Abuses uncovered at Montreal 'asylum'
Montreal -- In a scenario reminiscent of a 1950s-style insane asylum, scores of patients are being kept locked up in a Montreal psychiatric hospital even though they don't suffer from any psychiatric disorder, Quebec's Public Curator said yesterday in a devastating report.
The curator, Pierre Gabrièle, said that in Montreal's 567-bed Rivières-des-Prairies psychiatric hospital, patients have been strapped to their beds all night, kept abusively in straitjackets, or left zombie-like from too many drugs.
"It's an asylum-type institution, like from the 1950s," Mr. Gabrièle said in an interview yesterday.
The report describes agitated patients being given high-dosage cocktails of drugs. Two antipsychotic drugs at once have been given to 48 patients, a rare medical practice. Patients share underwear and socks and some men and women have been put in the same room without their consent.
The report catalogues a litany of inadequate diagnoses and poorly kept patient files as well as a drab and constrained world of electronically locked or padlocked doors.
The Public Curator, who acts as guardian for incapacitated Quebeckers, sent a team of experts to investigate the hospital for six weeks late last year.
Mr. Gabrièle, a career Quebec civil servant, recently took over the job, which itself had come under fire for mismanagement in a report last year. Under his leadership, he plans to launch inquiries into the treatment of his charges in several other Quebec institutions.
The team concluded that the hospital doesn't meet Quebec Health Department standards and no further patients should be sent there.
Among the team's findings was that 155 patients at the hospital don't have psychiatric problems at all, but suffer from autism, epilepsy, Down syndrome or mental retardation and should be out of the hospital and getting help in the community.
"We know that mental retardation is a permanent life condition and not an illness, strictly speaking," the report says. "Generally, these people . . . should be followed in the community, by a completely different type of service."
Yet some of these patients have languished in the hospital for as long as 30 years.
Rivière-des-Prairies is one of the smaller psychiatric hospitals in the province, with 567 patients. The curator, known in other provinces as the public trustee, represents 412 patients at the hospital who have no one else to look out for their interests. He said each of the 155 non-psychiatric cases will be re-evaluated, and may be released.
The report also outlined "abusive" use of medication and restraints. A third of patients sleep attached to their beds, some unable to turn around, forced to sleep on their backs all night.
The hospital's board of administration called the curator's report a "severe criticism," but said it approved of the findings. It promised to draw up a plan to respond to the recommendations and asked Quebec Health Minister Pauline Marois to name an outside observer to oversee the changes.
Mr. Gabrièle refused to assign blame for the hospital's problems, saying his job was to improve the situation, not point fingers. He said it wasn't clear whether the heavy use of restraints resulted from too few staff, was meant as punishment or was a preventive measure.
The Rivières-des-Prairies hospital has a history of troubles. In 1985, a Quebec government commission reported systemic abuse of patients by hospital staff.
Last summer, the hospital was in the headlines again when a mentally handicapped patient became pregnant after a sexual assault. The woman gave birth last October and has left the hospital.
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