The curtain goes up on Hamilton's West 5th Campus
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The Margaret and Charles Juravinski Centre for Integrated Healthcare, or St. Joseph’s West 5th Campus, opens next week. It ushers in a new era in the treatment of mental health. Officials want it to be a visible and vibrant part of the community. Its rooms are private, its design is spacious and bright.
The rebuilt Hamilton Psychiatric Hospital campus on West 5th Street is far more than a modern mental health facility.
Any patient could be sent to its clinics and the hope is the community will see it as the same as the city’s other hospitals.
“It was designed this way to destigmatize mental illness,” said Dr. Joseph Ferencz, interim chief of psychiatry at St. Joseph’s. “Bringing the community into the hospital contributes to people becoming more f amiliar and comfortable with a facility that treats people with mental illness. The idea is that mental illness is just an illness and does not have to be separated.”
One of the biggest impacts on Hamilton residents will be the addition of a magnetic resonance imaging (MRI) machine at the Margaret and Charles Juravinski Centre for Integrated Healthcare that will provide a variety of diagnostic imaging, including ultrasound.
It’s badly needed considering wait times are far from the province’s target of nine out of 10 patients getting an MRI scan within 28 days. It took 54 days at HHS and 45 days at St. Joseph’s from September to November 2013.
“Our hope is that it’s going to impact wait times for MRI,” said Dr. David Higgins, president of St. Joseph’s.
The focus so far has been on the move mental health patients will make Feb. 9 from the outdated buildings on the property that are for the most part being torn down. But they aren’t the only patients facing big changes.
St. Joseph’s is relocating all of its diabetes care to the West 5th campus from the urgent care centre in the city’s east end.
Its bariatric program, which is one of the largest in the country, will also be housed there as well as a general internal medicine clinic designed to treat those with the highest need who are using medical services most frequently.
There is space for a fourth outpatient clinic at the 855,000-squarefoot hospital but no decision has been made yet on what will go there.
The programs relocating are those used most often by mental health patients, as part of an attempt to make it easier for them to access other types of health care.
The other ways St. Joseph’s plans to draw the community into the hospital is by renting out its 5,900square-foot gymnasium and 300seat auditorium.
In addition, its 8 kilometres of walking trails, baseball diamond, soccer field, tennis court, labyrinth, gardens, chapel and cafeteria will be accessible to the public.
But at the heart of the new hospital is the vast improvement to mental health care.
There will be about 100 new inpatient beds by 2016, bringing the total capacity to 305. A dozen of those will be in a new unit dedicated to seniors with mental illness. The only specialized treatment offered now to seniors at the Mountain hospital is for dementia patients with severe behavioural issues. That program will also be expanded.
The forensic units for those with a major mental illness who have committed a criminal offence will more than double to 110 beds from 42.
At least 400 new staff will be hired over the next six years.
And for the first time, patients will be able to get treatment for mental illness and substance abuse together. It’s a significant step forward, considering more than half of those with mental illness also have substance abuse problems.
“It was an i mportant void we wanted to fill,” said Ferencz. “One of our goals is to increase our capacity to deal with these things together.”
The hospital features different layers of security, which is unique in mental health care.
There will be a secure perimeter that separates the outpatient and in-patient areas. Behind that line is another layer of security to get on and off the units.
Multiple layers allow patients to be off their units while remaining in a secure area. The space in between will have a coffee shop, library, hair salon, used-clothing store, games rooms, exercise room and the gym.
The most noticeable improvements are on the units themselves, which treat patients primarily with schizophrenia, bipolar disorder and major depression. Every patient has a private room with key card entry. That means other patients can’t come into the room uninvited. Only staff and the patient can open the door.
“People feel uncomfortable being in a facility like this,” said Ferencz. “The patient now has privacy and a sense of security they did not have before.”
The key card can also be programmed to allow patients to leave the unit or the secure perimeter at certain times, depending on where they’re at in their treatment.
The rooms themselves are 188 square feet and all have a window as well as an ensuite bathroom. They’ve been carefully designed to minimize the ability to self-harm. For example, there are no faucets in the bathroom. Instead, the water comes on automatically if you get close to it.
All the units have a courtyard, visitors’ lounge and dining room. The nursing station is at the centre with a clear view of all the corridors at a glance.
“You have to make it as humane and dignified as possible so people feel respected,” said Higgins.
Another major upgrade is four apartments designed to give mental health patients a trial run at living on their own. The apartments are 1,200 square feet and include a kitchen and laundry. They allow patients to spend a few weeks learning to be independent while help is only the push-of-a-button away.
“They have an opportunity to build up confidence,” said Ferencz. “You can treat symptoms but it doesn’t mean you’ve helped them get back to their life in a way they’ll have success. It’s not just about symptoms, it’s about a life they can sustain.”
One of the most impressive aspects of the building is that 70 per cent of it has access to natural light and all space has been designed to optimize the view.
Only Century Manor will remain of the old buildings on the 55-acre property, as it is being preserved for heritage reasons.
Mental health care has been at that site since 1876, when the Hamilton Asylum for the Insane opened its doors. At that time, it was quite isolated.
Now, St. Joseph’s wants the hospital to be a visible and vibrant part of the community and so chose to move it to the road instead of building close to the brow.
“We wanted it to be open and accessible,” said Ferencz.
St. Joseph’s is hoping to change attitudes about the illness that 20 per cent of Canadians will suffer from. Mental illness is the nation’s second-leading cause of disability. “We need to take a stand,” said Ferencz. “It’s just another branch of medicine. It’s not something separate and different."