British Columbia

New addiction and mental health facilities coming St. Paul's hospital

A new $3.5 million modular expansion to St. Paul's emergency room will be geared specifically toward patients suffering from addictions and mental health issues.

The HUB will be an emergency room expansion to treat addictions and mental health patients

Vancouver's St. Paul's Hospital is getting a new facility to expand its emergency room. The HUB will be geared toward patients with mental health or addictions issues. (Rafferty Baker/CBC)

St. Paul's Hospital psychiatrist Dr. Bill MacEwan was walking down the street a couple years ago in Vancouver's Downtown Eastside, an area where he often worked with patients.

Suddenly, Vancouver's then-chief of police Jim Chu pulled over next to him in an unmarked Ford police car.

"He pulls over and I think, 'uh-oh, I'm in trouble,'" said MacEwan, who had just jaywalked across the street.

But in fact, Chu was stopping because he had an idea about how to increase facilities for people with mental health and addictions issues in the city.

"[He] jumps out, and says, 'Bill, we've got an option here, we have an idea,' and that's really the foundation of how we brought this to fruition," said the psychiatrist.

Dr. Bill MacEwan, a St. Paul's Hospital psychiatrist, says the HUB will help provide more dignified care for vulnerable patients suffering from mental health or addictions. (Rafferty Baker/CBC)

Now, the idea is about to become a reality. St. Paul's is adding two modular units — one in each of the hospital's courtyards — to expand the emergency room with services specifically geared toward addictions and mental health issues.

The $3.5 million project, called the HUB, is intended to streamline treatment options for patients who could otherwise end up straight back on the street, rather than in psychiatric treatment or recovery programs.

A growing challenge

"We've had a massive upswing, in terms of the number of people coming to St. Paul's emerg for addictions, for mental health," said MacEwan. "We haven't really been satisfied with how we've been able to respond."

"On an annual basis, we get about 12,500 visits for mental health and addiction to our emerg and we only admit to our hospital about 20 per cent of those patients," he said.

"So many of those people are discharged, and what we're trying to do is divert them over to the HUB and the transitional centres, so we can make that visit to our hospital more meaningful."

​According to MacEwan, St. Paul's looked to Toronto's St. Michael's Hospital, where the Rotary Transition Centre gives vulnerable people who haven't been admitted to hospital after an emergency visit a place to rest and clean up.

The new transition centre at St. Paul's will serve the same a function, with about 10 beds.

The transition centre will have comforts like a shower. People will be able to stay and rest after an emergency room visit, or leave if they wish. (St. Paul's Hospital)

The other part of the HUB is an extension of the emergency room, just steps away, where another 10 beds will give patients what MacEwan calls more dignified care.

"It offers us better care for our patients. Often they're having to sit in waiting rooms or we have hallway stretchers, and now they get better — we think it's less stigmatizing and softer care. So people can say, 'Hmm, this is really useful, really helpful,' and they'll move on into treatment," he said.

The clinical care unit, a modular facility that will be installed in the St. Paul's Hospital courtyard, will serve as an emergency room expansion. (St. Paul's Hospital)

Police funding

Along with funding from the City of Vancouver and the St. Paul's Foundation, the Vancouver Police Foundation contributed $750,000 toward getting the HUB set up.

"When we're dealing with mental health related issues, the [Police] Foundation was fairly quick to recognize the burden of having 25 per cent of our time spent dealing with mental health related calls," said VPD Staff Sgt. Randy Fincham

"By providing another resource, it would free our officers up to prevent crime and help keep the community safe."

The province says the new measures strengthen what is already among Canada's most robust opioid strategies. (Rafferty Baker/CBC)

The HUB will be funded through Vancouver Coastal Health, at $3 million per year.

The project should be up and running some time this spring, and if St. Paul's moves locations, the modular units can be set up at the new site.

Follow Rafferty Baker on Twitter: @raffertybaker


Rafferty Baker is a video journalist with CBC News, based in Vancouver. You can find his stories on CBC Radio, television, and online at