Healthcare in Durham…
The healthcare system in Durham is under a complete crisis, as it has been for over a decade. Oshawa has a minimal amount of mental health support, hospital beds, and crisis services. Youth services are extremely scarce in Oshawa with public programs being overflowed and patients being kicked out of programs too early so the system can get through as many kids as possible. I’m going to be focussing on Lakeridge Health in this article because that is where I have my most experience within the system. I spent years as an inpatient and an outpatient youth being transferred to several long-term institutions along the way and spent a total consecutive three years in Lakeridge Hospital as an inpatient in the past eight years. Lakeridge has the longest waiting list I have ever experienced along with overworked doctors, untrained nurses, and stigma against mental health patients. The silver lining I’ll give Lakeridge is its security team, I want to point out Jennifer and Roxy here who have been some of the best workers in Lakeridge health I’ve been in contact with…including social workers, psychiatrists, and doctors.
I don’t blame Lakeridge Health to any degree for its poor care…it’s a government issue with lack of funding, resources, and poor skills training. Lakeridge is doing the best it can with the resources it has and it’s simply not enough. Waiting lists to even see an emerg doctor is averaged around 4-8 hours for mental health patients. I’ve had several nurses approach me in my advocacy work and tell me their “horror stories” of people committing suicide in the emerg bathrooms. This shouldn’t be happening. Not only are the waitlists long but to get treatment the people (of all ages) have to prove the legitimacy of their illness and this often results in the safety AFTER a suicide attempt rather than preventative care. That’s not even mentioning the patient’s attempt has to be within their danger standards for admission. Patients shouldn’t have to hurt themselves to get the help they desperately need and should be praised for seeking that help in the first place. Psychiatrists at Lakeridge are some of the worst doctors I have ever worked with, with the exception of Dr Parmar, almost all psychs at Lakeridge are poorly trained and very scarce.
As a political philosophy, justice, and law major at McMaster University I’m taught how to see things from a neutral perspective bringing only facts, research, and philosophic evidence to the table. I’m in a program which will result in a law degree and I will specialize in the health sector. As law students, we learn to never be biased and in our anthropology training, we learn that fieldwork is essential. Unknowingly, I went through eight years of fieldwork at Lakeridge Hospital, emerged in the mental health system. My situation is rare because a lot of people that have received care from Durham services have found themselves homeless, institutionalized, or dead while I find myself getting my law degree to fight back for my friends that have received exceptionally poor care. My point in giving you my educational background is the fact that I will not be bringing my personal anger or bias to the article, everything stated is a fact and all of the staff names I state are real, however, patients have been changed for their confidentially.
Psychiatrists Trained to Enhance Stigma, Mandate Danger, and Ignore Cries for Help
I’m going to be focussing on several psychiatrists at Lakeridge Health, as I said before there are some who I sincerely thank for their help and hard work. From Dr Parmar who works all day and night to help every single one of his patients and make sure of their safety, to Dr Singha who referred me to one of the greatest treatment centres in Canada while ensuring my safety and wellbeing.
I will be honest, psychiatry is not an easy job and many patients make it extremely hard for both their doctors and themselves. I know several patients who hate certain doctors who are/were simply doing their job and refuse their recommended care that is necessary for their own recovery. However, this does not mean that their concerns are not valid nor’ does it mean these are good doctors. One doctor I want to point out is Dr Ravielle who is a psychiatrist in the pediatric unit for both inpatient and outpatient. She should have her license to practice medicine taken away due to her blame the victim tactics, blame the parents resulting in run-aways and children’s safety issues, she has misdiagnosed several patients I personally know including myself, denies patients trauma, scares transitional youth patients as a tactic for them to avoid and “just recover” before the adult psychiatry unit, overprescribes and then refusal to refill medications resulting in withdrawal symptoms in kids as young as eight-years-old, and her overall demeanour of superiority over her patients. This type of treatment in the pediatric psychiatric unit is absolutely not acceptable. When I was fourteen I was scared when she did rounds because she “didn’t believe” my symptoms while making me convince her of my sickness which resulted in silencing me on childhood trauma, prescribing wrong medication, and misdiagnosing me altogether.
