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Oh man. Don't get me started. https://www.theglobeandmail.com/amp/canada/article-one-mental-health-solution-a-kinder-gentler-emergency-department-for/?utm_medium=Referrer%3A%20Social%20Network%20%2F%20Media&utm_campaign=Shared%20Web%20Article%20Links&__twitter_impression=true
I was in hospital recently following a suicide attempt. First in the ICU, half-conscious, then in an internal medicine ward with a 24-hour security guard assigned to me, then in a locked psych ward.
Perhaps incongruously, the psych ward was by far the hardest. I couldn't have my phone and needed a doctor's permission to wear my clothes. Because of COVID there were no visitors or passes, although we were all congregating at meal times anyway.
It was a nice facility in that it was newish and we all got our own rooms, there were common areas with games and a glassed-off outdoor pseudo-balcony where I spent as much time as I could. But it still felt like a prison.
I don't know how to make inpatient psych wards feel more like places that facilitate a path to wellness and less like holding tanks you need to escape as soon as possible. I know it will take resources, though.
The staff was friendly but wasn't there to establish a treatment plan. There wasn't enough face time with psychiatrists. And it's really hard to get outpatient care, which makes it much more likely you spend more time not improving in an environment that doesn't help you get well
If I hadn't already had an outpatient psychiatrist I'd have spent much more time involuntarily hospitalized in a ward that didn't have a plan for making my desire to die go away for good.
Getting compassionate, effective care in an environment that makes you feel like a real person shouldn't be a matter of luck. For Canadians with mental illness, it is.
A lot of people talk about our need for more psychiatric beds after decades of deinstitutionalization. And we do need that. But (a) we need better - effective, accessible - outpatient care so fewer people deteriorate to the point of needing inpatient psych care.
And (b) we need to make psych wards places of treatment and healing, with voluntary treatment prioritized, resources provided to make treatment plans possible and a pathway to effective outpatient care.
Wow sorry this wasn't meant to be such a rant. And it started out as a discussion of improving psych emerg. Which, frankly, needs to start with better access and less despairing waiting. A calming, compassionate environment would also be nice.
