Courtesy GNB/YouTube
New Brunswick’s health minister says more and more people are going to emergency rooms with addictions and mental health concerns.
Dorothy Shephard says recent events have put a spotlight on suicide and gaps in the system.
Shephard ordered a review of the mental health system in March following the death of 16-year-old Lexi Daken who was unable to access mental health services after waiting hours at Fredericton’s Chalmers Hospital and later died by suicide.
Shephard has announced 21 recommendations which came from the Department of Health and the two regional health authorities – Horizon and Vitalité – which she says will be implemented.
“The gravities of the situations that presented this action certainly weigh heavy on all of us. At the same time, I can’t tell you the excitement that has been created with staff,” she notes.
The province has grouped priority areas for 2021-2025 under the headings of education, emergency departments, and community addiction and mental health services.
Education
- Provide trauma-informed care training to emergency department staff, police, and other first responders. These modules are specifically designed to support staff in a busy emergency department environment.
- Launch a provincial awareness campaign for addiction and mental health crisis response services.
- Develop and distribute crisis care education/resource materials to individuals and community service providers.
- Re-establish and streamline the use of 811 as a 24-hour addiction and mental health telephone response line.
- Finalize the proposed draft Department of Health Suicide Prevention, Intervention, and Postvention Crisis Response Plan. Once finalized, implement accepted recommendations for suicide prevention, intervention and post-intervention.
Emergency departments
- Implement a standardized suicide care pathway for screening, assessment, intervention, safety planning and lethal means reduction for every patient who presents to an emergency department with suicidal thoughts.
- Expand the Education, Training and Knowledge Transfer Plan to include education for emergency department staff. This must continue to be a shared responsibility among emergency department and addiction and mental health staff.
- Develop and implement efficient and evidence-informed collaborative care models and care pathways to guide and support the care of individuals presenting to an emergency department with addiction and mental health concerns.
- Develop a plan to provide 24/7 coverage by the emergency department mental health care team.
- Expand the emergency department mental health care team with defined roles for professionals such as peer support, registered nurses, licensed practical nurses, social workers, and liaisons to the community.
- Ensure that the provision of specialist consultation by psychiatry is included in any collaborative care model or other care pathways.
- Continue the plan to implement a psychiatry resource strategy. Include consideration of the provision of emergency services in this strategy.
- Improve the environment for those presenting with addiction and mental health concerns at emergency departments by allocating space and defining other requirements to create a therapeutic environment, while maintaining safety features.
- Establish virtual emergency department mental health access locally and regionally. This recommendation is the key foundation to ensuring community hospitals have access to virtual mental health crisis care while presenting at emergency departments.
- Review options for optimizing the use of Mobile Crisis Services in supporting emergency departments and emergency department mental health care teams.
- Standardize the follow-up care process for all individuals presenting to the emergency department with addiction and mental health concerns. A “warm hand-off” approach is key to success.
- Standardize the transfer of information between care team members for every individual presenting to the emergency department with addiction and mental health concerns.
Community addiction and mental health services
- Provide funding to support staffing needs in both regional health authorities to address these two identified critical areas of need.
- Engage Integrated Service Delivery partner departments for a joint funding agreement to support Elsipogtog First Nation in the implementation of a team to support and provide services for children and youth.
- The Department of Health will support Horizon Health Network and the key stakeholders listed in the initial Saint John Crisis Care Centre project summary by funding a consultant project manager to develop a detailed business case and project proposal that captures and includes the anticipated effects of the recently released action items from the Interdepartmental Addiction and Mental Health Plan, such as walk-in clinics/single-session therapy and how these two projects intersect.
- Establish a mechanism that helps ensure that organizations requesting funds demonstrate an alignment with the overall Stepped Care Model and also ensures contracts are outcome-based.