The scary thing about this type of psychiatrist is the fact that they are found all around Lakeridge Hospital. I had a doctor tell me that because I had Borderline Personality Disorder (BPD) I wanted attention, therefore, when I went to emerg to prevent a suicide attempt she actually tempted me by saying “prove it” which resulted in me trying to jump off the top of the parking garage but I was stopped as soon as I started to fall by several police officers who grabbed me off the ledge and slammed my head into the pavement which resulted in a concussion. I was only 19 years old.
My best friend who inspires me daily to continue my fight for mental health/illness justice wrote a piece on her experiences through the system at Lakeridge Hospital:
The mental health system is not all that it’s made to be…not in Durham anyway. Waitlists to get help are years long, not all of the hospitals in Durham have mental health resources. Imagine having to go to the ER because of a mental health CRISIS, and being told you have to wait for several hours in a mental state that could explode at any second and then if you do feel the need for an admission to a hospital with a mental health unit, it doesn’t even mean you will be admitted because the harm you did to yourself is not severe enough for treatment.
Health care staff are honestly the worst for stigmatizing, dismissing and discriminating mental health issues ESPECIALLY when someone is in crisis. For example, multiple times I have been in severe crisis and in need of an admission to stay safe, but because one of my diagnosis’ is so stigmatized and misunderstood that anything related to it weather it be feelings or actions most hospitals will not admit me and just send me home which often results in some sort of severe self-harm in which an ambulance has to be called due to life endangerment or possibly worse a suicide attempt in which has resulted in my personal coma, stitches, and long medical journey.
When people go to the ER with a mental health crisis they go because they need help. You can be arrested underneath the mental health act and be brought to the hospital which can discharge right away even though you came in via the police. Little did I know though the last time I was brought to the hospital via police, when we got there I was met with a gurney with restraints on it which is typical…stigma solidifying my fate because I have a mental illness…that is not fair, and it is not right.
Nurses Ignore Patients Needs…
This one is probably one of the most aggravating parts of the system, even when I had visitors such as my parents to the unit they were shocked and disgusted at the nurse’s behaviour. Patients on the adult psychiatric unit at Lakeridge live in what we like to call a “bubble room.” There are cameras in the hallways and half the bedrooms, nurses have windows as walls for easy access, and the main lounge area is surrounded by glass walls and cemented tables/chairs for the patients…like a fishbowl. I personally don’t mind all of the glass walls and cameras because it does enhance safety and minimize conflict such as the panopticon theory created by philosopher Jeramy Bentham in the 1800s. However, it becomes a problem when patients line up outside of the nurse’s windows and are met with eye contact to simply be ignored as if they aren’t even there. A nurse will make eye contact and not even signal for patients to wait, she/he will turn around in their chairs and do things such as chat in a circle laughing, showing each other Youtube videos, and playing on Facebook. Patients will often leave or become agitated and knock on the window in which they are told to go back to their rooms because knocking is not permitted therefore waiting hours to ask a question as simple as “Can I get a glass of water?”
PICU and Misconduct
PICU stands for “Psychiatric Inpatient Care Unit” and is parallel to the community psych unit. PICU is for patients who need extra supervision and who suffer from more complex mental disorders. If you’ve ever watched the Netflix Series “Orange is the New Black” PICU would be the shoe. It’s the pits of the system and a place where the most misconduct happens against patients. The things I’ve seen in PICU are haunting, the things that have happened to me in PICU are haunting. I’m gonna put a trigger warning* here because PICU is where it gets really graphic.
