Canadian Hospitals, Part 2

By Sandra Kiume
December 3, 2006

Looking closer at mental health hospitalizations in Canada 2003-2004, the most common cause was depression and bipolar disorder (32%), followed by schizophrenia at 19.6%, and then substance-related disorders (especially in Arctic regions, where they’re the most common reason for admission). Organic, personality, anxiety and sexual disorders had significant numbers as well. Although anxiety disorders are common, and can be treated inpatient, it’s severe disorders that get the beds. Moderate mental illness is left out of this picture.

66 days was the average length of stay in all hospitals for mental illnesses a decade ago, but it dropped to 35 days in 2003-2004. Separations from hospitals (discharge or death) increased and now occur most often with mood disorders (except up north). Bipolar disorders and depression were both the most common cause for admission and most commonly discharged, then on to readmissions.

Addiction recovery services, especially residential rehab facilities and transitional housing for aftercare, as well as services specialized for crystal meth psychosis patients who can’t use traditional detox facilities due to agitation and violence, are not meeting the demand. In most provinces the worst delays involve organic disorders, and again, remember aging demographics as well as the long-term needs of neuropsychiatric geriatric patients, but in the Arctic the picture is quite different.

Inuit (formerly known as Eskimos) have more problems with substance abuse, are admitted more frequently, and discharged just as frequently from acute care general hospitals. Average length of stay is two days. It’s not a stretch to presume hospitals are keeping people just long enough to sober them up then releasing them instead of providing any effective treatment. In Nunavut, the Northwest Territories and Yukon (also in Nunatsiavut, formerly known as Labrador), there is a lack of addiction treatment facilities and services, including community counseling and rehab aftercare.

Northern regions also have a tragic suicide rate (over half the population succumbing, especially young males) and serious social problems like violence against women (often involving alcohol and drugs), and children abusing inhalants (most famously, in Davis Inlet). Hospitals don’t seem to be helping here. Wilfred Grenfell would be so disappointed. And, Inuit suicide and substance abuse was rare until the government “settled” communities just a few decades ago.

There are some innovative initiatives to address substance abuse in Inuit cultural contexts. But as the hospital statistics reveal, real change isn’t happening yet.