By Marvin Ross
A recent article in the Toronto Star described what can only be called a complete absurdity in dealing with some patients with mental illness. At any given time, there are dozens of patients residing in the Centre for Mental Health and Addictions (CAMH) in Toronto who do not need to be there. Even though they are stabilized, they need supportive housing and, in some cases, 24 hour a day supports.
There is nowhere to send them so hospital staff, showing some humanity, keep them in hospital.
These poor souls can be there for months and, in some cases, for years. At one point, there were 100 such patients but the current number is 59. Those are beds that are not available for acute treatment of patients who must wait even longer for the hospital care they need.
In some cases, the hospital declares vulnerable patients to be involuntary to keep them in hospital longer and safe. Their efforts to stabilize and improve a patient’s condition would be wiped out if the patient was discharged back to a homeless shelter or to living on the street. Most would end up back in an ER with any improvements nullified or, worse, in jail.
Humanity and compassion aside, there are the cost factors. One day in an acute care hospital costs the taxpayers $1000 although CAMH estimates the cost for this group to be about $11,000 a month. Supportive housing would cost on average about $2000. Bean counters should be able to understand that building supportive housing is much cheaper and allows hospitals to treat more acute care patients.
Sadly, our politicians don’t get it.
Chicago Med is one of my favourite TV shows for its depiction of psychiatry and serious mental illness. Oliver Platt has a continuing role as a psychiatrist in the ER and the March 1 episode had him convincing a family to allow their schizoaffective son to try ECT. The young man was on anti-psychotics but his symptoms had broken through and he refused to continue taking them.
Platt and his resident considered how to best help him and Platt thought that ECT might work. His explanation about ECT included telling the family that the delivery had improved considerably from the early days and that they should not be swayed by all the negative stereotypes portrayed in the media.
Viewers then got to watch the preparation and the actual simulated procedure. As this is a 60 minute TV episode, the young man got an immediate positive effect when it would probably take about 5 or so sessions but it was refreshing to see an honest depiction of a controversial therapy.
It also reminded me of the case of a young woman I met years ago when my son was in hospital. The woman had schizophrenia and had attempted suicide which led to her hospitalization. When I met her, she was undergoing ECT. Weeks later, I was in line to get a coffee in the hospital coffee shop when an attractive, well dressed young woman said hello. She realized that I was having trouble figuring out who she was and told me her name and said this is the new me after ECT.
She was a totally different person.