Posted at 5:00 am
Ariane Lacoursiere The press
Health workers working in Laval Psychiatry both in hospital and for external services deplore the glaring understaffing and lack of concern for their safety. The management of the CISSS de Laval claims to have the safety of the staff at heart and in recent months has commissioned a consultant to assess the organization of the services in the psychiatric ward of the Cité-de-la-Santé.
Devastated by the events of the past week, which led to a triple murder and the death of Abdulla Shaikh, who was being treated in psychiatric care at Laval, staff at the CISSS de Laval Outpatient Psychiatry Unit are concerned about the staff shortages affecting them. There, two teams work in the intensive environmental follow-up (SIM). These employees assess patients at home and in particular ensure that they do not pose a danger to the population. Another team takes care of the intervention program for the first psychotic episodes (PIPEP).
This summer, one of the teams only has two speakers out of ten. “How do you manage to carry out the necessary follow-ups under these conditions? Ask some workers who have contacted La Presse. They believe that “patients without proper follow-up care are living in the community” in Laval.
The CISSS de Laval confirms that the two SIM teams should normally consist of 22.8 full-time equivalents, but currently 14.3. However, spokeswoman Marie-Eve Despatie-Gagnon points out that the standards of the National Center of Excellence in Mental Health call for a ratio of nine patients per staff member and that Laval teams are currently below that threshold (114 users). The spokeswoman adds that the psychiatric teams “help each other” and that users who cannot be cared for by the SIM teams “are treated by a team of aftercare services of varying intensity and by the ambulance”.
Natacha Pelchat, national representative of Laval’s Alliance of professional and technical personal in health and social services (APTS), reiterates that there is “a constant workload” for mental health workers. “The working conditions are difficult. You have to be careful about attracting and retaining employees,” she says.
The lack of psychiatric staff in Laval is also affecting the medical profession.
Two psychiatrists usually support the outpatient care teams. But one of the two is currently on sick leave and the other has to spend most of the time in the hospital, where the lack of staff also plays a role. The CISSS de Laval states that it currently has 27 psychiatrists on its territory out of a total of 31 posts. However, absences bring the count to 18, explains Ms Despatie-Gagnon. A recruitment process is ongoing, but these absences have not led to any service interruptions, the spokesman assures.
Also in the hospital
Déreck Cyr, President of the Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (SIIIAL-CSQ), believes that “anything related to psychiatry in Laval doesn’t work”. “There are a lot of workers fleeing because there is no support,” he says. According to CISSS, 76 of the 430 mental health workers have left the sector over the past year, but 75 others have been hired.
However, an outside consultant was commissioned to “produce an organizational portrait of the CISSS de Laval psychiatric hospital wards”. The consultant must “propose actions related to the organization of services, clinical programming and staffing”. “This mandate does not relate to the services provided in outpatient clinics and in the community,” says Ms. Despatie-Gagnon.
Mr Cyr says his members have been victims of numerous violent incidents at the Cité-de-la-Santé Psychiatric Unit in recent years. Last January, a nurse had part of her little finger ripped off by a patient who had bitten her.
As early as 2018, an internal report denounced the many problems of violence in the psychiatric center of the Cité-de-la-Santé.
In May 2019, internships for medical students in the same unit were suspended “for safety reasons”.
Renovations have since been carried out in the unit. Infirmaries were secured. The doors of the rest rooms have been enlarged. Major work will begin in spring 2023 at a cost of $8 million. “Meanwhile, physical locations remain inadequate. And we’re losing a lot of staff as a result,” says Mr Cyr, who believes there is a “minimalization of violence” against mental health workers in Laval.
Home care workers are also complaining that their offices at 800 Boulevard Chomedey are still not sufficiently secure, despite the addition of alarm buttons in the offices. According to them, the security of the entrance is a particular problem. The CISSS de Laval ensures that employee safety is “a priority”. A plan to improve security at the Boulevard Chomedey site is underway. CISSS would like to mention that studies show that only 5% to 10% of people with a mental illness are at risk of violence and that “although mental disorders explain certain acts of violence, we must not make a link between violence and mental disorders can situations”.