Mental health patients choking emergencies

News 19 December, 2017
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    Hugo Duchaine

    Tuesday, 19 December 2017 22:35

    Tuesday, 19 December 2017 22:35

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    Cared for longer than the other and two times more often on a stretcher, the patients who present to the emergency department with mental health problems, clogs up the hospitals, reveals a report published on Tuesday.

    “It is a signal of alarm,” says the spokesperson in the health of the Parti québécois, Diane Lamarre, about the report of the commissioner of the health and well-being, Anne Robitaille.

    It reveals that during a visit to the emergency room, a patient’s mental health there will remain, on average 12.5 hours. It is 3.8 hours, more visits to the emergency for a physical health problem.

    21 hours

    The stay can last up to nearly 21 hours for severe disorders. Mental health problems include dementia, schizophrenia, anxiety and depression, or even suicide attempts, among others.

    Patients lying on a stretcher to the emergency in mental health are also approximately two times more numerous than the visits to the physical health.

    “An organization that is more or less efficient than the first line in mental health has a significant impact on the use of appropriate or non-emergency services,” writes the commissioner.

    If the first reflex of a person in distress is to go to the emergency room, it is true that front-line services, either in the community could come to their aid, ” said Ms. Lamarre.

    “We are definitely lacking in psychologists available in the first line,” continues the mp, who complained that the sick must now go through a family doctor to consult.

    Because, according to the report of the commissioner, a patient on 10 mental health is returned at least three times to the emergency in the same year.

    Worse still, ” continues Ms. Lamarre, patients are waiting eight hours to see a psychiatrist, and only 58 % of people with a serious condition are hospitalized. Therefore, almost half of which was returned to her home.

    Known issue

    “People with a serious mental health disorder are recognized by the scientific literature as causing a significant consumption of emergency services and hospitalization,” wrote by e-mail, a spokesman for the ministry of Health.

    This is why, she says, the mental health services have been subsidised to $ 26.5 million, including a $ million for crisis services, to provide care to more than 5,000 additional people.

    The government has also recently announced the creation of a public program of psychotherapy.

    By the numbers

    • 226 000 visits to mental health emergency departments in Quebec between march 2016 and march 2017.
    • This represents 6 % of all visits.
    • The litter-bound patients represent 56% of visits to the emergency in mental health. It is about two times higher than that for the visits to the physical health.
    • 9.3% of patients with a trouble light to leave the emergency room without medical care. This is the case of 4.3 % of the visits with a serious disorder.
    • The average time to obtain the consultation of a psychiatrist in the emergency is 8.2 hours.
    • Nearly one patient in ten (9 %) made at least three visits in the year.

    Visits mental health

    ♦ 37% – related disorders moderate

    ♦ 19% related to poisoning

    ♦ 31% – related disorders light

    ♦ 11% are serious disorders

    10 worst emergencies in Quebec, Tuesday (occupancy rate)

  • Hotel-Dieu de Sorel-Tracy (Montérégie) : 200%
  • Centre hospitalier Anna-Laberge (Montérégie) : 196 %
  • Hôpital du Suroît (Montérégie) : 191 %
  • Hospital of Saint-Eustache (Laurentides) : 175 %
  • Hôpital Honoré-Mercier (Montérégie) : 169 %
  • Hôpital Pierre-Boucher (Montérégie) : 157 %
  • Hospital Memphremagog (Eastern Townships) : 157 %
  • Hôpital Sainte-Croix (Mauricie and Centre-du-Québec) : 147 %
  • Hôpital Fleurimont (Estrie) : 146 %
  • Hospital and CLSC Val-d’or (Abitibi-Témiscamingue) : 145 %
  • Services too few subsidized

    The organizations that help people with mental health problems feel that they are under-funded by the government, which prevents them from well to relieve the emergency.

    “Mental health is the poor relation of the health system […] It will be necessary to make investments, because this is a nagging problem “, per ton the president of the provincial association of users committees, Pierre Blain, which is not surprising from the figures published Tuesday in the report of the commissioner.

    Photo Dominic Scali

    Pierre Blain
    Users committee

    A good not

    It welcomes, however, the program of access to psychotherapy, which he sees as a step in the right direction.

    But among the front-line services existing, there are the centres of crisis intervention. Their goal is precisely to reduce congestion in the emergency room, said the director of the Other house, one of these centers to Montreal, Isabelle Ferland.

    Last year, she came to the aid of more than 1000 patients. It laments that it lacks 200 000 $ to help more, such as providing a service both day and night, such as hospitals. His team is even in the emergencies, when they can, to give a helping hand.

    “[Crisis centers] are small organisms under-funded that are not in a position to offer the range of services they would like to “, she said.

    Not everywhere

    For her part, Hélène Fradet, director general of the Network Before cracking, which brings together 39 organizations from aid to families of people with mental illness, argues that unfortunately the centres of crisis intervention are not present in all regions.

    “We are under-funded,” she said. Its network has asked for no less than $ 7 million to the government to successfully respond to the request, and to relieve the families so that the emergency is only a last resort.

    “We need to help them from the beginning of the disease,” she advocates.