CALEB NICKERSON
PONTIAC Jan. 27, 2021
When someone has a physical injury, there’s usually a straightforward way for them to get help. Slap on a bandage, call up their doctor or in the most pressing circumstances, head for the emergency room.
However, when it comes to mental health, adequate services can be harder to come by, as one local patient recently discovered.
Due to the sensitive nature of their case, the patient will be referred to by the pseudonym Kelly.
Kelly had been going through a bit of a rough patch, after losing two close family members in the span of about six months. Her depression escalated into suicidal thoughts over the holidays and her physician decided it was in her best interest to . . .
be hospitalized in early January.
“I’ll tell you, it’s a broken heart is what it is,” Kelly said in an interview with THE EQUITY just over a week after she had been admitted. “I had to take two people off of life support and that’s not fair.”
When she first arrived, Kelly was seen by an intake worker, who gave her a number to call for an appointment with a mental health worker once she was released from hospital. Another option was to be seen later that week in Fort Coulonge.
Kelly said that it wasn’t clear how she was supposed to get there, since she had been admitted to the hospital for her own safety.
“I figured if they had seen me in here they would have came here, not make me go up there,” she said.
After Kelly’s physician and a former colleague complained about her situation to the hospital managers, a mental health worker began seeing her at the hospital, more than a week after she was first admitted.
In the meantime, she said it was difficult having to tell her story over and over again to the nurses on duty, who were tasked with helping her but only had a brief period of time to spend with her during their rounds.
“Every day I get a different nurse, so how’s she going to help me? I’m lying here crying in my bed and she says ‘What’s the matter’ and I’m going to have to explain it all again,” she said. “That’s not helping me, it’s making me more stressed, because I have to relive why I’m in here.”
A former health care worker herself, Kelly was sympathetic to the fact that the nurses on the ward could only do so much.
“The nurses, they do support you but they don’t have the tools and they don’t have the time,” she said.
Dr. John Wooton, the chief of general medicine at the Pontiac Community Hospital (PCH) and the head of the Pontiac Family Medicine Group (GMF), said that those who are admitted for mental health issues can be treated by a variety of specialized workers depending on the circumstances.
“The services they get depend on the resources available,” he said. “For example, they can be seen by a psychiatrist, a specialist, once a week in the Pontiac … Otherwise they’re looked after by the physician that admitted them. There’s a mental health team, so there are mental health workers who are social workers and … addictions councillors … a number of different councillors that look after patients in the community and may visit them in hospital if they’re known or they follow up with them in the community after they’re discharged.”
The psychiatrist that visits once a week can assess the patient, change medications and consult with the primary physician on the course of care. Wooton said that the mental health team mainly operates out of the region’s clinics.
“The mental health team is part of the CLSC, they visit the hospital but they aren’t permanently there,” he added. “They’re a community service that spills over into the hospital, as opposed to a hospital service that spills over into the community.”
THE EQUITY spoke with two sources at PCH with knowledge of the situation (known from here on as Source one and Source two), both of whom requested anonymity as they feared repercussions from the CISSSO for speaking with the media.
Source one was frustrated with the disconnect between the outpatient services and those offered in the hospital.
“We know what’s wrong with [Kelly], we know what the treatment is, it’s just that she’s not getting the treatment,” Source one said. “You can order a treatment for the patient in the hospital if you’re a doctor, but the patient won’t get it until they leave the hospital, it’s just so paradoxical.”
Source two explained that there can be a bit of a gap between the initial assessment of a patient and the follow up care.
“Whenever somebody’s admitted, every day there is a mental health consultant that either calls the floor or comes in person to see if there’s any new referrals, any new patients,” they said. “She does a first evaluation with that patient and then she sends a request to the city and then they appoint that patient a mental health consultant … The problem is is that the doctors, and I don’t blame them, would like these mental health patients to have somebody every day, to go and talk to them and evaluate them and you know, do therapy with them. It’s not offered.”
Short-staffing affects all aspects of health care in the region and mental health professionals are stretched thin across the territory, Source two said. They also noted that the hospital typically doesn’t deal with a large amount of mental health patients annually.
“We can go months where we don’t have any mental health patients. It just comes in spurts,” they said.
“The winter mostly. You’ll see it in November, December. That’s our months that are pretty much when we get them. I believe it’s going to get a little worse because of the COVID, it does affect the mental health patients a lot.”
Source two added that they have been told that the mental health care workers at the CLSCs have plenty on their plates already.
“I know that they don’t have … enough mental health councillors to go around, but it’s the same [as if] … you have a patient that’s admitted for physical health problem but they won’t see a doctor until they’re out. It doesn’t make any sense either,” they said.
Wooton said that from a historical standpoint, the level of mental health services has stayed relatively the same over time, but noted that the psychiatrist for the hospital isn’t typically replaced when he goes on leave.
“It’s probably increased in the sense that the CLSC has mental health staff but the GMF also has a social worker that manages some mental health cases. It’s a shared resource,” he said. “We have for many years had a psychiatrist who comes up once a week. That hasn’t changed, in the past there have been some problems getting that psychiatrist replaced if he was away, and that is still pretty much the case. When he’s on holiday, we’re short-staffed. But things have been pretty similar for the last number of years.”
When THE EQUITY last caught up with Kelly, she was home after nearly three weeks in PCH and was receiving two appointments with a mental health worker per week, one by phone and one in person.
She said that despite her experience in the hospital, she was in a much more positive state and was determined to use the tools that she had discussed with her assigned worker.
“She gave me the tools that I need, and I started going over them yesterday and I was like, woah. I highlighted a whole lot of things,” she said. “We’re going to work on this in steps. We’re going to go through the book together … At least we’ve got the ball rolling a little bit.”
If you or someone you know is struggling, dialing 811 option two in Quebec will connect you with a qualified social worker to speak with who can direct you to resources in your area. For those in crisis, Quebec’s suicide hotline, 1-866-APPELLE (1-866-277-3553), is available 24/7.
