'A very dangerous situation': Psychiatrists sound alarm over Sask. children's hospital design

Saskatchewan's health minister is promising to investigate the concerns of psychiatrists who say the province's $284-million children's hospital is rife with safety and suicide risks.

"Obviously, we're concerned. We want to make our facilities as safe as possible," Health Minister Jim Reiter said Wednesday afternoon, following a separate event for children's mental health in Saskatoon.

"We're going to reach out to those doctors and hopefully work our way through most of their concerns."

The concerns include poor sightlines from nursing stations, dangerous equipment stored in unlocked cupboards and room doors that are easily barricaded, creating the possibility of a suicide or hostage situation, according to a letter to the Saskatchewan Health Authority written by a group of psychiatrists, which was obtained by CBC News.

"It should not be this way. It's a very dangerous situation for the patient, but also for the workers," said Dr. Yanbo Zhang, the Saskatchewan representative for the Canadian Psychiatric Association.

"It needs to be fixed."

Following Reiter's comments Wednesday, Zhang said he hopes everyone can work together to fix the problems. That includes government officials, psychiatrists, security staff and others.

Opposition health critic Vicki Mowat said these mistakes should have been caught much earlier.

"This highlights the mismanagement of the Sask Party government. We're seeing their inability to manage projects of this scale," Mowat said.

Last week, hundreds of kids, parents and supporters were at the grand opening of the Jim Pattison Children's Hospital in Saskatoon. There was confetti, cheers, and a group ribbon cutting with a giant pair of scissors.

Officials touted the private rooms, animal themes and state of the art equipment. There's a sleep lab and a fully equipped pediatric intensive care unit for the youngest and sickest kids.

A play room features a floor design showing a winding river and stepping stones. In some of the 176 rooms, kids can change the colour of the lights by remote control.

But as the confetti was falling, the psychiatrists group was penning their scathing letter. They'd toured the building just days earlier and were shocked by what they saw.

They identified more than a dozen major safety risks, including a lack of basic precautions to prevent children from attempting suicide at the hospital.

The concerns listed in the letter to Saskatchewan Health Authority officials include:

• Poor sightlines from the nursing stations to most of the patients' rooms.
• An easily-opened fire exit door just steps from beds, through which psychiatric patients could flee.
• No security guard station.
• Sliding doors at the room entrances that were built with the tracks on the inside of rooms rather than the outside, allowing them to be barricaded by patients to harm themselves or take hostages.
• Upper-floor, elevated outdoor playground's protective glass railings that are too low to prevent a child from scaling them.
• Unlocked cupboards in some rooms containing rubber tubing and long bandages which can be used as ropes.
• Shower rods, ceiling vents and other fixtures that provide multiple ligature points, and can easily support a child's — or even an adult's — weight.

CBC News described the details to University of Saskatchewan adjunct professor and suicide prevention expert Jack Hicks. Hicks said he's disgusted by the situation, and said there's no excuse for it.

"I'm quite gobsmacked to hear this," Hicks said.

"It's alarming to learn that in 2019 a new facility would be constructed without the design team having factored in the risk. It's an inexcusable design flaw."

Hicks said it's particularly troubling to see this in Saskatchewan, where suicide rates are among the highest in Canada.

Hicks recently helped the Federation of Sovereign Indigenous Nations produce a major suicide prevention report. It showed the suicide rate for Indigenous girls is 29 times higher than the general population. He noted many of those girls will end up at the children's hospital.

The report said Saskatchewan desperately needs a suicide prevention strategy, but Hicks said little has been done. He said the hospital's flawed design is further evidence of the lack of concern for fragile, vulnerable mental health patients.

"I would just commend the doctors for speaking out so clearly. One can only hope the officials in charge would take immediate action to address their concerns," Hicks said.

Hicks and Zhang said big changes are needed before the first patients are admitted at the end of this month. Child psychiatrists agree.

"Please let us know if we can be of any assistance in coming up with a plan to make suicidal patients safe," stated the letter.

In a statement, Saskatchewan Health Authority officials said extensive consultations were held and they tried to follow best practices.

They say they take all concerns seriously, and plan to meet with the psychiatrists.

"We are following up with them to determine any additional changes needed," read the statement.

The health authority said there are two rooms set aside to do evaluations on children who are in danger of harming themselves or others, as well as other improvements over the current situation. 

It said it'll keep dangerous equipment away from children, but isn't saying what other changes will be made, how much it could cost, or whether it will be done before the first patients arrive Sept. 29.

Zhang was not part of the group involved in the letter, but noticed many of the same problems on a separate tour. He said there's no time to waste.

"This [hospital] could be a really good thing," he said. "But we cannot delay this."