Island Health has made improvements to psychiatric emergency services since a man injured himself in a suicide attempt in 2007, a few days after seeking treatment at the Royal Jubilee Hospital, but people suffering from mental illness are still short-changed by the health-care system.
That鈥檚 not because medical personnel don鈥檛 care or aren鈥檛 professional, but because mental-health resources are in short supply.
The sa国际传媒 Supreme Court ruled last week that a psychiatric nurse, an emergency physician and the health authority were negligent in the assessment and treatment of Joseph Briante, but were not to blame for the man鈥檚 suicide attempt that left him severely injured. Briante and his mother Carol Briante sued the nurse, doctor and the health authority.
Briante, then 32, was brought to the hospital by his family on Oct. 29, 2007, because he was paranoid and delusional, fearing, among other things, that he would be sacrificed on Halloween.
The court was told that family members thought their concerns were dismissed by the nurse, and that she and the physician failed to collect enough patient history. The on-call psychiatrist was not called, and Briante was discharged. On Nov. 4, he cut himself severely, resulting in an almost total loss of blood to the brain, which left him impaired. A former lawyer, he will not fully recover his mental ability, court documents said.
While sa国际传媒 Supreme Court Justice Keith Bracken found the doctor, nurse and the health authority were guilty of negligence, he said Briante might have harmed himself even if he had seen a psychiatrist or been admitted to the hospital for treatment.
Briante鈥檚 family says the information they tried to give the nurse showed that he was in a 鈥渇irst break psychosis,鈥� where professional intervention would have made a vital difference.
Island Health says things have improved since 2007, and that it now works hard to include family members in clinical teams and planning. The health authority hired a nurse educator about a year ago for psychiatric emergency services to help maintain nurses鈥� core competencies.
The court looked at what happened, but the public interest demands a look at why it happened. Although beds were available when Briante was at the Jubilee, the lack of resources and chronic overcrowding too often means there is no room for mentally ill people in the hospital and insufficient services in the community.
鈥淩ightly so, governments have moved away from institutionalizing people with mental illness to a community approach,鈥� Victoria police Chief Frank Elsner said in June. 鈥淭he problem has been it鈥檚 been drastically underfunded for years. So I think what we鈥檙e seeing now is the result of that drastic underfunding.鈥�
People arrested under the Mental Health Act are often bounced among police cells, hospitals, overcrowded drop-in centres and then right back to the streets, a rotating door with few long-term solutions.
In Briante鈥檚 case, he had a supportive, educated family who were at the hospital and tried to advocate for him. If their concerns were ignored, how much harder is it for those who are entirely alone when they seek help?
Difficult though it has been for Briante鈥檚 family, other mentally ill people will benefit from their long search for answers. Better training and more consultation with families will make a difference. But the gap in services is still too great.
Not all those who are in pain have broken bones. Not all those who need immediate treatment are bleeding. Mental illness is real, it鈥檚 painful and it too often has tragic outcomes. Failing to provide the needed resources does not save money, but only pushes the costs 鈥� greatly multiplied 鈥� down the road.
