November 9, 2018

In the health network, planning is the key to success. Decisions that are made too fast often turn out to be bad decisions with disastrous consequences. In recent years, mental health services underwent various reforms in which promises that were made often weren’t kept. Beds for patients with mental health issues are closed on a regular basis and the announced closure of the department of psychiatry at the Hôpital du Saint-Sacrement in Quebec City is just one example: first, it was the psychiatry emergency department, then within a few months, all of the short-term hospitalization beds were slated to close as well.

Are you familiar with the ER revolving door syndrome? People who don’t have a family doctor go to the ER to see one and, when they aren’t taken care of, they come back sooner or later. The revolving door syndrome is particularly present among patients with mental health disorders. The psychiatry emergency department and general ER are often the only way for these patients without a family doctor to be seen. When these people don’t receive help, far too often they come back with worsened conditions.

Even though the Ministère de la Santé et des Services sociaux has been saying that mental health is a priority for the last ten years, their actions don’t really seem to line up with the goal: to offer patients better access to services. The Liberal government’s last mental health action plan for 2015-2020 has big targets, and while it is still difficult to accurately measure its effectiveness, based on what we see in the health network, one might guess it will be off target. Service decentralization would be ideal, perhaps even essential, for both senior’s care and mental health, but if patients don’t have access to services, then we will continue to see these unfortunate cases multiply.

This week I had the opportunity to spend a day with healthcare professionals from the Institut universitaire en santé mentale de Montréal to talk about safe healthcare professional-to-patient ratios. I met people who are passionate about their work but who are struggling to find a way to meet their most fragile patients’ needs. Many of these healthcare professionals witnessed the mental health reforms firsthand but still haven’t seen any benefits.

During the last election campaign, parties talked a lot about access to front line health care. However, they barely mentioned how important it is to offer better access to front line mental health services. It is high time for politicians to deliver on the promise to provide care to this particularly vulnerable segment of the population.

The CAQ is now in charge at the National Assembly. The new government needs to focus on the organization of mental health care in order to better meet needs. Where should they start? Well, they could demand a moratorium on the closure of the psychiatry department at the Hôpital du Saint-Sacrement. That would be a good start!