2023-08-18 05:03:55
“They might have lost me if I hadn’t had this follow-up,” confides Mathieu*, seated near the window of a cafe in Plateau Mont-Royal. He is one of the first patients to benefit from Montreal’s mental health home hospitalization program, a model that Quebec wants to introduce across the province.
It’s a Wednesday followingnoon in August. Clinical nurse Janie Bouchard arranges to meet Mathieu at their usual café, as is the case several times a week. The other customers of the café do not know it, but Mathieu is “hospitalized” for mental health problems, that is to say that he is the subject of close medical monitoring at home.
Since June 12, the CIUSSS du Centre-Sud-de-l’Île-de-Montréal has been offering mental health home hospitalization. The team is made up of regarding fifteen health professionals who travel several times a day to meet the 14 patients they follow, including Mathieu. The Press benefited from privileged access to the program.
For several years, the man in his thirties has been dealing with intrusive thoughts, obsessive compulsive disorders, phobias and anxiety. “It prevented me from functioning completely. Imagine your worst fear and imagine it’s always there,” he says.
In June, his situation deteriorates and carrying out his daily activities becomes impossible. “The alarm in my brain never stopped. My thoughts were spinning. There’s nothing you can do to make it stop,” he said.
Exhausted, he went to Notre-Dame Hospital, where he was admitted for a one-week stay. “I walked into the hospital thinking, ‘If they don’t give me a follow-up, I’m going to kill myself. » »
After a few days, he is informed that there is a new hospital-at-home program. “At first, I wasn’t sure, because I’m in a roommate,” he says. A social worker and a nurse suggest that he meet at a café or in a park, rather than at his apartment.
They listened to me and gave me a follow-up plan. This meeting gave me hope. It was a key moment for me. To get better.
Mathieu
A model soon to be widespread
The home hospitalization program brings together regarding fifteen health professionals: nurses, administrative officer, psychiatrists, social workers.
PHOTO MARCO CAMPANOZZI, THE PRESS
Since June 12, the CIUSSS du Centre-Sud-de-l’Île-de-Montréal has offered mental health home hospitalization, a first in Montreal.
“We’ve wanted this service for a long time. To offer a [solution de rechange] traditional hospital service”, says Nathalie Lefrançois, head of program administration, alternatives to hospitalization. The service is offered to people aged 18 and over whose mental state is sufficiently unstable to require emergency services or hospitalization.
But here, there are no blue hospital gowns or curfews. “The person can receive equivalent care [à ceux qu’elle recevrait] in the hospital, but staying in his living environment,” says Ms.me The French.
Hospitalization at home generally extends over a period of six to eight weeks. “The goal is to mimic the hospital episode and then someone else takes over for the long-term follow-up,” says psychiatrist Marianne Genest.
PHOTO MARCO CAMPANOZZI, THE PRESS
Marianne Genest, psychiatrist, Nathalie Lefrançois, program administration manager, alternatives to hospitalization, and Janie Bouchard, nurse clinician
This model has already been implemented in the Capitale-Nationale since 2009. A separate home hospitalization program has also existed since 2015 at the University Institute of Mental Health in Montreal for elderly patients with mental health problems. The Capitale-Nationale model is also being deployed in Mauricie and in Centre-du-Québec, in Outaouais, in Laval, as well as in the west of Montreal.
“We want to continue to extend this model throughout Quebec”, declared to The Press the office of the minister responsible for social services, Lionel Carmant. The objective is to bring “mental health services closer to the community”. “This will allow us not only to avoid revolving doors, but also to keep the family more involved in care and services. »
“I was so reassured”
During the first weeks, Mathieu had meetings every day, then the frequency decreased to once a week. During the sessions, the team monitors his medication, assesses his needs and identifies factors that may have an impact on his mental health.
“The medication and the follow-up had a big effect,” he rejoices, noticing a decrease in the intensity of his symptoms over the past few weeks. Mathieu will end his home hospitalization at the end of August and will continue his outpatient follow-up through a separate program.
PHOTO MARCO CAMPANOZZI, THE PRESS
Nurse clinician Janie Bouchard, from the hospital at home team, speaks with the mother of a patient in the comfort of her living room.
One of the principles of the program is also to support and equip loved ones, underlines nurse clinician Janie Bouchard. Julie* experienced it. Her daughter Béatrice* has been part of the home care program since June.
From the moment the team arrived, everything changed. I was so reassured.
Julie, whose daughter benefits from the hospital-at-home program
“My daughter was always in an even mood, had a good lifestyle, she trained, thrifty, in her business, she has lots of friends”, explains Julie, installed in her living room. His behavior has completely changed this winter. “Overnight, she was talkative, her vocabulary was different, her facial expressions were different, we thought she was high. We didn’t recognize her. »
The family tries to take her to the hospital, but Beatrice refuses. “It was hell. For her, everything was fine,” says Julie, who had to obtain a court order to have her hospitalized. During her week-long hospital stay, Beatrice is diagnosed with bipolar disorder. He was finally offered to join the home hospitalization program in June.
At first, the team came to visit her three times a day. Separate meetings were held with Beatrice’s parents, to offer them advice and provide them with information materials. “It took a ton of bricks off my shoulders,” says Julie. “I really hope that this program will have children. I wish that to everyone. »
*Names have been changed to preserve patient anonymity.
Learn more
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- 1995
- Year of implementation of the first model of hospitalization at home in mental health, in the United Kingdom
Source: CIUSSS of the Capitale-Nationale
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