Rachel Jones wonders how much longer she and her son would have waited in a Halifax emergency room if he hadn’t escaped and tried to kill himself.
Jones took her 24 year-old son to the Queen Elizabeth II Health Sciences Centre last month because he was depressed, manic and suicidal.
CBC News is not naming Jones’s son, but his mother is speaking on his behalf while he recovers.
When they arrived at the hospital, Jones said she told triage nurses her son talked about killing himself by jumping off a building.
“I assumed that would be straight [forward],” Jones said in an interview. “Show the doctor and then send it off to the psych team so that he doesn’t sit and wait in the waiting room with people.”
That wasn’t the case. They sat in the waiting room for more than seven hours, Jones said, before her son asked to go to the bathroom.
When he was out of his mother’s sight he found an unlocked door and eventually made his way to the roof.
Security found Jones’s son, handcuffed him and put him in an interrogation room where he was held for several more hours.
He didn’t see a psychiatrist until about 18 hours after they first arrived at the hospital, Jones said.
“I don’t know quite why we had to wait that long … I could have lost my son and [so would have] his siblings and his father,” she said. “I don’t know how we would have recovered.”
Problem with the process
Jones, who has worked as a registered nurse since 1994, said she’s not blaming the staff.
Her problem, she said, is with the process.
An emergency department physician assesses a patient experiencing a mental health crisis and then decides whether they need to see a crisis-response clinician or a member of the psychiatry team, according to Nova Scotia Health.
Jones said the physicians are so busy that a nurse or other medical health professional should be able to make referrals to the psychiatric team to help people to access care quicker.
“It’s bureaucratic and it’s damaging to the young people, old people, whoever, who’ve got serious mental health challenges and they enter into emerg to wait all that time.”
Reducing wait times
An advocate with the Nova Scotia College of Social Workers agrees physicians shouldn’t be the only ones who can assess people coming into hospitals with mental health issues.
“They don’t need to be in control of everything,” N Siritsky said. “This model of mental health is based on this antiquated, physician-driven pharmaceutical concept.”
Siritsky said allowing social workers, who are already in hospitals, to intervene as soon as a patient comes into the hospital would relieve the burden on physicians and reduce wait times.
“Getting a social worker in there who can do some initial assessment, contribute to some of the treatment plans in a way that could help the provider when the provider finally arrives and reduces the amount of time the doctor actually has to spend with the patient,” they said.
“The social worker can provide some of the counselling and support and resources not just to the individual, but potentially to the family members or friends who came with that individual.”
Siritsky said changes like this need to be part of a larger shift in the delivery of mental health care in Nova Scotia to a collaborative and proactive approach to patient care.
The goal, Siritsky said, would be to prevent people struggling with mental health from ever having to go to the hospital in the first place.
A spokesperson for Nova Scotia Health said in an email Mental Health and Addictions Urgent Care Services saw a 30 per cent increase in demand for services in 2020, and a 10 per cent increase in demand for non-urgent services.
Questions remain
Rachel Jones said she still doesn’t understand why there was an unlocked door in the QEII emergency room.
“This was a near miss of great magnitude and I wonder if it’s even been talked about there,” she said. “Are they looking at it? Are they reviewing it?”
Nova Scotia Health did not respond to questions about protocols around unlocked doors in the hospital and if they’ve made any changes since this incident.
Jones said she’s not sure what she’ll do if her son experiences another mental health crisis. She said the experience has traumatized her son and leaves her worried and angry.
“I’m always going to have a fear that he’s just going to feel that he’s a problem in society because of the way it was handled.”
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