Sébastien Lagacé, the associate vice-president of mental health and addiction at Vitalité Health Network, has raised significant concerns regarding the impact of unnecessary hospitalizations on both patients and psychiatric staff in New Brunswick. In a recent interview with Gayle King, he described the struggle that people with mental health problems go through. The absence of a sufficient array of community housing alternatives pushes them to suffer longer hospitalizations than necessary.
Lagacé shone a light on a critical problem at the Restigouche Hospital Centre. Almost half of the patients are medically cleared but can’t go because there are not enough openings in community housing. This leaves patients on the receiving end of crushing, unrealistic expectations to rejoin the community as soon as possible. It confounds the healthcare providers who are charged with their care. Insufficient community resources trap patients in a cycle of prolonged hospitalization. Lagacé emphasized that we’re not just hurting individual patients with this situation – we’re hurting the whole psychiatric system.
Challenges in the Housing Market
On the interview, Lagacé pointed out the key problems affecting the rental and housing market. These problems especially impact people with a past of receiving psychiatric treatment. The stigma surrounding mental illness poses another barrier to obtaining and maintaining housing, leaving these individuals in a constant cycle of uncertainty. “The fact that they’ve been into a psychiatric institution creates a barrier for them to reintegrate into society,” Lagacé explained, emphasizing the need for supportive housing options tailored to the needs of these individuals.
He pointed out that government’s response to address this shortcoming has been lackluster at best. Much work to be done. Some progress has been made, for example the opening of new public housing developments and two supportive housing complexes in Moncton. All of these measures go just partway in addressing the growing demand. “Actual high-support housing options for folks with mental illnesses, we don’t have them in the province,” said Julia Woodhall-Melnik, a mental health advocate who echoed Lagacé’s sentiments.
That continued fight to marry healthcare and housing resources has continued to leave the most vulnerable people in our communities with little to no options. Lagacé expressed frustration at this disconnect, stating that “governments struggle to combine health and housing resources.” This gap contributes not only to the well-being of patients, but to the increased burden of costs for healthcare systems.
The Impact of Extended Hospitalization
The impact of longer hospitalization goes beyond the patients themselves. They hurt healthcare workers too. Lagacé stated that it is difficult for employees to see patients stuck in the system. These patients often lose their chances to flourish in our communities. “It’s difficult for employees to see patients being stuck in the system and not being able to flourish in society,” he stated.
Long stays in psychiatric hospitals are not uncommon and can be disheartening. They negatively impact patients’ mental health when these same patients would flourish in a less restrictive, more nurturing residential community. “The improvement that they experience gives them a chance…to start to build a life despite maybe the continuation of mental health symptoms,” Lagacé noted, emphasizing that timely reintegration is crucial for recovery.
In addition, the cost burden associated with avoidable inpatient stays is daunting. Mental health advocates have long noted that hospital care is the most expensive type of treatment. Julia Woodhall-Melnik remarked, “The financial implications are devastating…the most expensive form of care is hospital care…the dollars and cents don’t make sense there.” A common belief among thought leaders and experts is that we can deliver better care at lower cost by investing in community-based resources.
A Path Forward
Lagacé thinks an answer might be out there. To do that, he envisions assigning Flexible Assertive Community Treatment (FACT) teams to each individual living in supportive housing units. This approach could facilitate smoother transitions for patients moving from hospital settings to community living, providing them with the support necessary for successful integration.
“The role of the staff is to treat them to make sure that they can reintegrate into the community in a timely manner,” he explained, highlighting the importance of structured support during this transition phase. These efforts would go a long way in easing the burden now felt both at mental health facilities and by patients themselves.
Conversations to add more community resources are still in the works. Nevertheless, stakeholders still hope that bold action will address these urgent concerns. We remain in active conversations to hopefully increase the spaces available. These spaces might be like the ones we just recently funded.
