Psychiatric Intensive Care Unit (PICU)

From the March 28th edition of the Capital District Mental Health Program's Mental Health Happenings:

The Mental Health Program and the Department of Psychiatry are opening a Psychiatric Intensive Care Unit (PICU) at the East Coast Forensic Hospital (ECFH). This is for short-term stabilization of highly-agitated individuals, admitted to other mental health units with involuntary status, who are exhibiting aggressive and harmful behaviour towards others on their current unit. On April 1, 2011, the PICU will open for patients from inpatient psychiatry units in Capital Health. Referrals will be from the current attending psychiatrist to an ECFH psychiatrist.

The Psychiatric Intensive Care Unit is located in one of the Rehabilitation Units at the East Coast Forensic Hospital. The PICU has six single bedrooms, a spacious dayroom with lots of natural light, and a secure patio area. The whole of ECFH is specifically designed to create a calming atmosphere. The unit is staffed by clinicians who work effectively with a population whose specific needs include de-escalation of behaviours that pose a risk for harm to themselves and others.

The PICU will soon become a provincial resource - open to all the district health authorities across the province. Referrals will be made by a physician in the referring district, usually a psychiatrist, to a psychiatrist at the East Coast Forensic Hospital.

Please find attached the referral form and patient information handbook [actually a handbook for families]. [Links to these two documents are found below.]

If you have any questions, please contact James MacLean or Dr. Scott Theriault [460-7343; scott.theriault@cdha.nshealth.ca].

You are also welcome to call or email either of us.

Thank you.

Peter and Nick

Peter Croxall, Director
Capital Health Mental Health Program
464-4147
peter.croxall@cdha.nshealth.ca

Nick Delva, Professor and Head
Dalhousie University Department of Psychiatry
473-2464
Nicholas.Delva@cdha.nshealth.ca

PICU Handbook - March 2011

PICU Referral - March 2011


Photo credit

Freedom to be sick leaves families feeling chained

From today's edition of The Globe and Mail:

Caregivers who can't get mentally ill loved ones to seek help grapple with laws designed to protect civil rights

By André Picard

Mary Liz Greene [pictured] was in the midst of an animated conversation with her son when he suddenly lunged, grabbed her by the neck with two hands, then pushed his thumbs into the soft flesh of her throat, using the full force of his 6-foot, 200-pound frame.

Gasping for air, she felt the pressure let up for an instant, shoved him with all her might and fled to a neighbouring apartment to call 911.

“I'm lucky to be alive,” Ms. Greene said later, “although sometimes I doubt that.”

Her son, 24-year-old John Candow, suffers from severe bipolar disorder and, when untreated, is consumed by the delusion that he is Tony Soprano, the TV mobster. He has been living with his mother and, since he was diagnosed three years ago, has thrown knives at her, burned her with cigarettes, punched and kicked her repeatedly.

Last week's incident was the most violent yet. When police arrived, they were confronted with a psychotic young man holding a knife to his throat threatening suicide. They tasered, subdued and arrested him – and found 10 more knives in his knapsack.

When Ms. Greene, a Halifax social worker, visited her son at the East Coast Forensic Hospital a few days later, he reminded her, matter-of-factly, that he plans to kill her and chop her body to pieces.

“When John's not sick, when he's being treated, he's very loving. He's a sweet, beautiful boy,” Ms. Greene says tearfully.

But the central fact of the sordid tale is this: Mr. Candow refuses to get treatment, as is his right under Canadian law.

That right presents a dilemma for countless caregivers across the country whose loved ones have such severe mental illnesses as schizophrenia, bipolar disorder and addictions, especially when they also suffer from anosognosia – an inability to recognize they are sick.

To read the entire article, click here.

Photograph by Sandor Fizli for The Globe and Mail.