The total confinement of her patients really struck Ann Atkinson when she began work as a registered nurse four years ago at Hillsborough Hospital in Charlottetown.
She saw the residents of Unit 7 as forgotten people.
Atkinson certainly understands the need for the unit to be secure, in other words locked down, so the residents don’t have the freedom to come and go on their own. The residents, usually filling the unit to capacity at 16, pose a clear threat of harm to themselves, others or both.
Many were born with a mental challenge. Others have incurred mental damage as a result of a head injury.
A good number of the residents in Unit 7 have very little, if any, family contact.
Atkinson saw the need to open up the small walled-in world of her patients, who are often long-term residents, in some cases permanent ones. They should, she believed, be exposed to more. They should be able to do more.
Atkinson’s first act outside the box was to take residents that were deemed fit for the outing on a Christmas shopping excursion. It was a hit.
“They had a lovely time,’’ she recalled. “They were thrilled to death.’’
Atkinson saw no need to turn back. More shopping followed.
Trips to the movie and other outings like a ride aboard the Harbour Hippo and a trip to the Moncton Zoo took place for a select group from Unit 7. For some residents, outings simply are not a viable option.
Weekends at camp were eventually added to the mix with usually nine or 10 of the 16 residents deemed able to take part.
The Unit 7 residents took well to the camp environment that offered a welcome change of venue from their designated, secure area at Hillsborough Hospital.
They went to the beach. Each one picked up a medal during a sports day. The women enjoyed a spa as they got made up for a gala dinner. Face painting, making s'mores, singing by the campfire and ordering pizza all offered special moments that had long been denied in the lives of Unit 7 residents.
Atkinson, who last year received the Emily A. Bryant Award for providing outstanding mental health nursing service, says the impact of the outings is tangible.
The residents exhibit marked improvement in behaviour. Confidence is boosted. Self-esteem risen.
The outings are therapeutic, a meaningful part of the overall health care, even to the point in the odd case to perhaps result in a resident leaving Unit 7 earlier than might otherwise be possible.
Residents “just love’ the excursions, said Atkinson.
She even has a classroom for some residents of Unit 7. One-hour classes are held twice a week, on a different floor so residents can again leave their secure unit as they do when going on one outing or another. The classes address everything from reading to hand washing, socials skils to nutrition.
“I tell you they pay attention,’’ she said. “They are focused.’’
Margaret Kennedy, director of mental health and addictions with Health P.E.I., lauds Atkinson’s approach to providing health care to such a vulnerable group.
She concedes that the special initiatives Atkinson undertakes with the residents were not seen as important within the health-care system in Prince Edward Island until recently. She says health professionals used to be more paternalistic with these type of patients “where they just had to be institutionalized and looked after.’’
Today, emphasis is shifting to recovery and helping people achieve their full potential, notes Kennedy.
“We want to improve peoples’ quality of life, not just give them a pill,’’ she said.
More and more initiatives are springing up throughout the mental health and addictions system in P.E.I. to help clients stay well and manage their conditions.
For instance, clients with persistent chronic mental health have access to a community garden at Prince County Hospital in Summerside where attention is given to improving social skills, increasing sense of productivity and strengthening community engagement.
Another example of a concerted shift in the way the province provides health care is the yoga classes available for inpatients of detoxification.
“There is a lot of good work being done by our staff,’’ said Kennedy.
Still, only two to four per cent of the province’s health budget is allocated towards mental health. The Mental Health Commission of Canada recommends seven to nine per cent of total health-care expenditure be spent on mental health care.
“We’re a work in progress,’’ said Kennedy. “We are doing what we can to work within our budget...I think everybody has catching up to do.’’
Even though Kennedy and others view the outings by residents back at Unit 7 in Hillsborough Hospital as quite valuable, fundraising is still needed for it happen. The province as yet does not budget for these helpful initiatives.
Staff raises money through penny drives and appeals to church groups.
Atkinson says people hearing of the good things happening for the Unit 7 residents are contributing to help provide stimulation and personal growth.
Local business people, for instance, funded three camps.
“People have a soft heart for the needs that are in here,’’ said Atkinson.
Fundraising, like that being done for the benefit of Unit 7 residents, is not a bad idea, adds Kennedy. The outcome is community engagement.
“We want more people to be involved in the mental health of Prince Edward Islanders,’’ she said.