The unit is built with 8 single beds, the rooms are small with the beds cemented to the floor with restraints attached, visiting hours are restricted to 20 minutes, security is stationed around unit 24hrs/day, security cameras are in every room except the bathroom in which doesn’t lock, have any sort of hot water, and is supervised. Nothing is allowed in this unit, no cell phones, TV, laptops or computers, street clothes, shoes, outside food, hot drinks, binders, pens, or pencils. I guess it would easier to tell you that we are provided with safety gowns, socks, crayons, and paper (with good behaviour we get colouring pages). Meds are supervised and dispensed, meals are also supervised and served cold with plastic spoons only, and all hygiene products are organic and digestible. The stay on this unit is usually only 3-8 days but people have been on the unit for months and there is the possibility for isolation in which you cannot leave your own room…even for the bathroom. I was in the unit with a 19-year-old girl who was put into isolation for two weeks. She wasn’t allowed to shower, she had to eliminate in a bedpan, she was restrained for most of the day, and all of her “bubble room” windows were blocked by shades, she wasn’t allowed to talk to anyone but the nurses dispensing her meds. My heart ached for her because every night I could hear her crying “I want to see my mom.”
I REALLY want to point out here that I am a normal looking university student who blends into the crowd, I have a part-time job at a coffee shop, I’m a certified yoga teacher, vegan, and groom dogs in my spare time…you wouldn’t take a second look if you saw me on the street and I was both restrained, detained, and isolated on this unit. Mental illness is not visible so do NOT assume someone is “crazy,” or “messed up,” based on appearance. On the opposite side do NOT assume people who look “normal” have never dealt with mental illness because we all have a history people know nothing about. People, such as myself, who would have been considered crazy can live absolutely normal lives.
I’m going to give you two examples of the misconduct on this floor and then leave it because I could go on for hours about the things that go on in this unit. The first example is when I was transferred to the unit from the community psych unit. I wasn’t being safe in the community unit so I was transferred to PICU in which I begged and begged to stay away from. Several hours later I was still on the community unit, walking to get my medication when a nurse stood in front of me with her legs spread, I turned around to see three nurses behind me along with two security guards. When you have six grown adults standing in fight mode around you…it’s scary to say the least. I was slammed to the floor as I cried for help and when I tried to stand up I was met with two male security guards holding my shoulders and my legs in mid-air. The guard holding my feet dropped them and I slowly fell out of the shoulder hold, the nurse that I saw in the very beginning grabbed my ankle and literally dragged me into the PICU unit (there is a door connecting the two units) and then my head was kicked in by a security guards foot. This is not acceptable behaviour, instead of talking to me about the transfer I was physically forced into the unit and intimidated by six staff.
The next example I want to touch on is an experience from the emergency room where I was restrained in 12-point for 48 hours, in which I received my period (I’m transmale and wasn’t going through hormone therapy at the time so I still menstruated) and I had to lay in my own blood for over 24 hours.
I’ll admit that I was a tough patient to deal with a lot of the time but when I was met with care I always listened. I’m a reasonable person who was terrified, sick, and just wanted it to end. I want to point out some staff who really did care and contribute to my recovery…
Jennifer Younger (High school guidance counsellor)
Jenn (Ontario Shores BPD Clinic Therapist)
Sara (Social Worker)
Roxy & Jenn (Security)
Dr Parmar (Psych)
Dr Snalegrow (Psych)
Dr Fletcher (GP)
Sadly since I’ve seen dozens upon dozens of nurses I don’t remember every single one of their names but here are some happy experiences that happened throughout treatment that still reside with me…
- A nurse at Ontario Shores took me for a walk off the unit and linked her arm around mine as we walked. This wasn’t done as any part of restraint but was done out of care. Feeling the warmth of someone else is so powerful when weeks go by without any contact with other human beings. I could tell she cared.
- Wayne brought the adolescent unit down to the kitchen one Christmas to bake cookies together which brightened my day and I remember every Christmas. Being on the psych unit we aren’t allowed to recieve gifts at Christmas so baking cookies was really wonderful.
- A nurse came into my isolated room once every hour on the hour to check on me with a smile on her face…in isolation people tend to avoid the patient but this nurse came in with a happy voice and smile that brightened my day
- A nurse taught me how to belly dance on CAIP!
- The nurse and dietitian at my outpatient eating disorder treatment always went the extra mile and both followed and supported my advocacy work.
- I was playing TheSims on my PS4 on CAIP as a distraction when Steve sat beside me and watched me play. We didn’t talk and it wasn’t awkward. Just having him accompany me made me feel safe and calm.
