Hospital aims for rooms that are safe
West 5th psychiatric facility designed to reduce suicide risk
You won’t see a faucet. Or a shower head. Or a light bulb. Or a blind cord.
You will see shatterproof glass, built-in desks, doors that can be unlocked from both sides.
These are the grim reminders of the real threat of suicide throughout the West 5th Campus of St. Joseph’s Healthcare psychiatric hospital.
Less than four years old, the state-of-the-art facility was purpose-built with all the latest, best practices in suicide prevention in mind.
And yet last year three in-patients died by suicide within the hospital.
St. Joe’s released a report the week before last about those suicides and six others in 2016 by patients on day passes or by outpatients. The report does not include any information about how the three in-patients died or where in
the hospital they took their lives.
So, when I was given a tour of the hospital with an eye to patient safety, it was impossible to know what the already identified trouble spots are. Clearly they exist, because three people died.
“Ligature risks” are the greatest concern, says Peter Bieling, head of mental health and addiction services.
But in fairness, the lengths architects, designers and administrators have taken to make the hospital as safe as possible are vast.
I am taken to an as yet unopened unit of the hospital. (It will likely open soon as demand for beds grows, I am told.) My tour guides are Bieling, Dr. Peter Cook, who is chief of psychiatry, and Winnie Doyle, vice-president of clinical services, mental health and addiction.
Here we can examine a typical patient room without infringing on anyone’s privacy. We start in the ensuite bathroom. The door can be locked from the inside, but staff can use a key to unlock it from the outside. There is no security camera in the bathroom or the bedroom.
There is no shower head and no faucet on the sink. Water is sensor-activated and flows from holes in the wall. Temperature is controlled by buttons.
The “grab bar” by the toilet is a solid block — nothing can be looped or tied through it.
In the room itself, there are no lamps, since their cords and bulbs can be dangerous as can electrical sockets. Instead, there is a fully enclosed and tamper-proof light fixed in the ceiling. The large windows are shatter proof, with a blind encased between the two panels of glass and opened and closed with the press of a button.
The desk is fixed to the wall, and the door handles are levers which cannot bear any weight.
The space is a balance of safety considerations, infection control and livability.
“How do you create a space that people can make personal?” says Cook.
“Having personal space and having a sense of identify is critical,” adds Doyle.
The entire hospital is full of natural light from large windows. Patient rooms get the best view of the escarpment while staff offices take the less attractive angles. Hallways are wide, a gorgeous courtyard brims with gardens and the gymnasium is one of the best in the city. Units have names like Mountain, Orchard and Waterfall.
But most doors need a key pass to get through. Most walls are blank. Nearly every inch is monitored by cameras. And the lovely courtyard is surrounded by a tall mesh fence that is virtually impossible to climb.
A committee reviewing the report recommendations will consider what changes need to be made to the physical environment of the hospital in order to prevent future suicides.
For the safety of patients and the peace of mind of their families, I hope St. Joe’s makes the fine details of those changes public.
Having personal space and having a sense of identify is critical. WINNIE DOYLE VP OF CLINICAL SERVICES, MENTAL HEALTH AND ADDICTION