February 7, 2008	PDF format : 22 Kb

Nurses throughout the health care system are plagued by the same woeful deficiencies in services for the mentally ill that were documented this week in a report by the Vancouver Police Department. 

For community-based nurses there aren't enough resources to help their clients, and hospital nurses are overwhelmed by increasing numbers of mentally-ill patients showing up in the ER with little prospect they'll receive the care they need. The problem is compounded when so many mentally ill individuals are also addicted to drugs.

"Most of the problems stem from the ill-conceived downsizing of Riverview Hospital without a coherent plan for replacing those beds with community-based facilities," says Margaret Dhillon, executive councillor for the BC Nurses' Union. "The result has been a huge workload burden for nurses and the overcrowding of emergency wards and in-patient units that is undermining the quality of care available for all British Columbians."

"The caseloads of community mental health nurses have increased dramatically because the severity of illness and addiction has increased without additional staff hired to carry the load," says Sherry Moller, president of the Union of Psychiatric Nurses. "Our nurses are dealing with people and their families in crisis all the time without having any effective place to send them. So many people are falling through the cracks and it's tragic."

Dhillon and Moller welcome the commitment from Health Minister George Abbott that the government will ensure that a new psychiatric facility will be opened in the next few months for patients needing medium and long term care. Just as critical would be the establishment of many more supportive housing facilities and community health centres, adequately staffed by mental health professionals, and developed in conjunction with the communities involved.

They say that without such facilities, emergency room nurses and doctors are on the front lines with police in dealing with mental health patients in crisis. Before mental health patients can be transferred to a psychiatric unit, emergency room staff must stabilize them, often through sedation. More often than not they're placed in a bed in a hallway. In some cases hospital decongestion rules require ER nurses to transfer mental health patients onto regular medical units where they can mingle with the regular patient population.

In any event, hospital psychiatric wards are designed only for short-term stays, making the provision of community-based facilities and services all the more critical.