Psychiatric in- patient beds are important for many reasons

Re: “No sense in cutting psychiatric beds” ( Letters to the Editor, Feb. 14)

I was moved by Stacey Clarke’s recent letter in the Montreal Gazette in which she recounted her experience trying to be treated for bipolar disorder. As a psychiatrist with over 20 years’ experience working on an in- patient ward, I can understand her anger at the recent report that psychiatric beds will be slashed ( Montreal Gazette, Feb. 4). In- patient beds for psychiatric patients can serve many purposes. If the number of beds is reduced, only the sickest of the sick will be admitted, and then only for the shortest time possible. For some patients, a quick return to family, to their community and to work is desirable. Newer medications can make that possible, and, in an ideal world, outpatient treatment can continue to facilitate the healing process. Other mentally ill patients require time to allow medication and therapy to restore a modicum of stability.

An in- patient unit can offer more than just a venue for acute treatment. It offers an opportunity for a multidisciplinary staff to fully evaluate the patient and to provide a variety of treatment approaches. The ward milieu itself can offer a healing environment, especially if the staff is not under enormous pressure to discharge patients quickly to free up beds in order to admit sicker patients from the emergency ward. This pressure can lead to more requests for court- ordered treatment and to medication decisions aimed at rapid suppression of symptoms; these meds are not always easy for patients to tolerate.

Yes, day treatment programs exist, but for many patients and their families, healing requires an opportunity to be apart from the stresses that often contribute to the admission in the first place. Families often carry the burden of caring for patients who have been discharged before adequate control of psychiatric symptoms has been achieved.

I have been impressed by the dedication, patience and professionalism of the staff on the in- patient wards where I have worked. I’m worried that further cuts in the number of in- patient beds will erode the morale of staff and make it more difficult for the resources of an in- patient setting to provide a healing environment. Instead of a haven, the hospital will become another place where vulnerable people will feel unwelcome.

I’m glad Clarke finally received the in- patient treatment that she required, but her journey in the system subjected her and her family to unnecessary danger and trauma. Gerald Wiviott, Montreal