There were times Sherry Karolev felt so desperate she would go to the hospital hoping someone there could stop her from hurting herself.
And then, she’d wait, sometimes for hours, all alone.
“One night I just thought, I want to die. I just want to die,” the 52-year-old said. “It’s really hard, especially if you’re by yourself and you don’t have support…. Some people just change their minds and they walk out and they really need the services.”
Karolev said she’d finally be taken to a room, where she’d tell her story to the doctor, then to the psychiatrist, then to a crisis worker. In between, she’d wait longer.
“It would help if I didn’t have to repeat myself 40 zillion times. You tell your story to this person, to that one, and to this one and to that one. And it’s like, I have no energy, I don’t feel like telling my story a million times,” she said.
Windsor has one of the worst records in the region for patients who go to the emergency room for substance abuse treatment, get sent home and then return for more help in the same month, according to a report from the Erie St. Clair Local Health Integration Network.
“I don’t think there is a system that is able to meet all people’s needs,” said Janice Kaffer, president and CEO of Hotel-Dieu Grace Healthcare. “But I think we have an opportunity to do a much better job.”
Kaffer said a new plan — which complements the proposal for a new mega-hospital near Windsor Airport — is a once-in-a-lifetime opportunity to redefine health care for those with mental health illnesses and addictions.
“The way the system is right now, it’s scattered” — Janice Kaffer, president and CEO of Hotel-Dieu Grace Healthcare
Under the new plan mental health patients will be able to go to a transitional stability centre — not the hospital — where staff will listen to their stories once and direct them to the help they need. At the same time, there will be community teams and services spread throughout neighbourhoods to try to prevent patients from getting to the point where they have to go to a hospital, said Robert Moroz, who is responsible for outpatient and community services for Hotel-Dieu and the Canadian Mental Health Association.
The first step is an interim centre, which is expected to open downtown in May. Mental health patients in crisis will go there rather than a hospital emergency room. Hotel-Dieu Grace officials on Tuesday gave a tour of the new centre, located in a former bingo hall on Ouellette Avenue beside the Downtown Business Accelerator.
Clients arriving at the transitional stability centre will be checked by a nurse to make sure they are in the right place. The goal is to reduce the number of crisis visits by helping patients manage their mental health illnesses.
“The way the system is right now, it’s scattered,” Kaffer said. Programs have their own staff, their own charts, their own locations. “Over the next few years we’re going to be aligning all of that, so the patient comes to one place and we do all of the running around for them.”
Kaffer said patients and their families don’t really care who is helping them out — a doctor, a crisis worker, a psychiatrist or a community service, such as the Canadian Mental Health Association. They just want to get help, fast.
Currently, patients often head to the hospital because they don’t know where else to go or the services they need are closed at night.
Patricia Thomas is shown at the Hotel-Dieu Grace Hospital Transitional Stability Centre on Tuesday, March 29, 2016 in Windsor, Ont. Thomas works with the HDGH and the Canadian Mental Health Association on services that include the new centre on Ouellette Avenue which is nearing completion.
When the proposed mega-hospital is built, the Ouellette campus of Windsor Regional Hospital will return to Hotel-Dieu Grace. It will become the location of the transitional stability centre and of other community agencies that offer services to mental health and addictions patients.
Not all are confirmed yet, but Kaffer says the idea is to group all those organizations and programs in one place with one phone number.
That downtown location could also help emergency responders, said Windsor police Chief Al Frederick. They’ll be able to get to patients who need them more quickly, he said.
Location is a major concern for Tamara Kowalska, who runs the Windsor Youth Centre. She said she deals regularly with youth struggling to get the help they need but unable to afford a bus ticket to get themselves to the hospital.
5 things about the transitional stability centre
1 The idea came from a health-care model in Fort Myers, Fla., where a private hospital converted a building into a community hub with services for mental health patients. Windsor’s proposal is a first of its kind for the province, devised with input from multiple organizations: Hotel-Dieu Grace Healthcare, the Windsor Police Service, the Canadian Mental Health Association, local homeless shelters and other community programs.
2 Many of the programs and services already run out of the Jeanne Mance building on Ouellette Avenue, where hours are 8 a.m.-4 p.m. The transitional stability centre, at 736-744 Ouellette Ave. with the entrance off Dufferin, will have extended hours of 8 a.m.-8 p.m.
3 The centre is based on a model that emphasizes patients get better faster when they have a safe place to sleep. The centre will have showers, a cafeteria and a lounge area with computers. Patricia Thomas, with Hotel-Dieu and the Canadian Mental Health Association, said beds on the upstairs level offer short-term stays for people who don’t need to be in a hospital but need support for their mental health illness.
4 The location was chosen for its central, downtown location. It’s close to community partners, including the Downtown Mission, the Canadian Mental Health Association and an emergency room.
5 Patients going through a mental health crisis will still go to the hospital for urgent medical care. When the new mega-hospital is built, they can go directly there or to the emergency room at the former Grace hospital site on University Avenue West.
Kowalska wants to see more neighbourhood-centred programs that come to the youth, instead of expecting someone going through a mental health crisis to be able to figure out where to book an appointment, to wait for the day and time, and to figure out transportation to get there.
Teams based out of the new transitional stability centre downtown will help to do that, Kaffer said. Partnered with police and local agencies, they do home visits and run community programs to help patients where they are.
At her apartment on Windsor’s east side, Karolev sits on her couch, her thumb running back and forth over her wrist.
“That was usually where I tried, was here,” she said, pulling up the sleeve of her red sweatshirt to show several short, sharp scars beneath her wristwatch.
“A couple of times I said if I don’t get some help I’m going to go home and take these pills,” she said. “I threatened to take an overdose, but they took me seriously before I actually had to resort to it.”
Karolev said she’s been diagnosed with schizophrenia and is also bipolar. She had been doing well for several years when her first husband died, throwing her life into a tailspin. She landed in the Marentette rest home for about five months before she was able to feel like herself again.
She said sometimes it was hard just to know where to go when she needed help. She’d usually head straight to the hospital, hoping to eventually be admitted so that she was far away from drugs or knives.
In Karolev’s kitchen, she pulls a dosette of pills from the cupboard. It’s packed with plastic squares filled with brightly coloured pills — long white ovals, red circles, small green dots.
She, like many patients with mental health illnesses, takes multiple medications each day.
Some of the programs running out of the transitional stability centre will focus on ensuring patients take the right medicine at the right time. It’s all part of a plan to keep people more stable and healthy, and out of the emergency room.
Karolev says one of the successes for her was getting involved with the Canadian Mental Health Association — a key partner in the new plan. She became a volunteer and started working at the Ten Friends Diner.
“I felt better when I was volunteering. I felt wanted, I felt needed,” she said. “They’ve helped save my life more than once.”
Claudia den Boer Grima, CEO of Windsor and Essex County’s Canadian Mental Health Association, said the partnerships are a main focus to keep people like Karolev connected with the community and give them easy access to the resources they need.
“A mentally ill person is just as good as anybody else,” Karolev said. “If you have a broken leg, they treat you like you’re sick. Why should it be different for someone who has a mental health illness?”