Earlier this week communities in West Grey received some good news….and some not so good news. As hinted in the most recent South Bruce Grey Hospital Centre (SBGHC) community meeting in Durham, they have partnered with Brightshores and the Canadian Mental Health Association Grey Bruce (CMHA Grey Bruce) to open an outpatient Mental Health and Addictions Care clinic in that community.
That’s the good news. For a very long time, it has been difficult, and at times nearly impossible, for local residents to access mental health and addiction support close to home. People who required this vital component of healthcare had to travel to Owen Sound or large cities in southern Ontario such as London and Kitchener. Owen Sound is a long drive from West Grey, and it is not always feasible in winter weather. Additionally, noting that there is no public transportation system within the area, the cost of driving to those locations can be prohibitive for many. Residents of the area have long said that they would like to be able to more easily access the services they need.
Nancy Shaw, CEO of SBGHC, gave the following statement. “Access to mental health and addictions care is essential for the health and wellbeing of our communities. We are excited for this opportunity to collaborate with our local health system partners to enhance access to care for this specialized service”.
So far, so good. The clinic will provide a comprehensive list of services, including a mental health and addiction walk-in clinic, a rapid access addiction management clinic, family support worker, group services, including social recreation, clozapine clinic, counselling services, and psychiatrist clinics. This will considerably expand the range of health services available in Durham and will be accessible to residents of other nearby communities. It may possibly lead to some additional jobs in the town. And that’s never a bad thing.
So…now for the not-so-good news. The site chosen for the new clinic is the Durham hospital, in the space previously occupied by the inpatient unit. Looking at the list of clinics that will need to be accommodated, it is clear that the floor plan will be huge. They will require examining rooms, at least one waiting room, space for administrative staff, and space for group activities in addition to offices for the various clinics. The question that hangs in the air is, “What about the 10 inpatient beds that were taken from here last spring?” These are beds that were paid for by members of the Durham community and residents at recent community meetings have made it clear that they want them back. In summarizing the results of the first of these meetings, the CEO asserted that the board had heard loud and clear that the residents of the town want those beds back…along with the resumption of 24/7 ER service. When people expressed their concern about the rumoured mental health clinic replacing the inpatient unit, the CEO was asked, “Are you saying that the addition of this mental health outpatient clinic will not preclude the return of the 10 inpatient beds in question?” Her response was, “Yes. There will still be room for those beds.” What has changed?
There is also another consideration in describing the planned outpatient clinic. In response to a question from a resident about the potential for police to be delivering some patients to the site, the CEO assured them that services would be offered by appointment only. Yet some of the clinics listed in the information released by the service partners are offered on a walk in basis. So clearly not every contact will be by appointment only.
This clinic, under the right circumstances, could be a valuable addition to the town of Durham. But the task of building community support for this plan is an uphill climb at the moment. When residents are not included in the planning phase, they will naturally feel that their questions and concerns remain unaddressed. They are suspicious of the process. Was this plan in place when the decision to remove the inpatient beds was made at the board level? It was an in-camera meeting with no public consultation and no public record of the proceedings. This is not the way to build trust and support. If residents feel they cannot trust the process, they are unlikely to support the project.
What other options were considered before settling on this location? Was there a search for other viable locations in Durham? Is there perhaps a plan to expand the Durham hospital building to accommodate this new clinic? How can both of these objectives be realized and how much discussion has taken place with community leaders? Have they been consulted or is this plan unfolding in the same manner as the removal of the beds? In that case there was no prior notice to local council.
In a democracy, constituents elect community leaders to represent their interests and help them maneuver through a maze of federal and provincial legislation pertinent to their situation. Failing to keep local leaders advised and involved in planning that directly affects them can ultimately compromise support for even the best laid plans. Perhaps it is not too late to include local people familiar with their community in the process of adding this valuable and necessary component to the healthcare services available in Durham. Perhaps together they can figure a way to have both a fully functioning hospital and a mental health outpatient clinic.
In 1967 the movie Cool Hand Luke was released. The story had many themes and issues but is encapsulated by the sentence, “What we’ve got here is failure to communicate”. Everyone who saw that movie remembered that line. Even though people were talking to each other there was a disconnect that meant they were not reaching an understanding. And here too, even though there are press releases and public statements calculated to provide just enough information without the full story, it can be said there is a failure to communicate in a deep meaningful way that brings all of the affected parties together to achieve a common goal. Both of these ideas – opening this clinic and restoring the inpatient unit – have merit; it just needs the will to sit down with the right people and involve them in a meaningful way. There must be a way through this issue.
Brenda Scott
Co-chair, Grey Bruce Health Coalition