Patients spent days restrained in seclusion rooms at Restigouche hospital: N.B. Ombud report

A new report says a psychiatric hospital in Restigouche, N.B., used seclusion rooms and restraints.

The New Brunswick Ombud is recommending major changes after 12 complaints were made to the office between 2021 and 2023, describing unsanitary conditions while restrained in seclusion rooms at the Restigouche Hospital Centre.

The office reviewed about 950 hours of video footage, much of it surveillance video from inside the hospital, which is a specialized mental health facility that provides medium and longer term psychiatric help for New Brunswickers who suffer from complex mental illnesses.

The hospital also provides forensic psychiatry, which includes fitness-to-stand-trial assessments.

Ombud Marie-France Pelletier released her findings in front of a legislative committee Tuesday morning, saying she has been “personally troubled and saddened by the treatment and living conditions that some of these patients suffered through.”

Pelletier says it’s not a single procedure or policy or provincial organization that’s to blame, but an “entire system that is under pressure.” Her report looked at the use of restraints at all adult psychiatric centres in the province, but all the complaints stemmed from patients’ experiences while at the Restigouche Hospital Centre.

Her investigation found some patients spent long hours and days in restraints, often inside a seclusion room where patients are taken if they are “in crisis.”

Those patients were from “all walks of life and from every corner of the province,” with some sent to the hospital for a legal/forensic evaluation related to a criminal matter, while others had lived in the Restigouche Hospital Centre for many years.

The report describes these rooms as “bare, locked rooms, furnished with institutional beds that are equipped with physical restrain equipment …frosted windows for natural light and fluorescent ceiling lights that can be turned on or off from outside the room. There are no toilets or sinks.”

Patient spent 12 days in seclusion room: report

The 12 complainant’s stories are included in the report. In one complaint, “Adam” (name changed to protect the individual’s privacy) described being placed in the seclusion room for “what felt like a week.”

The investigation found, over the course of 16 days, Adam spent 324 hours in the room – including 12 consecutive days.

“Video footage shows Adam urinating at least 20 times and defecating into a cup inside the seclusion room because he was not provided an opportunity to use a toilet. RHC staff were aware of the state of Adam’s room and took no action to ensure cleanliness,” read the report.

At one point, staff pulled down Adam’s pants while he was restrained. He laid like that for seven minutes in front of six staff. It was all caught on video surveillance and reviewed by the office of the Ombud. This incident was referred to the RCMP, although no charges were ever laid.

Other complaints described difficulty eating due to the restraints. Some of the incidents did result in disciplinary measures, according to the report, including termination.

During the legislative committee Tuesday, New Brunswick Green Party leader David Coon asked Pelletier if she was given any reasons why these situations had to happen.

“The reasons why for me in some ways is irrelevant,” she told the committee. “It just shouldn’t have happened. There’s no reason for that to happen.”

Other complaints described difficulty eating due to the restraints. Some of the incidents did result in disciplinary measures, according to the report, including termination.

The report did identify moments of empathy and staff deploying the appropriate policies.

The recommendations include a look at the policies surrounding the use of restraints, de-escalation techniques and force techniques – like spit-hoods.

It also advised public health authorities to better equip seclusion rooms with a “reliable mechanism” for patients to communicate with staff, as well as hygiene essentials.

Another recommendation includes the establishment of a task force to address obstacles that might be keeping patients from community placements.

Health networks commit to ‘lasting change’

In a statement by Vitalité Health Network, which operates the Restigouche Hospital Centre, the healthy authority’s associate vice-president of Mental Health and Addiction calls the situations described in the report “unacceptable.”

Sébastien Lagacé says the authority has been working closely with the Ombud in reviewing “our approaches.”

“Upon my arrival in 2023, we undertook a major shift in our mental health services to modernize practices and reduce the stigma that has persisted for decades. Tangible progress has already been made, and the use of restraints has been significantly reduced,” Lagacé said. “We accept all the recommendations made and will continue the transformation we have begun to place prevention, dignity, and recovery at the heart of our care.”

Lagacé offered a “firm commitment” to bring about lasting change.

Pelletier’s investigation looked at all adult psychiatric facilities in the province, which included Horizon Health Network centres.

Horizon’s CEO Margaret Melanson said the network has also reviewed and accepted the recommendations.

“We will be undertaking a comprehensive review of the recommendations to develop a detailed action plan that will guide necessary improvements to our programs and processes,” Melanson said in an emailed statement.

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