Psychiatrists slam move to shut down mental health unit

A group of psychiatrists at Alberta Hospital Edmonton is fuming over a “recklessly misguided decision” to shut down a 20-bed unit that caters to mental health patients getting ready to move back into the community.

While Alberta Health Services said the move will help fund 37 new mental health beds of various types in Edmonton — including 15 transitional housing beds in the community — the psychiatrists say the new spaces can’t replace the care delivered in the unit.

The doctors’ concerns are contained in letters written to Health Minister Sarah Hoffman over the last month.

“We have little choice but to appeal to your office for a reversal of this decision, as there has been an erosion of trust between physicians and Alberta Health Services management,” says one of the letters dated Feb. 21.

“We remain concerned that any opinions at odds with AHS’s plans will be met with hostility and intimidation.”

The Wildrose party released the letters Tuesday, shortly after raising the issue in question period. Mental health critic Mark Smith grilled Hoffman on the “heavyhanded” decision, asking why she was ignoring the advice of frontline staff who care for the patients.

Hoffman fired back that Smith seemed to have his facts wrong, and said her government is increasing investments in mental health services.

The 20 beds in question belong to an Alternate Level of Care unit opened in late 2012 for patients who do not need to stay in an acute care (hospital) setting, but who are not yet ready to transition into independent living.

“Many of these ALC patients are chronically homeless, battling addictions along with significant mental illness, and require assistance with, for example, applying for financial supports, housing and addictions treatment programs before discharge,” says one of the psychiatrists’ letters.

Shutting down the unit will force such vulnerable patients back into acute care or hospital emergency departments, exacerbating the “revolving door” of an already backlogged mental health system, the doctors say.

Mark Snaterse, executive director of addiction and mental health for AHS, said the ward costs $2.8 million to operate each year, but has not seen the patient volume that was expected when it was opened.

As such, the decision was made to shift those resources to help fund new mental health beds, many of them at the Royal Alexandra Hospital, he said. The hospital opened a new psychiatric emergency department last month with four observation and assessment beds, and is set to open 12 adult acute mental health beds and six psychiatric intensive care beds in April.

“I’m confident that if people understand the big picture in terms of what we’re opening, that far outweighs what we need to close,” Snaterse said.

He said the 15 community-based transitional housing beds that are set to open will provide a better experience for patients now staying in what is essentially a hospital ward at Alberta Hospital Edmonton. He said the new spaces offer a more residential setting where patients can more easily resume work, school and other community activities.

In their letters, the psychiatrists say a better option than closing the unit would be to bolster services by adding social workers and independent living support staff.