MONTREAL -- The health ministry's plan to close half of the province's chronic-care beds for mentally ill patients is a definite cause for concern, says the Association des psychiatres du Quebec.
An estimated 3,000 of Quebec's 6,000 beds will be closed over the next five years in psychiatric institutions and other health care facilities.
"It's clear that the minister wants to make changes," said Dr. Yves Lamontagne, association president, noting a committee will be reporting to the minister this month on what shape care for the mentally ill should take. "The beds will no longer be for chronic care."
The Quebec auditor-general released a report in December of last year, critical of the previous reform that swept through mental health care in the province. He called the reform "a complete failure" and noted that funds that were to be diverted to other resources following de-institutionalization of patients never materialized.
Considering Quebec's track record, Dr. Lamontagne fears that a healthy investment will not be made in other resources following the future round of de-institutionalization.
"In past years, when we started to take mentally ill patients out of the hospitals and put them into the community, it's quite clear that the money did not follow," Dr. Lamontagne said.
With a substantial proportion of beds to close, half of the 3,000 being in the Montreal area, and with remaining beds existing for cases of emergency or critical care for psychiatric patients, community support will have to be beefed up to handle what will be a significantly increased load on health care services like CLSC's (community health clinics), according to Dr. Lamontagne.
"It has to be well-organized," he said. "I am afraid that if they do this too quickly, some patients will become homeless."
Ontario has invested in community resources and created teams, which include psychiatrists and social workers, to treat mentally ill patients, Dr. Lamontagne said.
"In Ontario, there is very good co-ordination between the hospitals and the clinics," Dr. Lamontagne said, adding he hopes the same collaboration will exist here. "They created teams to treat mentally ill patients. This should be done here in the CLSCs. We are not as well organized as in Ontario, as far as community services. It will be a job to create this system, and everyone will have to work together"
Dr. Lamontagne adds that if the government believes the shift will result in savings to the health care system, the plan should be reconsidered.
"If they think they are going to save money by doing this, it's not true," he said. "Good community services are as expensive as keeping patients in the hospital."
Martin Caillé, the press attaché to Health Minister Jean Rochon, said the goal of the initiative is not to reduce health care spending.
"We are not doing this to save money, but to provide better care for these patients," Caillé said.
"We have two times as many (chronic-care) beds in Quebec as in Ontario," he said. "We have put all our money in institutions. In the next five years, we want to reverse that trend. If we do save money, all the better, but that's not the objective."
Copyright © 1997 Maclean Hunter Publishing Limited
Reprinted with permission.
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