Yellowknife's new hospital is doing security differently

Last May, the N.W.T. Health and Social Services Authority introduced behavioural health workers to its psychiatric floor and emergency department. The new staff address patients' immediate needs and participate in activities.

Behavioural health workers address patients' immediate needs, participate in activities with patients

Brian Boyer is a behavioural health worker at Stanton Territorial Hospital in Yellowknife. The N.W.T.'s health authority created the new position to improve safety on the psychiatric floor and in the emergency department. (Kate Kyle/CBC)

Brian Boyer knows food can heal the soul.

That's why he often makes fry bread while working the night shift in the psychiatric ward at Yellowknife's Stanton Territorial Hospital.

"It helps [patients] not feel homesick," said Boyer, who is a behavioural health worker. The former correctional guard of 12 years is now providing a different kind of security as part of the health-care team.

"A lot of them can relate cooking to home," said Boyer, who says many of the clients are Indigenous.

"For one moment, they are not in this place."

This simple act of making connections through cooking is one way behavioural health workers like Boyer are making the hospital safer, and possibly reducing violence, says Jenna Scarfe, the manager of mental health services.

New security position

The Northwest Territories Health and Social Services Authority created the new security position on the psychiatric floor and in the emergency department of Yellowknife's new hospital when it opened last May.

"They're really involved in the patient experience," said Scarfe about the 15 employees who fill three positions at the hospital 24/7.

Behavioural health workers debrief with a nurse on the psychiatric floor at Stanton Territorial Hospital in Yellowknife. (Kate Kyle/CBC)

Behavioural health workers are integrated into the health-care team. Most have backgrounds in corrections, or have worked at the Salvation Army and Yellowknife's Sobering Centre. They're security staff, but they don't wear the uniforms typical of guards at other institutions.

Along with regular surveillance checks, their job is to help address patients' immediate needs, recognize potential risks and de-escalate situations, if needed. A lot of the time you'll find them participating in activities and spending time with patients.

"I don't know of anybody that's doing what we're doing," said Scarfe.

We can't see how we could have lived without them in our department. ​​​​- Mahen Manickum, critical care services manager

A report of the House of Commons Standing Committee on Health in 2019 found workplace violence is a "pervasive problem" in health-care settings across Canada. The Northwest Territories Health and Social Services Authority could not provide rates of violence at the old hospital in 2018, or at the new facility, before publication.

Jenna Scarfe is the manager for mental health services at Stanton Territorial Hospital in Yellowknife. (Kate Kyle/CBC)

But there have been "very serious situations," said Scarfe.

"Previously, nursing really took the lead in everything. So nurses were de-escalating, they were observing, [doing] perimeter checks, and making sure that the patients were safe," she said. 

Clinically integrated security is something Scarfe and other nurses at Stanton "dreamed of," she said. 

"It was quite scary being in the seclusion room and only having, you know, you and your nurse colleagues, you know, having to use your non-violent crisis [training] to deal with situations. It just wasn't enough in a lot of situations," she said.

Boyer on the psychiatric floor at Stanton Territorial Hospital. (Kate Kyle/CBC)

'It makes the nurses feel safe'

The psychiatric floor at the new hospital is nearly three times larger than the one at the old facility. Behavioural health workers join in on staff briefings, they're told about potential risks and how to best support patients, and they take part in activities.

"Just having the behavioural health workers able to meet the immediate needs is really supportive for the patient," said Scarfe, who says patients can get agitated waiting to use the phone or see a doctor.

"It makes the nurses feel safe." 

Since May 2019, the number of calls from the hospital to the RCMP has "generally" decreased, Lisa Giovanetto, a health authority spokesperson, said in an email. The authority could not immediately provide statistics on calls to the RCMP, saying it needed more time to "accurately calculate these figures."

Anecdotally, behavioural health workers are making a difference in the emergency department, too, said Mahen Manickum, manager of critical care services at Stanton Territorial Hospital.

"We can't see how we could have lived without them in our department," he said.

In one altercation at the old hospital, the RCMP got involved and staff went on stress leave, said Manickum.

Now, behavioural health workers are connecting with patients before things erupt. They are a familiar face to returning patients. 

"[Patients] know they can trust the behavioural health workers and what they're going to be able to provide for them," and this reduces anxiety, he said. 

The health authority is now following up with behavioural health workers and nurses to fine-tune the program.