Pictou County mental health care improving, says Nova Scotia Health Authority

Care for mental health patients in Pictou County is improving, according to the senior director of mental health and addictions services for the Nova Scotia Health Authority.

Dr. Linda Courey said services could soon be better than they were before the controversial closure of an eight-bed mental health unit at the Aberdeen Hospital in New Glasgow. 

No final decision has yet been made by the province on whether the short-term stay unit at the Aberdeen will reopen, but Courey said too many people mistakenly equate good care with in-patient beds.

"Since better patient care is provided in the community, we now have an opportunity to reallocate resources that were previously directed to running that unit," said Courey. 

"Now we can use those resources to bolster a full range of outpatient and emergency services. If the decision is eventually made to keep this unit closed — that's a good thing."

The closure of the mental health in-patient unit in August was triggered by the departure of two psychiatrists and a lack of nurses. Mental health advocates criticized the decision to close.

Since then, however, Courey said the health authority has hired one crisis social worker and two nurses working out of the emergency department of the Aberdeen to assess and help with patients who arrive with an addiction or mental health issue.

Follow-up care is provided through an outpatient clinic and Courey said patients who do require admission to a mental health unit are being transferred to the nearest available hospital.

Even so, one mental health advocacy group said there are still long wait lists for follow-up appointments through Pictou County Mental Health Services.

'Not there yet'

Elaine Garland, co-facilitator with Pictou County Mental Illness Family Support Group, agrees the best care for people with mental health problems is delivered outside a hospital, but services in the area are "not there yet."

Garland said she would still like to see a handful of mental health beds restored at the Aberdeen because families are now travelling to other parts of the province to visit relatives transferred to an available spot.

"We know family support is very important in becoming well and when it is that faraway, you can't do that," she said.

"That's why we are talking about the possibility of getting housing started here, so that doesn't have to happen. After you have had some counselling and your meds are set, you could come into a home like this."

To that end, Garland said about 40 people met Tuesday evening and agreed to form Pictou County's first small group home for people with addictions or mental illness.

But even when the unit at Aberdeen was open, patients were still being transferred to other hospitals, Courey said, mostly because it refused to accept "involuntary" admissions under the Involuntary Psychiatric Treatment Act. 

Fewer people require admission

Courey said that doesn't happen anywhere else in Nova Scotia, "nor is it consistent with provincial mental health standards for in-patient units."  

She said the situation came to light during a review of mental health services in northern Nova Scotia after the unit closed. 

A total of 143 people with mental health or addiction issues went to the Aberdeen emergency department between August and December 2015, after the mental health unit closed, according to data from the health authority. Roughly the same number arrived during the same period the year before, when the unit was open.

Courey said 17 patients were transferred for admission to other hospitals during the five months since the unit closed, what she described as "a dramatic decline."

"Far fewer people do require a mental health admission when you provide adequate support to the emergency room and follow up in our outpatient or community-based clinics," said Courey. 

"That is consistent with what's best for people. Admission to in-patient mental health units is not always the best solution."