Aug 22 2008
Why Critical Thinking is ESSENTIAL
Hospital stays shorter for mentally ill (thanks, C.M.)
Now, if you didn’t read any further, you might think that fewer people are drinking and driving and that mentally ill people are receiving more efficacious treatment–and possibly getting better help/support in the community. However, reading a bit further also reveals:
- The number of provincially funded RIDE spot checks have fallen off. Police checked 505,000 cars, boats and snowmobiles last year, compared with 616,000 checks in 2001.
- Robert Solomon, professor of law at the University of Western Ontario, said impaired driving charges may be going down but there has been little change in the number of deaths and injuries at the hands of impaired drivers (estimated by Mothers Against Drunk Driving at 60,000 people per year in Canada)
- Police are laying fewer formal charges because the laws are too complicated and leave officers drowning in paperwork, Solomon said. It takes police almost three hours to process a single case, only to watch the charges get backlogged and pleaded down in court, he added.
- “So basically what you have is a growing de facto decriminalization of impaired driving,” Soloman said. “What is supported by the research is the growing reluctance of police to lay the charge and the incredible burden on Crowns.”
- Other countries, particularly in Europe, do a better job than Canada, Solomon said. Many have lower blood alcohol limits, conduct random roadside breathalyzer testing and automatically test for alcohol following a serious accident, he said. “They take drinking and driving seriously and they enforce it rigorously,” Soloman said. “We don’t do that.”
As for the mental health issue:
- Drop (in hospital stay [for psychiatric patients]) reflects greater pressure on health system and is not a good-news story, officials [physicians and consumer advocates] warn
- There are fewer mental-health patients admitted to hospital per capita than five years ago. For those who do seek treatment, the average stay has plummeted 55 per cent, to 16 days in 2005-06 from 36 days in 2000-01.
- While the report did not include data to indicate levels of patient health at the time of release, it did reflect significant changes in the treatment of mental disorders, which have largely shifted from the realm of psychiatric-specific care facilities, where the most common length of stay is 26 days, to general hospitals, where the most common stay lasts eight days.
- “If people don’t understand what’s behind the numbers, they’ll think this is a good-news story. That worries me,” said Phil Upshall, national executive director of the Mood Disorders Society of Canada.
- Patrick White, president of the Canadian Psychiatric Association, said the drop in patients’ length of stay reflects overall “pressure on the system.” Because of hospital bed shortages - or inefficient use of beds allocated for psychiatric care - patients are being discharged more quickly even though they are sicker and more unstable than in the past, he said.
- While 16 days may seem like a long time to spend in hospital…for a patient with chronic schizophrenia who suffers a relapse, it is much too short…It should probably be a least 30 days, but there is pressure to free up the bed for someone else.
- Hospitals and hospital administrators have traditionally discriminated against mental-health conditions and people with them. That’s principally because of, in my view, the stigma attached to mental illnesses,” he said.
- “They’re discharging people into the community without the necessary supports. You would never discharge a patient with a broken back in need of a wheelchair without a wheelchair.”