$10M inpatient mental-health facility in Dartmouth sits half empty

When Simpson Landing was officially opened in Dartmouth, N.S., in the summer of 2012, then-NDP health minister Dave Wilson said it would "make life better for Nova Scotians living with a mental illness."

But just five years later, the $10 million facility on the Nova Scotia Hospital grounds sits half empty and 20 of its 40 inpatient rooms are gathering dust.

The space simply isn't needed because many patients are getting the care and support they require in the community, according to Dr. Scott Theriault, clinical director of mental health and addictions programs for the central zone of the Nova Scotia Health Authority.

In fact, Theriault said that mental health support is preferable to the kind of inpatient care Simpson Landing was conceived to deliver and was built for.

"A lot of those supports can be delivered in the community so, all things being equal, the patient's better served by being in the community than being out of the community," Theriault said.

Over budget

Simpson Landing was designed to help inpatients transition to the community and is made up of four bungalows with residential-style units and living spaces. It was originally expected to cost $6.7 million, but went over budget and ended up costing $10.3 million. 

So why did the Department of Health spend so much on a facility double the size needed?

According to Theriault, patients needed to be moved out of antiquated and inappropriate existing facilities.

"At the time there was a need to move the patients from the facility that they were in to a new facility so that we could empty the units that were no longer suitable."

And he said officials also figured Simpson Landing would house mainly patients who needed close supervision, rather than those who could learn to get by on their own, given proper help and therapy.

"I think at the time we overestimated one end of that continuum versus the other," said Theriault.

He said people also moved through the facility more quickly than anticipated and transitioned to the community.

Figures supplied by the Nova Scotia Health Authority show the occupancy rate at Simpson Landing was as high as 93 per cent in December 2012 but had dropped to 52.3 per cent by January 2015.

The health authority officially and quietly mothballed half the beds at the facility in September 2015, according to the statistics. Theriault said it made sense to scale back when those rates fell.

Friction over half-empty space

But operating a half-empty facility is creating friction. 

"It has been a source of ever-growing frustration for those in the mental-health system who cannot understand why they are not being used to house patients they were built to house, particularly with the increase in code census calls and the ridiculous state of the mental-health system in NSHA," one health worker said in an email to CBC News.

Code census happens when an emergency department is so overcrowded it is deemed unsafe. Staff in other departments then have 30 minutes to prepare to accept more patients in order to free up beds in emergency.

Different plans, options

The health authority said it was looking at other uses for the vacant part of Simpson Landing, but refused to discuss any or talk about a timeline.

"We're looking at, sort of, different plans, and different options that might be available to use this resource going forward," said Theriault. "Nothing is confirmed yet."

He said he didn't think it was "a waste of money" but it may be a "better fit" for some other service.

"I think what we will do is we'll probably look at what other kind of options are available to use this space, whether we use it on an inpatient basis or whether perhaps we use it on a day basis so that it could be day programming, something like that." 

Starr Dobson, president and CEO of the Mental Health Foundation of Nova Scotia, was unaware half of Simpson Landing had been closed.

"I have been made aware NSHA is looking at other options. I'm OK with that as long as it reflects the current needs," she said in an email reply to CBC News.