Unit 9 psychiatric ward full of patients awaiting nursing home beds

When the pandemic hit the province back in the spring, the Unit 9 psychiatric ward at the Queen Elizabeth Hospital in Charlottetown was emptied of patients to clear the way for potential COVID cases. A few Unit 9 patients were moved to Hillsborough Psychiatric Hospital but most were cleared to return home.

The rush of COVID-19 hospitalizations never happened. 

And instead of returning mental health patients to Unit 9, patients waiting for a spot in a nursing home were moved into that unit — and they're still there.

"I'm profoundly concerned. And in fact, all the psychiatry group together has been quite urgently advocating for a reopening of psychiatric beds on Unit 9," said Dr. Heather Keizer, chief of mental health and addictions on P.E.I.

Health and Wellness Minister James Aylward told CBC News that will happen.

"We do need to go back to reintroducing it as a psychiatric unit," he said. "Right now we're targeting for the end of October."

There are 20 beds in Unit 9 — 17 of them are currently being used by patients with dementia, said Aylward.

While health officials are in the process of locating spots in long-term care facilities, it will take time, said Aylward. He said the patients were transferred to Unit 9 from other units in the hospital as the ward is locked so patients can't wander, and there's less stimulation than other units. "It's a very quiet, serene environment," he said.

'We need those beds'

Keizer said the patients there now don't require a hospital level of care, but do "deserve appropriate and compassionate placement. And that's not simple. That's actually quite challenging."

However, she added, "We need those beds." 

Psychiatric patients show up who do need specialized in-patient care, she said, as they may be violent or showing extreme distress.

"They do need access to that specialized unit with specialized psychiatric support. We can contain them for some time in the emergency room. But then if they're in the emergency room, then the emergency beds are not available for medical patients. And so that has a bit of a domino effect. And that's the distressing piece here," said Keizer.

There are alternatives to being admitted to hospital, said Aylward.

There are mental health walk-in clinics in Montague, Charlottetown, Summerside and O'Leary.

Also, early in the pandemic — in April — psychiatric urgent care clinics (PUCCs) were set up at Hillsborough Hospital and Prince County Hospital.  A team of psychologists, crisis nurses, social workers, addictions workers were made available, with psychiatrists available on-call, via tele-health.

The PUCCs are open in the daytimes, until 7 p.m.

Keizer said anyone at serious risk to themselves or others would be admitted.

'People are just desperate'

Mental health and addictions advocate Ellen Taylor said she's heard from people who didn't know the PUCCs existed.

"They're going to emerg and waiting for a long period of time … and there's no beds. So they're having to deal with whatever they're dealing with at home. And a lot of the families are in crisis with emotional and financial stuff already," said Taylor. "People are just desperate and it's really sad."

To be turned away when someone reaches out for help can be devastating, she said.

There needs to be someone to listen to them and offer help, whether it's a psychiatrist, a doctor or a counsellor, to "figure out what path they need to take," said Taylor.

'We don't matter'

Another mental health advocate questions why the province chose to clear the mental health patients out of the hospital. "Of all the departments in the hospital when they're looking for, you know, what can move out, it was mental health care," said Sarah Stewart-Clark.

"That message alone was that we are, you know, the least important department in the hospital. We don't matter." 

"It pushed out those valuable beds," she said. "We need those for patients who are seeking health care for their mental health."

While the demand for psychiatric admissions was reduced during the summer, Keizer expects the need to rise this fall and peak over the winter.

"Certainly the stresses have gone up," said Keizer. "As we move then into the winter months, we are impacted by people maybe who have had struggles with regard to housing and finances," a situation she expects to be worse this year because of COVID.

Compounding the situation is "a significant rise in addictions" and a combination of serious substance abuse, along with psychiatric illness. "That's quite challenging," said Keizer.

Help line information:

Anyone needing emotional support, crisis intervention or help with problem solving in P.E.I. can contact The Island Helpline at 1-800-218-2885, 24 hours a day, 7 days a week.

For more information about mental health services on P.E.I., find resources from Health PEI here, or from the Canadian Mental Health Association P.E.I. Division here.

Islanders can also call the main toll-free COVID information line to find out how to get support and help if they're struggling with stress, anxiety or depression: 1-833-533-9333.

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