Mental health day hospital opening in Halifax next month

A new mental health day hospital is slated to open in Halifax by mid-April, with the goal of easing the pressure on Nova Scotia's psychiatric care system, which has been operating at or near maximum capacity since the beginning of the pandemic.

The referral-only service will be available to people who need intensive mental health care, but do not require 24-hour in-patient support. 

Brian Comer, the minister of mental health and addictions, announced the new model Wednesday afternoon. He said about 20 per cent of people admitted to psychiatric units don't need overnight care, and could get the same outcomes from a day unit while spending their nights at home.

"I do think it's very significant that 20 per cent of these people can go home at night and also receive the support of their families, which is a vital part of the treatment plan," Comer told reporters.

In-patient beds are hard to come by, especially in the central health zone, which includes the Halifax Regional Municipality. Comer said that means people are often transferred to other parts of the province, taking them away from their communities and support networks. Those transfers also take ambulances out of the mix for responding to emergency calls.

"These impacts are costly, inefficient, and most importantly, they aren't meeting the care needs of Nova Scotians," Comer said.

The day hospital will operate out of the Abbie J. Lane building at the QEII Health Sciences Centre, and will initially have capacity for 10 patients. Comer said that capacity could build to 20.

Patients are expected to visit the site for an average of two to four weeks.

Startup costs are just shy of $400,000, with annual operating costs of $1 million.

Taking cues from Ontario, abroad

The day hospital will be the only one of its kind in Nova Scotia, but the model is not new. A similar service used to exist in Halifax but was discontinued 15 years ago.

Dr. Sanjana Sridharan, the head of acute consultation and emergency psychiatry for Nova Scotia's health authority, said the day hospital model is well established in other jurisdictions.

Nova Scotia looked to psychiatric day hospitals in the United States, Australia, New Zealand, the United Kingdom and Ontario to develop this program, Sridharan said.

Sridharan said day hospitals could "absolutely" work in other parts of Nova Scotia outside Halifax.

Expansion possible

Comer said he'll be watching for results from the Halifax site before making any decisions about expansion.

"We need to have robust data to indicate if it's actually being effective at helping people," he said.

"As the minister, I would look very quickly to collect that data within the next, probably, six to 12 months to see if we can get this set up in other zones."

He predicted one major challenge, however, which is finding people to work at more day hospitals. Staffing shortages in health care have become such a critical issue for Nova Scotia in recent years that the province now has an office dedicated entirely to recruitment. 

When the office got going last fall, there were more than 2,000 vacancies across the system. The head of the recruitment office couldn't provide a more recent figure when he was asked for an update this week.

The Halifax day hospital has already hired all the staff it needs to open, which includes one full-time psychiatrist, who was hired out of Dalhousie University's psychiatric residency program, plus several nurses and social workers.