It’s not just a plan to build a new St. Paul’s Hospital but a plan to build a better hospital. For the thousands of patients who show up in the hospital’s emergency room every year, the change is going to be profound.
The vast majority of ER patients are from the Downtown Eastside with mental health or addiction issues. In the next part of a series on St. Paul’s Hospital, Global News looks at the new plan to save them.
Dr. Bill MacEwan’s office is a park bench outside of the Community Courts on Vancouver’s Downtown Eastside. Four days a week, the head of the Psychiatry Department at St. Paul’s Hospital tries to see as many patients as he can — all of them mentally ill, most of them addicted. He has several hundred patients and his goal every day is to help them before they need to be admitted to emergency at St. Paul’s Hospital.
“A week-and-a-half ago, out of 33 beds in emergency [at St. Paul’s], 21 were psychiatric patients,” says Dr. MacEwan.
“So everything else … gets pushed out. So we have to take those people out of [emergency] so the people in emergency can get appropriate care for their surgical problem or infection.”
The new St. Paul’s hopes to achieve that goal and leading the charge to change the way we treat addiction and mental health in B.C. is Dr. Evan Wood. And he says it starts with earlier intervention and evidence-based treatment.
“If you actually look at the burden of disease from untreated addiction, and then alongside that the evidence that shows we can dramatically improve public health and safety, reduce healthcare costs, and improve individuals and families that are struggling with untreated addiction.”
The current St. Paul’s emergency department has already tracked 9,500 visits related to mental health and addiction issues this year. That’s an 88.5 per cent increase since 2009. The head of the emergency department, Dr. Dan Kalla, calls it an epidemic.
“We call them our SAMI patients, severely addicted patients with mental illness,” says Kalla.
“We’re at the epicentre here at St. Paul’s. Our volumes have mushroomed up 160 per cent in last five years.”
READ MORE: Why do we need a new St. Paul’s Hospital?
The new St. Paul’s will have a centre similar to The Centre of Excellence for HIV/AIDS but for addiction and mental health. Patients with illnesses related to addiction issues will be fast-tracked to the new centre, where clinicians who specialize in addictions can help them.
“The whole vision is that we intervene earlier. Many of these people have had multiple interactions with the healthcare system,” says Dr. Wood.
“They are looking for treatment and the only place that they’re able to go is the emergency room. But that’s not the place to provide addiction treatment….There’s definitely huge potential to make a dramatic improvement in the burden of disease from addiction. We are hemorrhaging money into our healthcare system and criminal justice system because of people with untreated addiction. We can make a huge impact on those costs by providing evidence-based available addiction treatment.”