Crisis at the Crisis Response Center – Winnipeg Free Press

Staff at a Winnipeg mental health center are asking for more resources and security because of chronic understaffing and high numbers of patients in severe crisis, sources say. Free press.

At the Health Sciences Center's 24-hour crisis response center, staff have been concerned for their safety and the safety of patients for years, but Shared Health did not do enough, sources said.

“We want to help patients, but we don't think it's safe for patients to be there,” one health source said. “It's understaffed almost every day, and the acuity (of patients in crisis) is unprecedented.”

“We want to help patients, but we don't think it's safe for patients to be there.”– Employees, shared health

Some patients attack or threaten staff and guards.

The source said many clients say no to long waits at the inner-city facility, which is not a secure site and does not have enough closed or isolated rooms for patients awaiting involuntary psychiatric evaluations.

When an involuntary patient leaves, staff are instructed to call 911 and not to physically restrain them.

Trevor Farley, then 37, killed his parents and stabbed nursing supervisor Candice Shkwerek to death at Stephen Oaks General Hospital in 2021, leaving the crisis center despite being held involuntarily, a court heard.

After Farley was found not criminally responsible in October, Shkwerek said more needs to be done to prevent people from leaving the center if they are a danger to themselves or others.

Other concerns were raised after a young man in crisis self-harmed inside the facility on May 11. He died the next day after self-harming in a hospital ward while recovering from surgery, sources said. Free press.

The man's death is considered a serious incident and is subject to an internal investigation.

Concerns about resources and security have been raised with Shared Health several times, the source said. They believe that bureaucracy and budgets are obstacles to change.

Employees are burned out, demoralized, and morale is low, the person said.

The facility on the HSC campus opened in 2013 as a central access point for adults in crisis. Patients are not admitted, but they may be detained while awaiting transfer to a psychiatric facility.

The source said the facility was inadequate for today's needs, in part due to the increased number of people seeking care, increased acuity, understaffing and only one closed room.

“(Some patients) wait days to be taken to the hospital,” the person said. “The center has almost become an emergency care center that doesn't have the resources to run it.”

“(Some patients) wait days to be taken to the hospital. The center has become an acute care center without the resources to manage it.”– Source

People who ask for help cannot be turned away, they added.

Standard operating procedure says the center should only have a maximum of two clients on a “Form 4” at a time — a request for an involuntary psychiatric evaluation — but three or more is common, the source said.

A source said the center was understaffed overnight and lacked 24-7 psychiatrist coverage. There is usually one security guard at any given time, despite at least two requests, they added.

“When clients come in, part of the screening questions is if they have thoughts of killing people, and most say yes,” the person said. “It's very scary.”

Mandatory overtime is another concern.

“When clients come in, part of the screening questions is whether they have thoughts of killing people, and most say yes. It's so scary”– Source

“It's hard to stay awake for 15 or 16 hours,” the source said.

Shared Health is working with staff to “develop processes to safely provide crisis services,” said Dr. James Bolton, medical director of crisis services and HSC's acute psychiatry unit.

“We are also looking at staffing levels for each shift,” he said in a statement.

Other steps, Bolton said, include “clarifying” the criteria and protocols when EMS personnel choose the most appropriate site for care and “streamlining” the notification process when an involuntary patient leaves without permission.

In 2019, a nursing student was sexually assaulted by a patient. The review led to changes to the building's layout, including a new security desk in the waiting room, new windows in patient rooms and security cameras, Bolton said.

The center has a total of eight assessment rooms, he said.

Health Minister Uzoma Asagwara said frontline workers want to do everything they can for patients.

“Listening to people and hearing critical incident reports will be key to how we can improve safety and improve care at CRC,” the minister said in a statement.

In the 2022-23 fiscal year, the Crisis Response Center and Crisis Stabilization Unit covered about 13,800 people.

Jason Linklater, president of the Manitoba Health Professionals Association, said clinical staffing levels have stabilized since the center opened.

“Public Health has not offered any additional resources despite the volume of people seeking help and the severity and severity of mental health problems, in part due to the methamphetamine crisis, but this has been a growing trend over the years,” he said in a statement.

Sometimes a full list of 15 patients receives care and up to 10 more are waiting to be evaluated, Linklater said.

Marion Cooper, CEO of the Canadian Mental Health Association of Manitoba, said the center will be community-based.

“It's really become a mental health ER facility. It wasn't designed to be a single resource, and it's become that,” he said.

Available services are limited, so people are often told to go to a crisis centre, Cooper said, noting that Manitoba has no psychiatric beds.

“All these cases indicate the need for a complete review of the crisis aid system,” he said.

Cooper said creating community-based and mobile services could help provide early intervention and take pressure off crisis centers that have struggled to recruit and retain staff.

CUPE Local 204, which represents health care workers, has raised concerns about staffing levels and safety on the HSC campus, said President Margaret Schroeder.

The Manitoba Nurses Union also demanded improvements.

“We know from the overwhelming number of nurses' reports that mental health and addiction issues place a huge demand on our health care system,” President Darlene Jackson said in a statement. “We also know that the current safety and security issues facing all healthcare facilities are a critical concern for patients and staff.

“When and where resources are inadequate, patients, staff and the public face greater risks and poorer overall health outcomes.”

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