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

Mental health beds full up

An article published in the January 5th edition of The Chronicle Herald:

Capital Health faced with ‘unrelenting demand’ for admissions since September

By John McPhee, Health Reporter

Capital Health’s psychiatric care system has been under "almost unrelenting" pressure this fall, the head of psychiatric services said Tuesday.

Every one of the district’s 69 mental health acute care beds has been filled since September.

Ian Slayter [pictured] doesn’t know why there has been such a continuous need for admission.

"Our length of stay has decreased a little bit but we still have a lot of people coming for care," he said. "Any particular week, it’s not more than usual, but we’ve had week after week of almost unrelenting demand for beds."

Those who are waiting for acute care beds are either kept in the emergency department where they were admitted or, more preferably, sent to a psychiatric bed in a nearby health district, Slayter said.

Compounding the problem, patients often stay in psychiatric beds after they’re ready to be discharged. That’s because there’s often nowhere in the community — such as supported apartments or nursing home beds — for them to go, Slayter said.

"It’s like filling up a bathtub. Sooner or later you’re gong to overflow."

A woman who contacted The Chronicle Herald said she was turned away from the Cobequid Community Health Centre’s emergency department this week, even though she was told she needed treatment.

The elderly Beaver Bank woman, who didn’t want to be identified, said she was previously treated and hospitalized for acute anxiety.

"One doctor tried to get me in the hospital (but) another doctor told me that the beds were filled," she said. "We have a desperate problem here."

Slayter couldn’t comment on the woman’s specific case, but said hospitals don’t send anyone home who needs to be admitted.

"If the people assessing the patient feel they need to be in hospital . . . then we will keep them in emergency until we have a bed to send them to," he said.

Psychiatric services has been trying to deal with the shortage of psychiatric beds with several programs, Slayter said.

"We’ve been taking some of the more complex cases and building residential placements for people," he said. "It costs quite a bit of money — it’s a 24-hour support service — but when no one else has been willing to take them, we’ve done that in several cases over the past couple of years."

In another program, 35 to 40 people have been placed in supported apartments, where people live alone but they can call for help any time of the day, he said.

And plans are in the works for a psychiatric intensive care unit at the East Coast Forensics Hospital in Dartmouth. Five to 10 beds will be established in early spring for people at a high risk of harming themselves or others.

(jmcphee@herald.ca)