LHSC opens separate mental health and addictions ERs

London’s largest hospital network plans to open a separate emergency room for mental health and addiction patients, The Free Press has learned.

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London’s largest hospital network plans to open a separate emergency room for mental health and addiction patients, The Free Press has learned.

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The London Health Sciences Centre, in the midst of a multi-million dollar planning process to guide the coming decades, says an adult mental health care center and emergency department dedicated to mental health and addiction are part of his vision for the future.

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“We knew we had to do better,” said Brad Campbell, administrative director of LHSC’s corporate hospital.

“Our current emergency is underbuilt for the volume of people it’s seeing,” he said. “They were designed 20 years ago and the population has changed dramatically.”

A busy emergency room full of sick people who need urgent care is a chaotic environment that doesn’t work well for people who need help with a mental health or drug crisis, Campbell said.

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“There was both an issue of stigma, but also a recognition that our current model of service delivery does not meet needs in a way that I think any of us would say ‘This is a contemporary approach to supporting an often vulnerable and marginalized population,’ he said.

“We want to show ourselves differently in the way we accompany people. We want to address health disparities.

London hospitals have been criticized for their handling of homelessness, including sending people back to the streets. A recent health and homelessness summit brought together hospitals, community organisations, city hall and developers to start drawing up a revamped system to better help homeless Londoners.

The LHSC already runs three strands of urgent care at Victoria Hospital, for adults and children, and at the University Hospital.

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The entrance to the emergency department of University Hospital London.  (Derek Ruttan/The London Free Press)
The entrance to the emergency department of University Hospital London. (Derek Ruttan/The London Free Press)

Details of the new mental health center and emergency room ais still unclear, including the location and how it would work. Campbell said he expects more clarity on the concept in the next three to four months. What is evident is the pressure that complex mental health and addictions cases place on emergency services.

Many patients facing these challenges return to the emergency room several times a year, increasing wait times. Police and paramedics are looking for ways to avoid spending hours waiting in the emergency room with patients in crisis until they can access care. About 1,650 homeless people account for more than 6,300 emergency room visits each year, an average of about four visits per year for each person, according to data shared at the November summit.

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Dedicated mental health ERs are used at the Toronto Center for Addiction and Mental Health and Vancouver General Hospital, Campbell said.

The concept has initial support from the leaders of several organizations that help people with addictions and mental illnesses.

But with the praise for LHSC thinking big and bold, caution has come.

LHSC has the resources to help people in crisis that other organizations don’t, said Scott Courtice, executive director of the London InterCommunity Health Centre. But existing emergency rooms at the hospital are not suitable for people in deep crisis, he said.

“Some of the people we serve, very marginalized people in mental health and addictions crisis, need an approach that takes into account the violence and the trauma that they don’t always get in the emergency department,” said he declared.

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Courtice said he would rather see a facility “not in a giant hospital with the blue H at the top”.

“A smaller community setting would probably be more people-friendly, a place where it’s a bit friendlier, just because the hospital environment can be an intense, triggering place for people.”

Courtice called LHSC’s vision “promising”, but said it would all come down to the details, including the need to partner with agencies like LIHC.

“I’m glad . . . that no one is justifying the status quo, that it’s recognized that the way services are delivered right now is not meeting the needs of people in crisis, and that the people providing care are burning out. So let’s do something bold and different. I’m all behind it.

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A center would work well as part of the treatment network that starts with community organizations trying to keep people out of the emergency room, said Sonja Burke, director of harm reduction services at Regional HIV/AIDS Connection London.

“Our outreach teams can’t do much. Community services are not funded, we are not robust enough to have 24/7. . . emergency care.”

But people with addictions and mental health issues have long felt stigmatized in hospital emergency rooms, she said. Hospital culture needs to change if a kind of separate, hospital-run facility is going to make a difference, Burke said.

“The hospital has a long way to go to change the internal culture. Hospitals always come with a lot of bureaucracy and rules. Would this place be self-contained?

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Campbell emphasized community partnerships, with other health care facilities and community organizations, as a key part of the planning process.

We don’t think of those in isolation, we think of those in partnership with all the different partners. How might we support this interconnected and coordinated system of care that extends beyond hospital walls to better support the people who need our services? »

LHSC will now consult St. Joseph’s Health Care London – which runs inpatient mental health services – the five acute care hospitals responsible for most of its patient referrals, as well as Windsor Regional Hospital, Campbell said .

“You can’t build new hospitals or think about building new hospitals very often,” he said. “We have this opportunity now and it’s very exciting.”

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