I am Gordon “Gordie” Ireland, I have been dealing with PTSD (Post Traumatic Stress Disorder) since 1986. I was sexually assaulted when I was 16 by a Neurologist (Dr. Waller) I never dealt with or knew I had PTSD until July 2015 when I ended up trying to commit suicide and landed in Lakeridge Health Oshawa hospital. While waiting in emerge for a bed I tried cutting my left arm with a plastic knife.
I was on the Mental health unit for a little over two (2) weeks, I was only allowed to stay for a maximum of 3 weeks due to the lack of beds and the large demand of patients needing a bed. In my opinion there is not enough Mental health beds for all of the people dealing with mental health issues. There was a couple of Psychiatrists that were there for the money only and not for the patients, the Psychiatrists were also pill pushers instead of listening to their patients they would write a prescription and say, “here you go take these and you will feel better”. I feel that isn’t dealing with the issues causing the mental health problems.
There is also a nurse there that all of the patients despise as she is miserable, doesn’t care what or how she says to patients. She also likes to get patients to lose their cool so she can put them into the lockdown area for severe mental health disorders.
Once I was released I found there was nothing for men who have been sexually assaulted, however, there is loads of places for females. This I believe is unfair to males.
In conclusion, I believe there should be more mental health beds, better Psychiatrists, better nurses or a code of conduct that nurses should have to follow and also more help for males that have been sexually assaulted.
Thank you in advance for your time
The reason I originally wrote this article was to talk about the upcoming 2018 election, challenging Ontario’s leaders on what they are/would do for mental health if elected. I did research on every party and found many goals for the mental health system in Ontario but they lacked a plan…it’s easy to say something and completely different to actually plan/do it. I’ve created a list of possible routines that if put in place could help the mental health system in Ontario and maybe even Lakeridge.
- Make mental health training essential for ALL hospital staff…no matter the unit
- Hire more emerg staff for mental health. Crisis staff are being overworked and it’s showing.
- Add a mental health unit in the student curriculum as young as possible that emphasizes coping, disorders, and stigma
- Provide mental health staff with training and positive reinforcement with NO tolerance on misconduct
- Provide GP’s, Psychs, and all outpatient medical teams with easy access to resources and referrals
- Check up on the psych unit WORKERS mental health…their job is not easy
- Mandate a 12 week limit on referral response times WITH penalty
- Create more inpatient eating disorder programming throughout the province (TGH is not enough for an entire province)
- Create walkthroughs throughout mental health hospitals and organizations making sure there is no misconduct, deadlines are being met, and mandate patient surveys (even if it’s once per year)
- Create crisis centres in areas with overcrowded hospitals such as Oshawa
How Am I Qualified to Make This Argument?
I’ve been put through the mental health system for several years, after spending three years on the pediatric psychiatric unit at Lakeridge Hospital I was transferred to Ontario Shores (OS) where I was treated in the long-term inpatient pediatric psych unit (the unit has since been closed). A couple years later I was sent to Toronto for treatment where I spent over a year on the eating disorders unit at Toronto General Hospital (TGH). Soon after my discharge from TGH, I was transferred to Homewood Health Centre where I received treatment for benzodiazepine and alcohol addiction, within my time at Homewood I was transferred again to the complicated psychiatric unit for my core diagnoses of Borderline Personality Disorder. This process took around eight years to finally make it to where I am today as an outpatient who attends McMaster University majoring in Justice, Political Philosophy, and Law. I was lucky enough to receive several grants to Ryerson University a couple years ago where I spent time in the Radio and Television Arts program and the Not-For-Profit, Voluntary business sector. Throughout my time in the Canadian mental health system, I was admitted to several other hospitals for short-term stays such as Centenary Hospital, PineWood Health Centre, CMHA Group Housing, The Gerstein Crisis Centre, and several outpatient clinics including Carea, ED Program, CYFP, The Wellness Centre, The 519, The Mindfulness Clinic, and Ontario Shores BPD Clinic.