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Short Hospital Stays Failing Schizophrenic Patients

Sonja Puzic, The Windsor Star
Published: Thursday, April 17, 2008

Canadian hospitals are recording high rates of readmissions for schizophrenia patients, suggesting that some of them are being released too quickly after the initial hospitalization.

A report released Thursday by the Canadian Institute for Health Information (CIHI) found that nearly 40 per cent of schizophrenia patients discharged from a general hospital in Canada were readmitted for mental illness through emergency departments within a year. Between 2003 and 2005, one in eight schizophrenia patients -- or 12 per cent -- were readmitted to hospital within 30 days of their initial discharge.

Sonja Grbevski, director of mental health services at Hotel-Dieu Grace Hospital, said it's safe to assume that the latest statistics are "a good reflection" of the problems faced by local schizophrenics and health-care providers.

" Our individuals with schizophrenia are not much different than those any place else," she said, adding that the presence of other conditions, such as substance abuse, increase a schizophrenic's likelihood of being hospitalized again.

Schizophrenia is a brain disorder that affects an estimated one in every 100 Canadians. It's marked by delusions, hallucinations, disorganized speech and social dysfunction.

Schizophrenics are readmitted to hospital more frequently than those diagnosed with other mental disorders. But the CIHI report found that schizophrenia patients with the longest initial hospital stays -- seven weeks or longer -- were less than half as likely to be readmitted within 30 days of discharge, compared to those whose hospital stays were one week or less.

The chronic and debilitating nature of schizophrenia requires longer periods of stabilization than other mental health illnesses, the institute says.

"We're kind of setting people up for failure," said Pamela Forsythe, the president of the Schizophrenia Society of Canada. "If we send people out before there's been a chance to arrange appropriate followup services or address issues around inadequate housing or access to appropriate supports and treatments ... the gains that may be starting to appear from the time in hospital are very quickly lost."

Forsythe added that it's "very taxing" on the health system to have schizophrenia patients readmitted frequently through already overburdened emergency departments.

Grbevski said bed shortages at Hotel-Dieu and other local hospitals makes lengthy hospital stays an ongoing challenge.

"We're an acute facility. We need to be able to intervene fast and discharge fast," she said.

Adding to the problem are "tapped out" community resources, Grbevski added. Windsor-Essex does not have enough family physicians and psychiatrists who can provide proper care and supervision for schizophrenics, especially those who stop taking their medication.

"The problems become cyclical and they have to come back to the hospital for restabilization or medication adjustments," she said.

The lack of resources for schizophrenia patients is "a definite problem" locally, said Victoria Shearon, former chair of Schizophrenia Society of Ontario's Windsor-Essex chapter, who still sits on the organization's leadership committee.

"We have some wonderful programs here," she said. "But there aren't enough psychiatrists. The reality is that (schizophrenics) end up in hospital because they need to adjust their medication. And oftentimes it's difficult to find a bed for someone like that."

Although the community has made "great strides" in raising awareness about the disorder, mental health is still not always treated as seriously as other chronic illnesses, such as heart disease, Shearon said.

Grbevski said Hotel-Dieu's mental health department is currently re-examining its practices in an effort to better address patients' needs.

"We're looking at redesigning our program to better match the type of service required for individuals that come to us and make it more specific."

-with files from Canwest wire services

© The Windsor Star 2008

Reproduced from http://www.canada.com/windsorstar/news/story.html?id=dbf8209a-b812-4e6e-8fba-6290bb119419&k=9048

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