Hos­pi­tal aims for rooms that are safe

West 5th psy­chi­atric fa­cil­ity de­signed to re­duce sui­cide risk

The Hamilton Spectator - - FRONT PAGE - SU­SAN CLAIRMONT

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

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