary” – Source
“It's difficult to maintain vigilance at the 15th or 16th hour,” the official said.
Dr. James Bolton, medical director of crisis services and emergency psychiatry at HSC, said Shared Health is working with staff to “develop processes to safely deliver crisis services.”
“We are also reviewing staffing levels for each shift,” he said in a statement.
Bolton said other measures include “improving” the standards and procedures by which emergency medical staff determine the best place for care and “streamlining” the notification process when an involuntary patient leaves without permission. Said to be included.
In 2019, a nursing student was sexually assaulted by a patient. Bolton said the review resulted in changes to the building's layout, including a new security desk in the waiting room and new windows and security cameras in patient rooms.
The center has eight evaluation rooms in total.
Health Minister Asagwala Uzoma said frontline staff want to do the best for patients.
“Listening to people and reporting serious incidents will be key to learning how to increase safety and improve care at CRCs,” the minister said in a statement.
In fiscal year 2022-23, crisis response centers and crisis stabilization units cared for approximately 13,800 people.
Mike Deal/Free Press File Health Minister Uzoma Asakawa said frontline staff want to do their best for patients.
Jason Linklater, president of the Manitoba Health Care Professionals Association, said clinician staffing levels have stagnated since the center opened.
“Despite the large number of people seeking help, and despite the growing severity and severity of mental health issues, shared health is not providing additional resources. Part of the reason is that “While this is certainly driven by the methamphetamine crisis, this is a trend that has been growing for years,” he said in a statement.
In some cases, all 15 patients are being treated, with up to 10 more awaiting evaluation, Linklater said.
Marion Cooper, CEO of the Canadian Mental Health Association in Manitoba, said the center was designed to be community-based.
“It's actually evolved into more of a mental health ER environment. It wasn't designed to be the only resource, but it has become the only resource,” she said. Ta.
Existing services are limited, so people are often told to go to crisis centres, Cooper said, noting Manitoba also lacks psychiatric beds.
“All of these situations speak to the need for a complete overhaul of the crisis management system,” she says.
Cooper said the creation of community-based mobile services could help provide early intervention and relieve pressure on crisis centers that are struggling to recruit and retain staff.
CUPE Local 204, which represents medical support workers, has expressed concerns about staffing levels and safety on the HSC campus, said Chancellor Margaret Schroeder.
The Manitoba Nurses Union also called for improvements.
“We know from numerous reports from nurses that mental health and addiction issues are increasing the burden on our strained health care system,” President Darlene Jackson said in a statement. “We also know that current safety and security issues in all healthcare facilities are significant for patients and staff.
“Wherever and whenever resources are inadequate, patients, staff and the public face greater risks and worse overall health outcomes.”
chris.kitching@freepress.mb.ca
chris kitchen
reporter
As a general assignment reporter, Chris covers a little bit of everything for the Free Press.
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