Say what? Mental health patients to be moved to acute care beds?

Historic Building No. 1 at Alberta Hospital Edmonton.
Below, the hospital’s entrance; its landmark water tower; Building No. 12; the Rose Sinclair Pavilion (Building No. 5); and Building No. 9.

Was it just me, or did I hear a report not so long ago that Alberta has too many patients who don’t require acute care taking up space in our hospitals’ acute care beds?

Isn’t this supposed to be why we have a “crisis,” in health care funding, part of why our health costs are “out of control”?

The argument that inappropriate patients must be moved out of acute care beds has most certainly been used to justify the creation of privately run assisted living facilities and the like. After all, we’re told, they’re a great way to make sure acute care hospital beds are used efficiently for what they were intended to do.

What’s more, moving continuing-care patients out of scarce acute care beds means acute care patients who have been hanging around hospital emergency wards can be moved into them, reducing those scandalously long waiting times in Emergency…

I mention all this because of a seemingly unrelated announcement. Did you notice on Friday how Alberta Health Services quietly published a little news release saying that it is “continuing the evolution of community-based mental health treatment in the province, and is accelerating its move away from a largely institution-based system”?

“Uh-oh,” I thought when I heard this. In most places, “community based mental health treatment” is a euphemism for turning the mentally ill into the streets and forgetting about them. The trouble with the mentally ill, of course, is that they mostly don’t vote, and those that don’t have families to support them are mostly poor as well, so it’s extremely hard to get politicians, especially Conservative ones who don’t have to use public transit, to give a hoot about them. The people the mentally ill bother, of course, are mostly poor too.

However, that’s not the case here in Alberta, the news release assured us. AHS had to base mental health services in the community, see, because they’ve decided “not to proceed with the redevelopment of the Alberta Hospital Edmonton (AHE) site.”

If this sounds to you like a bank telling its poor and elderly customers that they’re closing their local branch “to serve you better,” well, I’m sure nothing could be further from the truth. …

Anyway, a “patient family handout” linked to the release helps us answer this question: “If AHE closes, where will its patients be put?”

This is something you might wonder if you were a mental health patient – or the parent, spouse or child of one – contemplating the meaning of Friday’s announcement. In fact, you might ask the same question if you’re just a citizen with no involvement with mental illness at all, other than needing a strategy for getting to and from work through the increasingly dangerous streets of Edmonton or Calgary.

The answer in the handout was not particularly reassuring. “Care for the mentally ill has evolved significantly since the early 1900s when mental hospitals were the major site of treatment and care for the mentally ill,” the handout explains, conjuring up horror-movie images of gothic institutions for the criminally insane. (To the author’s credit, he or she resisted the temptation to note that AHE, founded in 1923, was then known as the Institute for the Feeble Minded.)

“Therapeutic advances in the form of medications and treatment philosophies have allowed us to do a better job of providing care and support in the community,” it adds. I am sure there is some truth to this – but, as noted above, many of us can be forgiven if we suspect that most North American jurisdictions, infected by the virus of neocon voodoo economics, have used these alleged advances in treatment as an excuse to save money by turning the mentally ill into the streets.

AHS vows that this is not so: “I can tell you categorically that none of these patients is going to end up on the streets,” asserted Dr. Patrick White, mental health services director of the province-wide health “superboard,” according to a story in yesterday’s Edmonton Journal.

So where are they going to go? Well, the AHS news release says this: “Patients with mental illness will be transitioned from Alberta Hospital Edmonton to capacity in the community or acute care hospitals depending on need.” (Emphasis added.)

So there you have it. Capacity in the community – whatever that means – or acute care facilities.

Of course, in a year or two, we’ll be told that the mentally ill will have to clear out of those acute care beds to make way for acute care patients.

Then they’ll end up on the streets!

“Alberta Health Services is working hard to ensure we are providing the right care in the right place,” the handout says.

I guess we’ll see about that. Some of us may even have the opportunity to experience it first hand, one way or another.

One Comment on "Say what? Mental health patients to be moved to acute care beds?"

  1. Anonymous says:

    Well that’s great news, deinstitutionalize, and throw very needy people back into the community and now we have a guarantee that these people will not end up on the streets? From another perspective we are going to move them from a safe institution, into small basement suites, with a door to the back alley, a fire alarm that’s not working, and far distances from any kind of major programming promoting increased isolation. On the matter of accountability could we throw someone in AHS in jail once this gets disproven? I’ve met patients from Alberta Hospital before and they have huge needs.
    I am not one for promoting institutions over community settings, but how is the public going to know if this move is good idea for all when this decision has in genesis in saving money?

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