$10M mental-health reno for hospital

By 2019, psychiatric patients at the Queensway Carleton Hospital shouldn’t feel as though they’re locked away in a sanitarium, hoping for passes to visit the Tim Hortons so they can be in a nicer place than the one where they’re supposed to be getting better.

The hospital is planning a $10-million renovation to its 24-bed mental-health unit, which is in space built in the 1970s for non-psychiatric patients. It’s dingy, shabby and grim.

“The space is too small, it’s too congested, there’s no privacy, it’s difficult to find space for therapeutic interactions with patients,” said Dr. Fergus McNestry, a gentle white-haired Irishman who’s one of six full-time staff psychiatrists at the southwestern Ottawa hospital. “It’s very difficult for patients to manage being in a confined space with other people who have mental-health challenges. It can create a toxic environment that is counter-therapeutic and exactly the opposite of what we want to achieve.”

By all the standard measures, the Queensway Carleton’s mental-health unit does a good job treating its patients, McNestry said, but they hear over and over in followup surveys that the unit’s a miserable place to spend time.

Work on a massive improvement is to begin next year and be done in 2019. Friday, the Ontario government promised to cover $9 million of the bill (the amounts are approximate — the hospital will seek bids on the work when it’s ready to). The result should be two renovated floors and a 7,000-square-foot addition, with more outside light and space.

The upgraded unit will have more space to treat outpatients but McNestry said they’re hoping to add just four more beds.

A nicer environment should speed recovery for people whose mental illnesses are severe enough that they need to be hospitalized. “The more efficient and effective we are, the fewer beds we need. It’s not all about bed numbers,” McNestry said.

Dealing with rising demand for mental-health treatment is straining hospitals across Ontario, especially all-purpose “community hospitals” like the Queensway Carleton. Specialty psychiatric hospitals like the Royal Ottawa have seen their funding nibbled away by inflation and smaller hospitals have tried to pick up the slack.

Even so, as long as they’re basically functional, many people try to gut out disorders like anxiety and depression — or, worse, selfmedicate with drugs or alcohol — then end up in an emergency room in complete crisis.

Now that publicity campaigns are breaking down the barrier of shame that’s kept people from asking for help earlier, they’re seeking treatment. Family doctors can help with simpler cases, but patients with more serious problems find there’s nowhere ready to treat them.

The Queensway Carleton is adding two or three psychiatrists by the end of summer, he said, and there’s enough work for that many again. It’ll definitely take more staff to run the expanded unit. Bed numbers and staff do matter and nobody knows for sure how many the Queensway Carleton or other hospitals need.

“That’s a moving target. With all of these anti-stigma campaigns and everything else, and bearing in mind that people suffering from major depressive illnesses, currently maybe 40 per cent come forward — the more the stigma around mental health is broken down, the more people come forward. So the actual end point in terms of what this community actually needs is not clear,” McNestry said.

Bob Chiarelli, the infrastructure minister and MPP for Ottawa West-Nepean, promised the provincial money and got given one of the hospital’s “Champion of Care” awards for staff who’ve earned kudos from patients.

Chiarelli’s son Christopher was diagnosed with schizophrenia as a young man, something Chiarelli said he brings up sometimes as he travels around the province.

“It opens the floodgates,” he said.

“As soon as I mention that, almost automatically — ‘My brother has bi-polar, my aunt, somebody else, has schizophrenia.’ They all have experience of mental illness.” Hospitals like the Queensway Carleton are crucial in meeting the need for care, he said.

The hospital still has to raise money for the expansion through donations and won’t know precisely what it can build for a while yet.