Family members with schizophrenia, one of the more frustrating mental illnesses to treat, often face a bumpy treatment road filled with potholes and setbacks. Many people with schizophrenia believe there’s nothing wrong with them. Or the medications they take often have significant, negative side effects.
So even though schizophrenia can often be treated fairly effectively with medications and psychotherapy, it often is not because medication compliance becomes a significant ongoing issue.
This results in many people with schizophrenia going in and out of inpatient care. Because inpatient psychiatric care is virtually non-existent in most states any longer, this means a primary treatment point for people with chronic, serious mental illness defaults to the local hospital emergency room (ER).
While most ERs are setup to handle people with a serious mental illness fairly well, ERs aren’t exactly known for their warm-fuzzy, emotionally-supportive environments. So people slip through the cracks.
In this case, the woman with schizophrenia who slipped through one hospital ER’s cracks was Cindy Ciarafoni, a mother of two, who died when she apparently wandered out of the ER and tried crossing a busy highway. She was struck by a car and later died from her injuries. Now her family wants to know what happened, but the hospital is being tight-lipped.
Cindy’s story is that she had a history in the past three years of deteriorating behavior. In the past 6 months alone, she had been hospitalized about once a month, according to her family.
On New Year’s Day, she was acting strangely in a local Toronto coffee house. Police were called, who then called paramedics to take her to the hospital when it was apparent Cindy was suffering from a mental illness and needed treatment.
She was dropped off at the hospital just before 5:00 pm, and signed in by the triage nurse to the emergency room at Humber River Regional Hospital’s Church St. campus.
Her family was notified by the police of her hospital admission, but since it had become a commonplace occurrence, her family was not concerned for her safety or well-being. They knew she’d be kept under observation for at least 72 hours.
A day later, they got another phone call from the police. This was not as good a call, because Cindy had been hit by a car 10 kilometers north of the hospital.
Here’s the kicker. The hospital has refused to answer questions about the incident, citing “patient confidentiality.” But when the family has tried to get answers, all they’ve gotten is a stone wall:
Danny said he never received a call to tell him his wife had left the emergency department without being assessed or admitted. The family said the hospital has been uncooperative about telling them what happened that night.
“They’re not even calling us back, so it’s frustrating,” Ciarafoni-McGrath said.
Why is the Humber River Regional Hospital stonewalling? What have they got to hide, except for the fact that a patient was dropped off in their ER, and they didn’t notice when she left on her own long before being seen by a doctor.
But the hospital emergency record obtained by the family shows that when a physician attempted to begin a preliminary assessment six hours later, at 11:36 p.m., there was no answer — indicated by a slashed zero and the word “answer.”
This is the problem when hospital ERs become dumping grounds for people with serious mental illness who need special attention and care. Some hospitals are just ill-equipped and their staff aren’t properly trained to help such people.
This tragedy could’ve been prevented had the hospital had a procedure in place to ensure that people with special mental health needs are properly taken care of once signed in. Not left in the waiting room like someone with a broken arm. Staff training is also a must, because they need to be alerted about the needs of people with a mental health issue.
Hopefully answers will be forthcoming. In the meantime, hospitals should take this opportunity to review their own ER procedures to ensure they take into account the needs of people who have a mental health concern.
Read the full story: Family seeks answers after woman with schizophrenia dies on road
Photo: Renee Ciarafoni-McGrath with her mother, Cindy, at Renee’s wedding supplied by the family.