Territory struggles with ‘paltry’ mental health services

Dr. Rao Tadepalli has a word to describe the state of mental-health services in the Whitehorse General Hospital.

Dr. Rao Tadepalli has a word to describe the state of mental-health services in the Whitehorse General Hospital.

“It could be described as paltry. P-A-L-T-R-Y,” says the president of the Yukon Medical Association.

“It’s not critical. It’s not a war situation,” he said. “But it’s definitely a stress situation.”

Staffing, security and facilities dedicated to mental health in the hospital all fall short of what is necessary, said Tadepalli.

“What we’re asking for is the bare minimum,” he said.

Inadequate mental-health services have been the subject of Tadepalli’s criticism for four years.

He’s seen some improvements, such as the hiring of two psychiatrists. But the staffing of mental-health nurses in the hospital still falls short of a recommendation, issued by his association in 2007, that there be at least two such nurses on staff.

There is currently only one mental-health nurse on call, he said.

Other support staff, such as social workers —  the hospital has one — are also badly needed, he said.

Mental health matters because, by Tadepalli’s estimate, one in five patients treated at the hospital suffer from some form of mental illness, which may range from clinical depression to schizophrenia.

Sometimes the mentally ill abuse alcohol and street drugs to self-medicate. Booze and drugs can trigger episodes of psychosis and other symptoms of mental illness.

The tangled knot of drug and alcohol abuse and mental illness is “a huge problem” in the Yukon, said Tadepalli.

The hospital’s emergency room is, for many, the default place to seek detox treatment. This creates big backlogs in hospital services.

What are the consequences of inadequate services? Tadepalli points to the number of alcoholics who freeze to death in snowbanks each year.

The hospital also needs a dedicated psychiatric ward, he said. Currently, most of the mentally ill are scattered among other patients, he said.

There’s only one secure room to keep the acutely mentally ill. There should be more, said Tadepalli.

There also needs to be more security, for when mentally ill patients become violent.

Staff are fearful of being attacked. Some are hit by patients. Others receive threats. There may be no guard nearby.

Most government workers are not subject to violence, or threats of violence on a regular basis. Doctors and nurses should be no exception, said Tadepalli.

But Tadepalli fears what may happen if he may get what he wishes. A hospital with a secure psychiatric ward may be viewed by the courts as a better place to send inmates suffering from mental illness than Whitehorse Correctional Centre.

He doesn’t want anyone confusing the role of the hospital. It’s not a jail, or an asylum.

“Whitehorse General Hospital is not a substitute for an adequate prison facility,” he said. “We’re trying to provide basic care.”

Improvements could also be made by amending the Mental Health Act. When an acutely mentally ill patient needs to be sent Outside, a lengthy procedure must first be followed, which takes around 60 hours, said Tadepalli.

Free beds in Outside institutions are hard to come by. And, when found, it’s not always possible to hold them as long as is currently needed.

“That’s an added stress for us,” he said.

Contact John Thompson at johnt@yukon-news.com.