Psychiatrist pulls services from ER over safety concerns

A psychiatrist is refusing to offer consultations at the Sechelt Hospital emergency room in an effort to get Vancouver Coastal Health (VCH) to address safety concerns.

Dr. Anthony Barale, medical lead for the Addictions and Mental Health Unit in Sechelt, has been practising on the Sunshine Coast for the past eight years.

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On Dec. 5 he emailed colleagues to inform them that as of the following day he was withdrawing psychiatric consultation services from the ER “until further notice.”

Barale’s decision was prompted by concerns about the safety protocols for dealing with patients who become violent.

“I have been pursuing changes over many years now with little response from VCH and certainly no acknowledgment, at all, of the urgent nature of our concerns,” Barale said in the email. “I am no longer prepared to risk life and limb for an organization that has consistently paid scant attention to our myriad of concerns communicated to VCH over many years. The evidence for VCH’s unwillingness to attribute any sense of urgency to assisting us with our truly awful working conditions is overwhelming and would be apparent and obvious to all by the most uncaring and callous of persons.”

Barale told Coast Reporter this week that his decision to withdraw consulting services for the ER will not impact any of his other work, and that he’s hoping meetings planned with VCH officials in the coming days will result in him resuming work in the ER.

“It’s very important for the people of the Sunshine Coast… We want to be able to provide safe high levels of care in the emergency room,” he said.

Other doctors associated with the hospital drafted a letter to VCH supporting Barale.

“The current psychiatric in-patient unit is clearly unsafe, both for staff and patients, a fact acknowledged by administrators for more than six years. All efforts to build a more suitable space have been blocked,” the letter said. “There has been no sense of urgency attached to the need for a safer work environment in the in-patient unit, the outpatient buildings and in the ER.”

The letter also claimed “the psychiatrists have been treated with disrespect by the hospital leadership” and pointed to the results of the recent Doctors of BC Health Authority Engagement Survey, which suggested physicians working at the hospital are unhappy with VCH leadership.

There were 27 responses to that survey from doctors associated with the hospital, with an average negative response rate to the nine statements on the questionnaire of 73 per cent, well above the numbers for other VCH facilities.

The BC Nurses Union (BCNU) has been campaigning to increase public awareness of the high risk of violence nurses throughout the province face at work.

When contacted by Coast Reporter, the BCNU said it has also raised concerns about safety at Sechelt Hospital.

Kath-Ann Terrett, chair of the union’s Coastal Mountain Region, said numerous reports have been filed by nurses citing “actual and potential threats to safety.”

Terrett said the BCNU has asked VCH for more community mental health and addiction resources, security guards who can do hands-on interventions, more nursing staff to make it possible to respond faster to diffuse situations, more violence intervention training, and secure rooms where patients can be treated with less risk of harm to themselves and others. 

She said those requests “have not been addressed by the health authority in a meaningful way.”

Karin Olson, chief operating officer of VCH Coastal, was not available for an interview, but in a written statement said, “Vancouver Coastal Health has been actively engaging with the facility engagement committee at Sechelt Hospital this week to address their concerns. We’re hopeful for a positive outcome – these discussions are currently ongoing so we won’t be able to provide an update until they’ve concluded and we can announce a clear path forward. We’re committed to ensuring Sechelt Hospital is a safe environment for all patients and staff.”

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