'Crisis mode:' St. Joseph's Hospital doubling emergency psychiatric unit amid more meth use

A rise in meth use and the current opioid crisis have caused an "all-time high" in the demand for emergency mental health services at St. Joseph's hospital in Hamilton.

The growing meth problem in the city is also impacting community services like shelter networks and mission centres.

"It's heartbreaking," Dr. Peter Bieling, the vice president of mental health and addictions, tells CBC News.

He says the number of patients has steadily climbed by 10 per cent each year, with many coming from as far as Grimsby and Haldimand.

In 2019, about 4,000 patients visited them last year for emergency psychiatric care.

On average that's about 11 patients a day — but there are only 10 spaces in the ward. 

Now, the hospital is hoping to double it's space and give it a much-needed makeover.

St. Joseph's needs about $6 million to create the revamped emergency mental health unit. So far, it has raised $1.5 million and hopes to gather at least $475,000 from this year's Around the Bay race.

The plan will modernize a space that is archaic, unnecessarily harsh and has few boundaries for patients with drastically different needs.

'A nightmare scenario'

Bieling says they see just about every kind of patient you can think of in the unit.

"You see the classic mental health conditions like mood disorders and schizophrenia … and people who are brought in crisis, in handcuffs by police who are not people we can easily talk to right now because they're high on something," Bieling says.

"Lots of people with dementia, unfortunately can end up in a setting like this ... but we can also see somebody who's 20-years-old, home from university, tells mom and dad at Christmas holidays, 'school isn't going well and I want to kill myself.' "

Despite the vast difference in circumstances, all the current rooms, built 20 years ago, are made to handle the worse cases scenarios.

The hall is full of institutional-looking rooms with security cameras inside  — the bleak spaces wouldn't stand out in a prison. 

In some, a cold-looking mattress leans against a wall next to a giant patched up hole, feet away from a steel toilet.

Others have a single, teal chair and lights that don't work.

"Why these rooms look like this, I can't tell you anymore," Bieling says.

The hall normally has a smell, he says, and noise travels through the walls. When the room next to you holds a restless, screaming patient, you'll hear it.

Some people stay for three hours, but others stay for three days.

"It's a nightmare scenario for someone thinking, 'do I need to be on camera, do I need this hard wall and to have someone next to me who is pounding on the wall telling all of us to 'go f—k ourselves,' " Bieling says.

"Right now, they hear it and they might get to thinking: 'is that my future, am I going to be yelling and screaming or need to be arrested by the police?' "

When the unit is overloaded, staff have to push into the hospital's emergency department, which normally has about four beds open for them.

But that's not ideal if a patient is disruptive and scares other hospital patients.

Hamilton is in 'crisis mode'

Hamilton is already dealing with an opioid crisis, but the city says meth is on the rise at a far more rapid rate — and it is strangling community services.

The drug's inexpensive cost, paired with its psychotic side effects and withdrawal symptoms pose a serious problem.

Eleanor Harvey, the addictions services directors at the local Mission Services says the city's homeless population resort to the drug as a survival tool.

"Meth is a very powerful stimulant which will keep them awake so they're not falling asleep at night and if they're at risk of coming into harm, it makes them very vigilant," she says.

"They can keep track of all their belongings, it keeps you moving and it gives you a lot of energy so you don't feel cold, you can walk forever."

While the city says meth users aren't dying at the same rate as opioid users, it still hits the healthcare system hard. 

Harvey says the Mission Services have seen a "significant rise" in meth users and the Hamilton Urban Core Community Health Centre — a facility for the inner city — says Steeltown is in "crisis mode."

The Shelter Health Network is another ground-level buffer for St. Joe's.

The group of doctors offer daily in-house rehab and clinics in shelters to help people avoid the hospital.

"We're seeing an awful lot of mental health issues associated with drug use," Dr. Kerry Beal, lead physician of the network, tells CBC News, noting the numbers are some of the highest she's seen.

"When you're talking waiting times, there are certainly long lines to get our rehab facilities."

The problem will soon be amplified as the network is losing a site in Beasley on Ferguson Street, just north of Cannon Street.

The space is one of a few spots with harm reduction supplies and is the only site within the network that allows visitors to stay indoors all day.

Beal says they aren't sure where they'll relocate to, but the loss will displace people.

The wait times for some patients, Beal says, is "absolutely ridiculous."

A $6 million dream

The new floor plan at St. Joseph's would double the current space, featuring 10 new rooms. The staff quarters will sit in the middle of the two halls. One hall will hold more intense and disruptive patients and will have a separate entrance.

The renovation would fix up old rooms, sound-proof walls and also add spaces where patients could stay with their families — something the current facilities don't offer.

The construction will create a domino effect of disruption.

It would take over the hospital's fracture clinic, which would move to a different building and displace mammography, which will move to West 5th campus.

The two halls will also be built separately, which will also lead to the sound of hammering and drilling.

But Bieling says it's a small price to pay for a dire need.

The new facility is expected to be ready by the end of 2021.