Posted at 5:00 a.m.
Health workers working in psychiatry in Laval, both in the hospital and for external services, deplore the glaring lack of personnel and the lack of consideration for their safety. The management of the CISSS de Laval claims to have the safety of employees at heart and in recent months has mandated a consultant to evaluate the organization of services at the psychiatry unit of the Cité-de-la-Santé.
Shaken by the events of last week that led to a triple murder and the death of Abdulla Shaikh, who was being treated in Laval in psychiatry, workers in the outpatient psychiatry services at the CISSS de Laval are concerned about the lack of staff who affect them. Two teams work there in intensive follow-up in the environment (SIM). These workers assess patients at home and ensure in particular that they do not represent a danger to the population. Another team takes care of the intervention program during first psychotic episodes (PIPEP).
This summer, one of the teams has only two speakers out of ten. “Under these conditions, how do you manage to carry out the necessary follow-ups? “, wonder some workers, who contacted The Press. They believe that “patients live in the community without adequate follow-up” in Laval.
The CISSS de Laval confirms that the two SIM teams should normally be made up of 22.8 full-time equivalents, but currently have 14.3. Spokesperson Marie-Eve Despatie-Gagnon indicates, however, that the standards of the National Center of Excellence in Mental Health provide for a ratio of nine patients per worker and that the Laval teams are currently below this threshold (114 users). The spokesperson adds that the mental health teams “help each other” and that users who cannot be taken care of by the SIM teams are taken care of “by a team of follow-up services of varying intensity and by the outpatient clinic.
National representative for the Alliance of professional and technical personnel in health and social services (APTS) of Laval, Natacha Pelchat affirms that there is “a constant overload” for mental health workers. “The working conditions are difficult. You have to look at attracting and retaining staff,” she says.
The lack of psychiatric personnel in Laval also affects the medical profession.
Normally, two psychiatrists support the outpatient care teams. But one of the two is currently on sick leave and the other must spend most of his time in the hospital, where the lack of staff is also important. The CISSS de Laval says it currently has 27 psychiatrists on its territory out of a total of 31 positions. Absences, however, bring the count to 18, explains Mme Despatie-Gagnon. A recruitment process is underway, but these absences do not cause any breaks in service, assures the spokesperson.
Also in the hospital
President of the Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (SIIIAL-CSQ), Déreck Cyr believes that “everything related to psychiatry in Laval does not work”. “There is a lot of exodus of workers, because there is no support,” he says. The CISSS says that 76 of the 430 mental health employees have left the sector in the past year, but that 75 others have been recruited.
An external consultant was however mandated to “produce an organizational portrait of the psychiatric hospitalization units at the CISSS de Laval”. The consultant must “suggest courses of action related to the organization of services, clinical programming and human resources”. “This mandate is not related to the services offered in the outpatient clinic and in the community,” says Ms.me Despatie-Gagnon.
Mr. Cyr says his members have been victims of numerous violent incidents in recent years at the Cité-de-la-Santé psychiatry unit. Last January, a nurse had part of her little finger torn off by a patient who had bitten her.
Already in 2018, an internal report denounced the many problems of violence in the psychiatry unit of the Cité-de-la-Santé.
In May 2019, internships for medical students had been suspended in the same unit “given security issues”.
Since then, renovations have been carried out in the unit. Nursing stations have been secured. The doors of the restraining rooms have been enlarged. Major work at a cost of $8 million will begin in the spring of 2023. “In the meantime, the physical locations remain inadequate. And we lose a lot of workers because of that,” says Mr. Cyr, who believes that there is a “trivialization of violence” against psychiatric workers in Laval.
Outpatient care workers also complain that their offices, located at 800 boulevard Chomedey, are not yet sufficiently secure, despite the addition of alarm buttons in the offices. The security of the entrance is a particular problem, according to them. The CISSS de Laval ensures that employee safety is “a priority”. A plan to improve the security of the premises on Boulevard Chomedey is underway. The CISSS would like to mention that studies show that only 5% to 10% of people suffering from a mental illness are at risk of violence and that “we must not make the association between violence and mental disorders, although mental disorders can explain certain violent situations”.