VANCOUVER, July 19, 2013 /CNW/ - Families and advocates for children
with serious mental health challenges are speaking out against a
month-long closure of the child psychiatry inpatient unit at BC
The month-long closure from July 19 to August 19 is to allow for a
redesign of the treatment model used at the unit. The program is being
redesigned from a 24/7 inpatient program to a Monday to Friday day
program. The redesign includes reducing the number of Youth and Family
Counsellors (YFCs) from the health care team working with the children
aged 5 to 12 years old and their families.
In a management document circulated to staff, the change in program says
"A day treatment model will improve the quality of care for children
and their families through consistency in staffing and a focus on
relationship development. This is in keeping with evidence-based
practice and with a focus on attachment theory and trauma informed
Five counsellors will be removed from the program, and will be replaced
by a part time nurse. As a result of the reduced service through the
closure of the weekend and nights in the program, nurses will be
rescheduled to cover the day program.
HSA, the union that represents the YFCs, says members are stumped by the
"Youth and Family Counselors have been working in the program for years,
and are at a loss to explain how removing them from the team improves
the treatment plan," said Val Avery, vice president of the Health
Sciences Association of BC. There has been no consultation with front
line staff or allied health professionals regarding changes to the
program, and there has been no public forum for discussion of program
changes and their impact on families," she said.
While the program plan is supposed to increase the nurse to patient
ratio, counsellors say that adding more nurses at the expense of
counsellors trained and experienced in cognitive-behavioural
interventions, crisis management, therapeutic support, parent
education, and other skills will contribute to a decline in outcomes
for children in the program.
"It takes a whole team to provide the kind of services and treatment
that these children need," Avery said.
The YFCs are concerned the changes will impact the children, families
and community support teams because of the reduction of services
available to families who depend on the mental health services at BC
Children's Hospital. Among the changes will be a reduction in the level
of assessments and treatments provided by the in-patient program. Staff
say the continuous process of program redesign without evaluation and
staff training has resulted in an increase in threat of emotional and
physical violence to patients, families, and staff. In 2012/2013, there
were more than 300 reports of behavioural safety related events.
Nurses who work in the program are also concerned about the elimination
of the YFCs.
"YFCs are a valuable resource… and bring a skill set that nurses do not
possess. As the registered nurses (RNs) and Registered Psychiatric
Nurses (RPNs) we oppose these changes," nurses who work in the program
said in a July 2 letter to management.
Sally Comin's son was referred to the program 10 years ago at the age of
7, having been bounced around from a number of community resources.
When all those resources were exhausted, her son ended up at BC
Children's Hospital. It was there that they learned more about his
challenges and strategies for managing and coping with them.
"If it wasn't for the youth counsellors, who observed him, worked with
him, and came up with a behaviour program that we were able to use at
home, we would have lost him to foster care," Comin said.
"He formed a relationship with one of the counsellors, and that trust
and consistency was essential. As is the overnight stay. You can't
observe everything in a three-hour daytime visit," she said.
The service reduction comes on the heels of a scathing report of the
Representative for Children and Youth on the status of mental health
services for youth and families. The report lambastes the lack of acute
care in hospitals and inadequate supports for families and caregivers.
The report also sheds light on a fractured and confusing system of care
and a "distinct lack of provincial leadership and accountability."
Tara Skobel, spokesperson for the Child and Youth Care Association of
BC, notes that the YFCs play an important role in the
multi-disciplinary care vulnerable young people receive. It is the
YFC's role to deal with the behaviours, the emotions and social aspects
of the children's stay in the hospital.
"It is concerning that the specialized skill set and education that
professional Child and Youth Care workers bring to this important
resource will be lost in this re-design, particularly at a time when we
are hearing more and more about the need for more supports for British
Columbian's vulnerable young people," she said.
Skobel said the change to a day program effectively eliminates what is
often a 'last-resort' option for families who don't have the ability or
resources to commute from outlying areas to the west side of Vancouver
for the program.
"The planned shift from a 24/7 program to a day program will inevitably
reduce access to the program for families who live outside the Metro
Vancouver region, the program - which is already limited to 10 spots -
will be inaccessible and for the families who are suffering because of
a lack of resources, this will be a significant blow."
Link to Still Waiting: First-hand Experiences with Youth Mental Health Services
in BC, April 2013 (Report of the
Representative for Children and Youth):
SOURCE: Health Sciences Association of British Columbia
For further information:
Miriam Sobrino, Health Sciences Association of BC: 604 329 0994; firstname.lastname@example.org
Tara Skobel, Child and Youth Care Association of BC: 250 891 4083; email@example.com