‘Do no harm’: Psychiatrist hopes lessons are learned from Restigouche Hospital Centre probe

A seclusion room inside the Restigouche Hospital Centre is pictured.

Dr. Karen Shin says the details released about the treatment of patients at New Brunswick’s Restigouche Hospital Centre are “extremely distressing” ands she hopes the system learns from those mistakes.

The chair of Ontario’s Psychiatric Association and chief of psychiatry at St. Michael’s Hospital in Toronto says seclusion rooms and restraints should only be used if every other de-escalation or therapeutic method has been tried.

New Brunswick Ombud Marie-France Pelletier released the results of her latest investigation into the facility this week, looking into the use of restraints and seclusion rooms after her office received 12 complaints from patients at the Restigouche Hospital Centre in Campbellton, N.B.

Those complaints described being restrained in seclusion rooms for hours and sometimes even days at a time. The patients said they weren’t allowed to leave to use the bathroom, so they had to urinate and defecate in cups or pillowcases and were not always offered meals or water.

Some described unsettling accounts of being in a state of undress in front of staff.

Dr. Shin says patients who are seeking help are often already at their most vulnerable – and sometimes “fearful of engaging in mental health services because of stigma.”

That’s why it’s critical they are treated with dignity, she says.

“What really struck me is the, the oath you take, that I take, as a physician, is to do no harm,” she said in an interview with CTV Atlantic. “And when we are thinking about our individual care, when we’re trying to create systems and hospital-based policies, is to ensure that we do no harm.”

She advises taking a ‘sober look’ at the recommendations, so care is improved – and to bring back trust in the system.

“Because I think that that’s, you know, really going to be required within the hospital and within the community to say that, you know, we can have the trust that concerns will be heard and also that the care will improve,” she said.

She says, in her experience within a hospital setting, checks and balances are critical and must be consistent when seclusion rooms or restraints are used.

Because those methods “are not the goal.”

“It’s actually used in times when it might be unsafe for patients or might be unsafe for other patients that are admitted or other staff members. It’s always with a sense of safety that’s required,” she said.

“But even when it is used, we have to ensure that care, treatment, attention, proper follow-up is all instituted within the plan. And I would say even more so because we want to ensure that when we’re making some choices that are extremely restrictive for patients, that they are being attended to and feel that we try to maintain that therapeutic alliance.”

The New Brunswick government and health authorities have accepted the Ombud’s recommendations and say they have already undertaken a number of them, specifically better monitoring of patients while in seclusion rooms.

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