Mental health centre struggles to divert patients from ERs

A mental health crisis centre that opened in Winnipeg earlier this year has not diverted as many patients from emergency rooms as officials had hoped, CBC News has learned.

Whenthe $12.3-million Mental Health Crisis Response Centre had its grand opening in May,officials said the facility would ease the pressure on ERs, which see more than 10,000 patients with mental health concerns each year.

The Winnipeg Regional Health Authority (WRHA) told CBC News it had hoped the crisis centre would reduce traffic to emergency rooms by 50 per cent over two years.

However, more mental health patients have been going to ERs since the centre opened, according to WRHA numbers obtainedunder an access-to-information request.

Between June and September 2012, the emergency room at the Health Sciences Centre had 895 patients visit with a mental health complaint.

In the same period this year (June-September), 936 patients went to the HSC emergency room with a mental health complaint.

• Document:Number of patients who present with mental health symptoms at the HSC ER from April 2012 to September 2013

"The numbers right now don't show a decline," Dr. Murray Enns, medical director of the WRHA's adult mental health program, said in an interview.

"We would obviously like to see more decline in those numbers. What it attests to is the fact that there was a lot of unmet need."

To date, there have been roughly 2000 visits by patients to the centre.

Psychiatrists have left in past year

The crisis centre is available 24 hours a day, seven days a week, and staffed by mental health professionals who can handle suicidal behaviour cases, emotional trauma assessments, crisis interventions and immediate risk assessments.

The centre is located adjacent to the Health Sciences Centre and staff work closely with the hospital's emergency room.

CBC News has also learned that 12 psychiatrists have left the health region in the past year, with two citing the crisis centre as a factor.

A WRHA briefing note from this past summer identified the "diminishing numbers of community hospital psychiatrists combined with the need to address psychiatric coverage of the new Crisis Response Centre" as an issue.

The WRHA admits that it struggled to staff the centre at first, as many new recruits did not want to work on evenings and weekends.

The health authority has since recruited 10 new psychiatrists, according to officials.

Psychiatrists at the CRC are paid a contractor rate of $173.40 per hour with a 40 per cent top up for any call back hours. The WRHA says there are only 3 other roles in which psychiatrists get that rate, including those working in the Shared Care Psychiatry program with family doctors, those working at Psychiatry Urgent Referral Clinics and with PACT, assertive community treatment teams.The contractor rate used by the WRHA is negotiated on behalf of physicians by Doctors Manitoba.

The WRHA says the team sees anywhere from five to 25 patients per day and that 14 per cent of people showing up at CRC are seen directly by a psychiatrist. It says psychiatrists provide indirect care by working with the social workers and nurses on the front lines at the CRC.

Chris Summerville, executive director of the Manitoba Schizophrenia Society, says numbers aside, the centre has been getting good reviews from clients.

"People who were going to emergency room in a mental health crisis were having to wait long periods of time seven and eight and 12, 15 hours," he said.

"We now have this facility in which people are seen quicker and faster. They've created a safe, welcoming, empathic environment."

The WRHA says it hopes to increase the number of patients going to the Mental Health Crisis Response Centre.

Number of patients going to ER

Below are the Winnipeg Regional Health Authority's numbers, obtained by CBC News through an access-to-information request, on how many patients with mental health symptoms went to the Health Sciences Centre's emergency room for each month between April 2012 and September 2013.

Read the psychiatry briefing note

Below is a WRHAbriefing notediscussing the "diminishing numbers of community hospital psychiatristscombined with the need to address psychiatric coverage of the new Crisis Response Centre."