Audits into how the Interior Health Authority handles mentally ill patients reveal paperwork problems that could pose a high risk to both patients and the IHA.
The documents were obtained by NL News through the Freedom of Information and Privacy Protection Act.
A 2012 audit examined what happens to people who come in contact with the healthcare system through hospital emergency rooms within the IHA.
The audit found paperwork that was often incomplete, and instances where the system failed to alert caregivers of a patient’s history within the system.
The problem existed especially in cases involving involuntary mental health patients, or people who are under what is called an extended leave discharge, where they are under IHA care, but have a level of independence that allows them to live in the community.
Rick Turner, Co-Chair, BC Health Coalition says the findings are alarming.
“The information that people in the E.R. need or that people who might be able to treat involuntary mental health patients aren’t being alerted simply isn’t there. I’m worried that people are going to hurt themselves or hurt someone else.”
Turner says a follow-up audit in 2016 determined the missing or incomplete paperwork could be potentially high risk to patients, “and in some instances things were even worse than in 2012 and that’s very alarming.”
Another risk according to Turner, is that people who shouldn’t be held involuntarily could end up being held against their will.
He says it’s unclear whether the problems identified exist province wide, but adds they were definitely present across the IHA.
Dr. Paul Dagg, Program Medical Director, Interior Health Authority says major progress has been made making sure forms are properly filled out.
“One of the challenges with these Mental Health Act forms is they’re completed often by physicians in the community or in the emergency rooms because that’s the point of contact and there was some variability in terms of the amount of detail included in the forms. We also found talking to physicians that there was some confusion about the amount of time requirements for the various forms. Because of that, one of our big steps was to set up educational tools online that are available for physicians anytime so they could understand better what form they need to complete and what information to put on that form.”
Dagg says the “high risk” mentioned in the audits didn’t refer to patients not getting care when they needed it.
“If a form is completed but not completed with as much information as was necessary we deemed that a high risk. We designated it a high risk because of a patient’s legal rights.”
He says the IHA takes the rights of patients to have due process before being held involuntarily very seriously.
“There’s absolutely no indication anyone fell through the cracks or didn’t get the care they required. The forms were completed, the forms were used to certify people if they required certification. It was really a matter of we could do a better job. For example, if a patient appears in front of a mental health review panel, which is their right under the Mental Health Act to allow someone to challenge their certification, the reasons for their certification would be clearly documented in writing.”
He says a patient’s treating physician is also always part of a mental health review panel.
The Interior Health Authority has acted on seven of twelve of the recommendations made in the audits.
Dagg says it’s only a matter of time until action on the rest of the recommendations is completed.