GBGH pushing for new 36-bed, $100M mental health wing

Local residents are underserved in one key area of healthcare.

And that’s something the folks at Georgian Bay General Hospital say they want to change. The Midland hospital has made adding a comprehensive acute mental health program a key priority as it heads into a new year.

“The first patient I saw here was for a Form One (assessment under the Mental Health Act), there were concerns of self-harm,” says GBGH chief of staff Dr. Vik Ralhan, who began working at GBGH 13 years ago.

“Since then, not a shift goes by that I haven’t seen someone here under the Mental Health Act.”

Ralhan says many patients who arrive at the hospital’s emergency department often have other underlying medical issues or vice versa.

That means that while medical staff are treating one healthcare issue, such as occurs with a cardiac patient, that person’s mental health is being left untreated since GBGH isn’t a “schedule one" facility.

“We make sure they’re safe, but they have to go somewhere else for that (treatment),” he says, noting medical staff’s hands are tied in the amount of care a patient exhibiting mental-health issues can receive. It’s not a holistic approach to care.”

Ralhan says mental-health concerns affect all ages and should be treated on the same level as cancer and cardiac issues.

“This is not just a Midland problem. It’s a provincial problem, it’s a Canadian problem,” Ralhan says, noting the hospital hopes to get ministry approval to eventually operate 18 acute mental health beds.

“These are new beds that we need in the region.”

Currentl6y, GBGH cares for approximately 1,700 mental-health patients every year. This works out to about three patients in crisis every day.

Some of those arriving at the hospital are Form One patients, which means they have to stay at the hospital until they can be transferred to an accredited mental-health unit.

The problem, according to hospital officials, is that the hospital doesn’t have acute mental health services and is not equipped or funded to care for mental health patients.

Therefore, when a patient arrives in crisis at the hospital, the emergency room is the first point of contact. From there, he or she will be transferred to an acute mental health bed at Royal Victoria Regional Health Centre, Orillia Soldiers’ Memorial Hospital, Waypoint Centre for Mental Health Care or, due to lack of beds, sometimes even farther afield.

However, when beds are full across the region, which is common, patients must wait at GBGH until an appropriate bed becomes available — sometimes for days — delaying care and contributing to a worsening of their mental-health state.

Ralhan says that while mental health issues have always been present in many coming to the hospital’s emergency department, the number of cases has skyrocketed in the past few years and now represents about 40% of all patients.

“The pandemic showed that more people are suffering,” he says, noting issues affecting those heading to the emergency department can range from psychosis to self-harm.

“For us as physicians, it’s about trying to break down barriers to try to designate it.”

GBGH president and CEO Matthew Lawson says the hospital has submitted a detailed schematic to the ministry that identifies projected patient volumes and the projected square footage needed for the new unit.

If they gain approval, hospital staff would then work through the tendering process and work closely with mental health experts, according to Lawson.

If everything went well, Lawson says they hope a new 66,000-square-foot unit could be operational within the next few years. The total cost of the project would be $100 million with the province picking up 90 percent of capital costs.

“It would have dedicated space for inpatient and outpatient services,” he says, noting the new unit would be built as a wing attached to the existing hospital.

“It would also include a large amount of outdoor green-space. Sometimes, that connection with nature is very important.”

Besides the aforementioned 18 acute beds, the new unit would have 10 geriatric beds and eight beds for a specialized psychiatric intensive-care unit.

“It would bring us up to 150 beds as an organization,” Lawson says.

Lawson says that under the current system patients are left playing the waiting game in a less than ideal setting.

“They’re in an off-white room with an exam bed,” he says, noting Simcoe Muskoka has the second longest wait time in the province for a mental health bed.

“They’re not receiving any (mental-health) care and we’re asking them to sit and wait. There’s not enough capacity within the entire system for those suffering with mental-health issues. We know that it’s a lifelong illness.

"We recently had a patient waiting here over 100 hours to see a psychiatrist. That's not helping them get any better and, in some cases, it's escalating their condition because they're not getting the care they need."

The need for an acute mental health program was the inspiration for the hospital foundation’s recent gala focusing on mental-health awareness and advocacy.

And this is where foundation executive director Nicole Kraftscik decided to share her own story of mental illness and recovery with a wider audience beyond close friends, immediate co-workers and family.

“I remember the moment (friend and colleague) Jen Russell came in and we decided that I would talk about it for the gala,” Kraftscik says. “It was really important.

“People are getting lost in this system, and people are suffering. And, whether it’s your neighbour, your grandmother, your father, or brother or sister, mental health does not discriminate.”