Quebecers are forced to live in hospital for several months, even years, even if they are no longer sick because there is absolutely no space in CHSLDs or adapted residences, especially in mental health.
Three patients have lived over the past five years at the Douglas Mental Health University Institute in Montreal, because they did not have a place in an adapted resource.
One of them even lived there for more than 3,000 days, or a little over eight years, show documents obtained by The newspaper through a request for access to information. They were finally all transferred a month ago, thanks to the opening of new places, management confirmed.
At the Anna-Laberge Hospital in Châteauguay, a patient with mental health issues has also been waiting for a transfer for almost two years (647 days).
“No other place”
“At the moment, we have no other place,” replies Jade St-Jean, spokesperson for the Integrated Health and Social Services Center of Montérégie-Ouest, who is looking in several regions. The hospital is not the best environment, but the safest.”
At the Hôtel-Dieu de Sherbrooke, five patients had been waiting for a transfer for more than a year, last November.
Patients called ALC (alternative level of care) in the jargon received treatment in hospital for a physical or mental health problem and are now recovered. They no longer need to be in the hospital, but wait for a place to become available elsewhere (CHSLD, RI, etc.).
Patients who have lived in the hospital for a long time
- Douglas Mental Health University Institute 3098 days* (8 years)
- Douglas Mental Health University Institute 2158 days* (5 years)
- Douglas Mental Health University Institute 2034 days* (5 years)
- Hôtel-Dieu de Sherbrooke 806 days (2 years)
- Hôtel-Dieu de Sherbrooke 728 days (2 years)
- Anna-Laberge Hospital (Châteauguay) 647 days (1 year and nine months)
- Hôtel-Dieu de Sherbrooke 492 days (1 year and 4 months)
- Philippe-Pinel Institute of Psychiatry 466 days (15 months)
- Charles-LeMoyne Hospital 409 days (13 months)
- Hôtel-Dieu de Sherbrooke 388 days (1 year)
- Charles-LeMoyne Hospital 388 days (1 year)
- St. Mary’s Hospital 293 days (9 months)
- Notre-Dame Hospital (Montreal) 217 days (7 months)
- Lakeshore Hospital (Pointe-Claire) 215 days (7 months)
- Haut-Richelieu Hospital 195 days (6 months)
- Honoré-Mercier Hospital (Saint-Hyacinthe) 187 days (6 months)
- Pierre-Boucher Hospital (Longueuil) 185 days (6 months)
- Malartic Hospital 166 days (5 months)
*These patients were placed within the last month, confirmed the CIUSSS de l’Ouest-de-l’Île-de-Montréal
Source: Data provided by the CISSS, at the end of November 2023. Some patients may have been transferred since that time.
Currently, 1,949 NSA patients are waiting in the network, according to data from the Department of Health and Social Services. They occupy 12% of all hospital beds, causing congestion in emergency rooms.
According to our data, many ALC patients stay two or three months in the hospital, whether in Montreal or in a remote region.
“It’s really a big, big problem,” reacts the Dr David Lussier, geriatrician. We have a huge capacity problem that cannot be resolved overnight. But it’s been going on for years.”
Risks of infections
Everyone agrees that the hospital is not the right place for these people. When these patients have psychiatric issues, the profile is often accompanied by other issues (drug addiction, violence, etc.).
“From a clinical perspective, if you have a mental illness […], the hospital is not the right place. This is acute care, these are people in crisis,” underlines Amine Saadi, mental health and addiction program director for the CIUSSS de l’Ouest-de-l’Île-de-Montréal, to which the Douglas Institute reports.
The observation is the same for seniors who are waiting to go to a CHSLD. In hospital, they risk catching infections, are bedridden and have no access to leisure activities.
“They were not stimulated as they should be, did not go to the dining room, no karaoke, no bingo,” underlines the Dr Lussier, who advocates transfers “as quickly as possible”.
According to the latter, the creation of “post-acute” care units is a solution to be advocated for seniors waiting for a place. This allows seniors to be taken out of hospitals by temporarily placing them in a CHSLD where they receive appropriate care.
At the CIUSSS de l’Estrie, each day of hospitalization for an NSA patient costs on average $1,650. Elsewhere, fees are generally at least $500 per day, depending on the answers obtained.
At the Quebec University Hospital, NSA patients wait on average between 7 and 16 days before being transferred, depending on the hospital. However, the CHU refused to give precise waiting figures for all patients.