It's not just hospitals in large centres like Guelph that are struggling with how to deal with patients who have mental health issues - smaller centres, like Fergus, have fewer patients with mental health emergencies but they also have fewer resources. 

A report recently released by the Waterloo-Wellington Local Health Integration Network is the first step to improving mental health care in the region, especially for smaller centres, according to the CEO of three hospitals in Wellington County.

"I think it's exciting to see the problem defined in such a way that it now becomes a monster that we can tackle," said Jerome Quenneville, who runs hospitals in Fergus, Mount Forest and Palmerston. "When all you're dealing with is the symptoms of delays in care, you really struggle with, 'So, what's the answer to change that cycle?'"

Between 2012 and 2014, the number of mental health emergencies increased dramatically in Wellington County: by 9 per cent at Louise Marshall hospital in Mount Forest and by 11.6 per cent at Palmerston and District Hospital.

Inadequate resources

Quenneville said his rural hospitals do not have appropriate safe rooms for people in psychiatric crisis and that the emergency rooms are not staffed to meet the increasing demand for mental health care. 

'It will at some point need some investment ... from a provincial level, in order to really get the bigger gains.' - Jerome Quenneville, North Wellington Health Care

"If we have to dedicate individuals to supporting individuals who have mental health needs — in other words, providing ongoing supervision —  it really ties up the few people we have available for care delivery in a way that is taxing on our system," he said.

Often, hospital staff ask local OPP officers to stay with people who come to the emergency room in mental distress, because the hospitals do not have security personnel. 

"You may sit in a hospital situation for days ... which is really difficult in a small town," Quenneville said. "People may notice that you've been guarded by a couple OPP officers in your home hospital facility and that does nothing to help a person bounce back from that situation down the road."

Investment needed

Safe spaces and adequate staffing are two areas of improvement identified in the LHIN's report, which was released last week. 

"It will at some point need some investment ... from a provincial level, in order to really get the bigger gains," he said.

In the meantime, the hospital is looking for ways to make small changes, such as having a psychiatrist on staff at one of the rural hospitals.