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

Hospitals told to meet mental health standards

An article posted today by CBC.ca:

Health minister sends letters after AG's report

Nova Scotia's Minister of Health has sent hospitals across the province a reminder about their obligations when it comes to mental health services.

Maureen MacDonald [pictured] has ordered top hospital administrators to comply with seven orders, in a one-page letter sent to all nine of the province's district health authorities.

MacDonald said the directive is a response to criticism levelled against her department in a recent report by the province's auditor general.

"I was surprised when I saw the auditor's report," she said Thursday. "There is no point in having standards if you don't implement and monitor the standards."

Last week, Auditor General Jacques Lapointe released a report that looked at whether Nova Scotians were able to access timely mental health care, no matter where they live in the province.

He said Nova Scotia was failing to meet its standards when treating mental illness, and said there is no plan to fix the situation.

Lapointe also said there was inadequate oversight of the system and no effective monitoring of the standards.

The auditor general's office found that of 538 Nova Scotians who received mental health care in Colchester-Hants counties, the Annapolis Valley and the Capital District Health Authority in Halifax, only 14 per cent of the patients got care that met mental health standards.

MacDonald said the letter — sent by Deputy Minister Kevin McNamara on her behalf — was sent to the CEOs of the health authorities on the same day Lapointe's report was released.


DHAs


"District health authorities are not spending their own money and they're not spending my money, they're spending the public money and they need to be accountable for that," she said.

"I'm accountable for the health care system on the floor of the house of assembly but the district health authorities are accountable to me for how they deliver health care services."

MacDonald said as part of her seven directives, she reminded hospitals they cannot refuse to admit patients simply because they do not live in the district.

"There are no geographic barriers to getting health-care services within the province of Nova Scotia," she said.

The Health Minister said she has not yet heard from any of the health authorities in the week since she issued the directives.

Health authority responds

Peter Croxall, the director of the mental health program in the Capital District Health Authority, said one of the problems is that the standards are vague and hard to measure.

"Full of, really, of too much mental health jargon and not really written in a clear, explicit fashion," he said.

Croxall said statistics show one in five Nova Scotians will develop a mental illness.

That large number makes the issue difficult to address, he said.

"The fact that we only have … four per cent of the health budget, I think you can draw your own conclusions from that," said Croxall.

"I'm not saying that we're doing terribly badly but we certainly could use more resources or a redistribution of resources within health into the mental health area."

Croxall said in his experience, there was nothing to indicate Nova Scotians were getting substandard care, despite the auditor general's findings.