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North York hospital hopes new ER mental health zone will be ‘a place of solace’

North York General Hospital opened a new mental health zone in its emergency department on Thursday, saying it aims to create a safe space for patients coming into the ER during a mental health crisis. 

Known as the purple zone, the hospital says the space includes individual treatment rooms with trauma-informed features, such as adjustable lighting and showers, away from the typical noise of the emergency department. 

The hospital says it will also incorporate mental health assessments into the triage process, cutting down on patient wait times to see a mental health consultant. 

“The need for this kind of innovative and advanced mental health program is undeniable,” said Dr. Everton Gooden, president and CEO of the hospital, during the zone unveiling on Thursday. 

The COVID-19 pandemic saw a rise in reported mental health problems across Ontario. One in four Ontarians sought help for their mental health challenges, according to a February 2022 Canadian Mental Health Association survey

Hospital using collaborative care model

Murat Guler is one of four non-clinical peer navigators the hospital is dedicating to working in the new zone. Peer navigators are people who have lived experience with mental health struggle and recovery, he said. 

Guler said he works through conversations with patients, in which he aims to push against stigma, provide comfort and nurture hope for the future. 

Patients in crisis often struggle to have these conversations in the loud emergency room setting, he said. 

“If you have a broken leg or a sore stomach, these kinds of things can be overlooked,” he said. “But with mental health, the little stimuli gets magnified. It makes it even hard to think straight, let alone being in crisis.

A man speaks into a microphone in front of blue balloons.
During the opening of the new mental health zone, Dr. Everton Gooden, president and CEO of North York General Hospital, said there is an undeniable need for an innovative and advanced mental health program. (Mark Bochsler/CBC)

Guler said the new zone “can be a place of solace” for patients, where they can feel safe.

“Once you achieve that, then people are a lot more open to the things that they need to do in their life, both in clinic treatment and in the wellness they need to engage with to get well and stay well,” he said.  

By embedding nurses who are trained in both emergency medicine and psychiatry into the emergency department team, patients will receive integrated holistic care, said Dr. Kevin Wasko, the hospital’s chief of emergency medicine and program medical director. 

It will mean that nurses can begin mental health assessments during the triage process, he said, rather than waiting for a mental health consultant. 

Man in a white lab coat speaks into a microphone.
Dr. Kevin Wasko, chief of emergency medicine and program medical director at North York General Hospital, said nurses in the emergency department team will be trained in both psychiatry and emergency medicine. (Mark Bochsler/CBC)

Other Toronto hospitals have mental health zones in their emergency departments, but Wasko described this model as “very innovative” in its approach to sharing operations between psychiatric and emergency medicine. 

“It really is a collaboration,” he said. 

Helping patients feel comfortable

The purple zone is an exciting realization of a patient-driven vision that began 10 years ago, said Sandy Marangos, clinical director for the hospital’s mental health and addictions program.

Conversations started with the hospital’s patient advisory committee, said Marango, a mental health nurse for decades. She recalled patients saying they wanted a place in the emergency department that feels safe and quiet to help facilitate discussions with staff.

Staff from community partners, such as Eva’s Initiatives for Homeless Youth, will also be integrated into the new mental health zone, Marangos said. 

Richard St. Onge, a former patient who attended the zone’s unveiling, said the space would have been “phenomenal” had it existed when he went to the ER four years ago after his depression became unmanageable.

St. Onge recalled feelings of paranoia and discomfort while discussing his mental health in the crowded setting. 

“I was wondering what people think of me,” he said. “I was looking at the nurse station, wondering if they think I’m a crook.” 

A man in a green shirt and black jacket speaking into a CBC News microphone.
Former North York General Hospital patient Richard St. Onge, who visited the emergency room while dealing with a mental health crisis four years ago, says the new mental health zone offers privacy and can reduce patient inhibitions. (Mark Bochsler/CBC)

If the new mental health zone existed at the time, St. Onge said it would have been “phenomenal” for him. Within this private setting, he said paranoia and inhibitions about speaking openly can be reduced.

“In here you’re safe. You can be honest, you can be open,” he said. “You don’t have to feel ashamed.”

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