Leaked memo outlines shortages at Alberta Hospital

EDMONTON – A severe shortage of psychiatrists at Alberta Hospital Edmonton in September threatened bed closures at the mental health facility, according to a leaked Alberta Health Services memo.

Hours before, there was also a critical demand for in-patient mental health beds in Edmonton hospitals which prompted a top mental health doctor to ask all psychiatrists to consider discharging patients no longer needing acute care. At the time, eight mental health patients were waiting in emergency stretchers for beds. Another two patients waiting for elective surgery also needed beds.

That call for help resulted in “some movement of patients,” wrote Dr. Richard Hibbard, Edmonton zone clinical department head for addiction and mental health, who thanked staff for their “terrific efforts.” But Hibbard asked that psychiatrists working in hospitals such as the University, Grey Nuns or Royal Alexandra Hospitals consider providing temporary help at the mental hospital in Edmonton’s northeast.

“In order to avoid any bed closures, we are asking if there are any zone psychiatrists who would be willing to provide locum services for (Alberta Hospital),” Hibbard said in the Sept. 14 memo.

Liberal MLA Dr. David Swann said a memo in which the department head pleads for help to clear space is a “deeply troubling development.”

“People are really stressed, not only the patients needing care, but also the physicians and nurses and psychologists and mental health workers who are trying to cope with the demand in the appropriate place,” said Swann, whose party received the leaked memos. He said even though more mental health patients can be cared for in the community, more mental health beds are also needed so people aren’t pushed to the streets.

“They push people to the very limits of their capacity and beyond their capacity when they need a bed for somebody more urgent,” Swann said. “A suicidal patient, somebody who walks in with a gun or threat of suicide has to push somebody else out so it becomes a question of choosing the least risky person to release.”

Dr. Owen Heisler, Alberta Health Services’ medical director for the Edmonton zone, said patients are never forced onto the streets. They are discharged from hospital only when there are appropriate supports ready to help them in the community and consent from the medical experts.

“At the end of the day, we need to provide safe patient care and that’s the most important thing,” Heisler said. He said there are days when staff and beds are overwhelmed by the number of mental health patients seeking care.

“It’s those days we struggle,” he said, noting that physicians and managers usually phone each other to find care options. The written memo alerted doctors who may not have known about the crowded backup in emergency. They could then push others to redouble their efforts to create supports in the community for those waiting to leave hospital, but not yet discharged.

“The number of patients vary from day to day and their severity varies from time to time,” Heisler said. “There are some times we get quite tight and times we have some extra capacity.”

On Sept. 14, Heisler said one psychiatrist volunteered to work at Alberta Hospital to help during the crunch. Another two have applied for job openings, although they include international graduates whose credentials need checking. Two psychiatrists are needed immediately at the mental health facility, a number that will rise as doctors approach retirement or change work, he said. Approximately 30 psychiatrists work at Alberta Hospital.

On Wednesday afternoon, four patients in Edmonton hospital emergencies were waiting for mental health beds. In the Peter Lougheed Hospital in Calgary, Swann said seven such patients were waiting.