London's mental health wards are bursting at the seams, new numbers show just how badly
In 2019, there were more mental health patients than beds at Victoria Hospital for 179 out of 181 days
New numbers obtained by CBC News paint a dire picture of the state of mental healthcare in London, with the city's two major treatment centres bursting at the seams with more patients than beds almost every day in the first six months of 2019.
The Ontario Ministry of Health data was obtained through the province's Freedom of Information and Protection of Privacy Act.
The numbers suggest the Victoria campus of the London Health Sciences Centre (LHSC) has the largest overcapacity problem, with more mental health patients than beds for 179 of those 181 days. The hospital's average capacity on any given night was around 111.5 per cent.
Tom McHugh, the LHSC executive in charge of mental health programs at southwestern Ontario's largest hospital, said the reason the number is high is because the emergency department is often the first stop for anyone in the midst of a full blown mental health crisis.
"We're here 24 hours a day, so they come to emerg," he said. "We take people on an urgent and emergent basis."
With wait times of up to six days in 2018 for people suffering from mental illness, McHugh said the overcrowding is taking its toll on patients.
"It is a very hard thing to be admitted and wait in an [emergency department] when you're having a mental health crisis," he said. "We're doing everything we can to make it better."
McHugh said making it better involves regular coordination with other community agencies, such as the Canadian Mental Health Association or Parkwood Institute, which specializes in long-term and complex mental health care.
"We try to work hand in glove," he said.
Except the "glove" in Parkwood's case is also burst at the seams. According to Ministry of Health data, the hospital's mental health wards were overcapacity 176 out of the first 181 days of 2019, with the institution's average capacity at 102.9 per cent.
"Every night when the lights go down we pretty much have every bed filled," said Jodi Younger, the St. Joseph's Healthcare London executive in charge of patient care and quality.
Capacity issues have been a problem for a long time, she said, but the introduction of powerful and dangerous drugs such as fentanyl and crystal meth has made the problem worse.
"We're seeing more in our crystal meth and opioid presentations, which actually have more lethality attached to them, more overdose risk and those kinds of things than say alcohol, which has been a long-standing substance people have used over time," said Younger.
Parkwood deals with complex and long-term cases, so patients tend to stay longer at the hospital than at LHSC's Victoria campus, which deals with acute cases or sudden and rapid onsets of a mental health episode.
Patients at Parkwood stay an average of 30 to 50 days. Half of all patients stay 90 days or longer, with about a third occupying beds for more than a year.
The long length of stay is because often the illness is so complex, they need constant supervision and few places outside of the hospital offer that kind of support.
'They have nowhere to go'
"They have nowhere to go," Younger said.
Health officials refer to it as "psychiatric alternate level care," a new and emerging idea in mental healthcare similar to "alternate level care," the health system's official label for people who are sometimes referred to colloquially as "bed blockers."
"That is someone for whom no further new treatment is going to change their clinical picture and really it's about a different discharge environment that's going to support them to leave hospital," Younger said.
London's rising housing costs have created two problems: people with complex mental health can't afford rent and agencies looking to help them can't afford to buy a property where they can live and be properly monitored.
More affordable housing offers a potential solution when it comes to discharging patients, said Younger.
"Not just affordable housing, but supported housing," she said. "People with mental health and addiction needs to have somewhere to go and be discharged to."
with files from Andrew Lupton