Quebec introduces new measures to cut down on psychiatric hospitalizations

New plan to reduce mental health hospital visits Quebec announced a plan to reduce the number of hospitalizations and ER visits for people experiencing a mental health crisis.

Being admitted to a psychiatric hospital can sometimes be a traumatic experience for people with mental health issues – and to that end, the Quebec government has announced new measures to prevent and avoid those stays.

Social Services Minister Lionel Carmant was at the Douglas Mental Health University Institute in Montreal on Monday to announce three new initiatives as part of the 2022-2026 interdepartmental mental health action plan.

The plan focuses on prevention and options for avoiding psychiatric hospitalization. The document notes that, for many patients, hospitalization is “a negative, stigmatizing experience which, if prolonged, will hinder their self-determination, autonomy and recovery process.”

Described as "promising," parallel paths are being proposed to prevent or reduce the length of hospitalizations.

"The more we can follow them in their living environment, the better," said Carmant. “That's the shift our government wants to make.”

There are three measures presented in the plan:

RAPID RESPONSE TEAMS

Specialized rapid response teams and community mental health relays will welcome and accompany patients experiencing a crisis episode after they are discharged from the emergency department.

“What we really want is for mental health care in emergency departments to be specific to mental health," explained Carmant. “With a specific intake, an assessment that's not necessarily done by the emergency physician, but by a dedicated team — and with follow-up in the community — we'll ensure better fluidity and avoid service breakdowns.”

Carmant would like to see this approach implemented throughout Quebec within 18 months.

INTERVENTION UNITS

The second proposal involves "brief psychiatric intervention units." This involves taking in patients for very short stays during a crisis episode. More specifically, the Douglas Institute has 12 beds reserved for patient care for 48 to 72 hours “in order to resolve the crisis and facilitate a return home.”

Echoing the minister's comments, Dr. Amine Saadi, director of mental health and addictions programs at CIUSSS de l'Ouest-de-l'Île-de-Montréal, spoke of a philosophy of intervention in the patient's environment.

“The sooner they return to their natural social environment, the better for their recovery process," he reiterated.

“On the other hand, it certainly puts less pressure on our emergency departments, on our care units, and we can also have early discharges to home hospitalization," said Saadi.

INTENSIVE HOME TREATMENT

That’s exactly what the third measure proposes — to offer “brief intensive home treatment" with the help of the patient's own support system. This ensures that patients receive all the same services, but in their own homes.

Since last month, the Douglas Institute has been offering all these options to patients when their condition allows it. For the moment, the focus is on people with mood disorders, anxiety disorders and psychotic disorders.

In addition to CIUSSS de l'Ouest-de-l'Île-de-Montréal, of which the institute is a part, CIUSSS du Centre-Sud-de-l'Île-de-Montréal is the only other region to offer all these services.

Five other regions have begun to roll out the three measures at their own pace. They are CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, CIUSSS de la Capitale-Nationale, CIUSSS de la Mauricie-et-du-Centre-du-Québec, CISSS de Laval and CISSS de l'Outaouais.

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-- This report by The Canadian Press was first published in French on Oct. 30, 2023. The Canadian Press health content is funded through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.