Up to twice as many patients as mental health beds at Jo Brant

Burlington hospital forced to use conference rooms

People with mental health issues are being cared for in conference rooms at Joseph Brant Hospital because of overcrowding so extreme that some days there are nearly twice as many patients as beds.

Mental health occupancy rates have soared as high as 188 per cent at the Burlington hospital, reveals overcrowding data obtained by The Spectator through freedom of information legislation.

It means Joseph Brant had up to 30 patients but only 16 mental health beds funded by the province.

As a result, the hospital was forced to squeeze three beds into two-person rooms, use unconventional spaces or leave patients needing specialized mental health care languishing in the emergency department.

None of these extra beds are paid for by the Ministry of Health and Long-Term Care.

“There is a gap in capacity for crisis response across the province,” said Steve Lurie, executive director at the Canadian Mental Health Association Toronto Branch.

“Overall, hospital overcrowding is a

problem. The root cause of it is that there really has been not enough investment in alternatives that would keep people out of hospital.”

Joseph Brant had more patients than mental health beds every single day from June 1 to Dec. 1, the time frame provided to The Spectator.

“These are not new issues,” said Cheryl Gustafson, director of mental health and rehabilitation services at the hospital.

Gustafson said it has been years since there were enough beds for all of the Burlington patients needing mental health care.

“It means there aren’t a lot of private spaces they have available to them to go to,” she said about the effect on patients. “The biggest impact is finding a space where they can actually have quiet time away from other folks.”

The lowest occupancy rate over the six-month period was 106 per cent but it rarely dipped that low.

Two-thirds of the time, it was between 130 per cent and 159 per cent occupancy, meaning there were typically 21 to 25 patients for the 16 beds.

Nearly one in five days, the occupancy rate was 160 per cent or more, which translates into at least 26 patients needing care.

“What you are seeing is the results of underfunding of the mental health system,” said Lurie. “Ontario spends about 6.5 per cent of its overall health budget on mental health and addictions when the Mental Health Commission (of Canada) standard is a spending level of 9 per cent.”

Over a year ago, Joseph Brant asked the province for more than $20 million to vastly expand mental health services including doubling the number of in-patient beds to 32. It still has no answer.

In the meantime, it is trying to find other ways to cope by rolling

out a number of initiatives to get patients from the emergency room into a mental health bed sooner, leave the hospital faster with support or prevent them from being admitted at all.

“We really work closely with our community to create those made-in-Burlington solutions that help people in this community get what they need, when they need it,” Gustafson said.

Hamilton has not seen overcrowding at the same level as Joseph Brant when it comes to mental health care.

Around that same time frame, St. Joseph’s Healthcare had a mental health occupancy hovering around 100 per cent. Sometimes, St. Joseph’s even had more beds than mental health patients.

One factor could be the infusion of roughly 100 additional mental health beds at the newlybuilt West 5th campus between 2014 and 2016.

In addition, Lurie says the Crisis Outreach and Support Team (COAST) in Hamilton is better resourced than many others in the province.

And mental health care leaders here pioneered a successful program that makes psychiatrists and other specialists more readily

available to family doctors.

But for many communities, the reality is closer to Burlington and Lurie says it only gets worse with the ongoing opioid crisis.

“All political parties in the current election campaign have pledged to add more money and the federal government also said it would add money over 10 years,” he said. “It’s a testament to the fact that there is finally a recognition that there aren’t enough resources on the ground to provide the needed community based mental health care.”

But the funding isn’t rolling out yet so overcrowding continues to be an issue, Lurie said.

“One would hope that three years from now, if the money that the federal government has promised and the provincial government appears to be promising hits the streets, you wouldn’t have occupancy rates in the mental health unit of 180 per cent”