Former patients say Whitehorse mental health unit is unsafe for patients and staff alike

It's supposed to be a safe place for people experiencing acute mental health episodes, but three former patients say the secure medical unit at Whitehorse General Hospital isn't safe for doctors or those seeking treatment alike.

In November, four psychiatrists withdrew services from the hospital after one of them was assaulted by a patient in the secure medical unit. The assault came just days after the psychiatrists warned the patient posed a risk to staff.

In a letter to the Yukon Hospital Corporation, the psychiatrists berated health officials for conditions on the unit and a lack of emergency training for staff. 

"[P]ractising 'inpatient psychiatry' here has been akin to being forced to do surgery in a broom closet without anesthesia," the doctors wrote. 

People who have undergone treatment at the secure medical unit say shortcomings at the current facility also put patients at risk.

'Nobody's feeling safe in this unit'

Syrena Oswald spent approximately three weeks in the unit following a manic episode in June 2019. Oswald said the first few days of admission allowed her to sleep, which helped her recover. But she ended up in a dispute with unit nurses who wouldn't allow her to phone anyone other than her sister (patients aren't allowed to have cellphones).

Oswald said when she walked out of her room, yelling the names and phone numbers of friends and family she wanted to speak to, unit staff made no attempt to calm her down.

"They grabbed me, threw me into this seclusion room, which I didn't even know was there, pinned me down and just injected a needle in my ass," she said. "And so, of course, I guess I passed out, I went to sleep and when I came to, I was really upset."

Oswald acknowledges she was being loud and aggressive, but said she was not being violent or threatening self-harm. She said she also received excellent care from some nurses and a psychiatrist. Still, she said, staff on the secure unit need more training in de-escalation.  

"Psychiatrists need to feel safe, all the staff need to feel safe, but the patients need to feel safe," she said. "And it feels now that nobody's feeling safe in this unit."

'Really dehumanizing'

CBC News also spoke with two other people who were admitted to the secure medical unit. CBC has granted both of them anonymity out of privacy concerns. 

One patient said the blanket cellphone ban contributes to patients feeling at risk on the unit. They said the ban means patients can't record wrongdoing by staff or look up medications they're being prescribed. 

The patient described an incident where an aggressive patient was threatening doctors and nurses, who locked themselves in the unit. The person said the patients, whose rooms cannot be locked, were left vulnerable.

The patient also described a general lack of psychiatric services. 

The patient said they've left the unit "against medical advice" because they felt unsafe. The Yukon Hospital Corporation has said it has added more nurses and plans to add more security staff to the unit, but the patient said that won't solve the underlying problems.

"We're all kind of on the same side, like nobody wants to see anybody getting beat up at work or as a patient, but the unit itself, how it's set up, has major problems," the patient said. "And I don't think just adding a security guard is going to be the solution to that."

They put their knee on my back, and then they put this big needle in my hip. I have no idea to this day what those drugs were, but I was out within, you know, the next 30 seconds.- Patient admitted into secure medical unit at Whitehorse General Hospital

A third patient who was admitted to the secure medical unit after having a manic episode said she was kept in one of the unit's two "seclusion rooms" because the other rooms were full. 

She said the seclusion room is "pretty much like being in jail" and triggered a panic attack. She said she still doesn't know if the staff who responded were nurses or security guards.

"They tackled me to the ground," she said. "They put their knee on my back, and then they put this big needle in my hip. I have no idea to this day what those drugs were, but I was out within, you know, the next 30 seconds."

"Two days later, I was seen by a psychiatrist and given more medication. And there really just isn't any treatment. And it was just really dehumanizing to be treated that way and thrown to the ground like that."

Despite her experience, the patient said she sympathizes with the psychiatrists who withdrew their services from the hospital. The doctors' letter said it had been 14 years since hospital staff had received Code White training for dealing with violent patients, though the doctors acknowledged it was scheduled to begin in early November.

"I find it really brave for them to stand up and say, 'No, we're not going to work somewhere where we're not safe,'" she said. "And I applaud them for it, honestly."

Expansion not a total solution, hospital CEO says

Through a spokesperson, hospital corporation CEO Jason Bilsky declined an interview request. 

But speaking to the Yukon Legislative Assembly's committee of the whole Nov. 19, Bilsky said the hospital corporation is well aware of the secure medical unit's shortcomings.

"The existing SMU is essentially a converted inpatient medical ward," he said. "It was never designed to fill the functions expected of it and it does result in some very real safety and quality care concerns." 

There are longstanding plans to replace the existing unit. In 2018, the hospital completed a $72-million expansion with a new emergency room and a vacant second-floor space for a new secure unit.

Bilsky said that unit would include eight beds, with room to expand to 12. And it would contain a secure "zone" where staff could hold violent patients, more space to treat patients and an area for Indigenous cultural use.

The expansion would cost between $14 million and $21 million, Bilsky said. Health minister Pauline Frost has said construction would start in 2022.

But Bilsky said that even with a new facility it's important to recognize the secure medical unit's limitations. It's not an in-patient psychiatric facility. People will still need access to treatment outside the hospital and, sometimes, outside the territory.

"The challenge will continue to be that there will be patients who will exceed the level of care that we can provide within that facility," Bilsky said. "I wish it was different, but it is not."