Questions for Further Discussion:

a. What mechanisms should be explored to more closely coordinate
services for patients between aifferent elements of the service
system? -

2. ACUTE PSYCHIATRIC CARE
Proolems:

~ aifficuity in gaining access for patients to acute care services for
general and especially emergency psychiatric care;
- management of those patients with severe behavioural disorders.

Consensus:

2.1 There shoula be a reallocation of acute care capacity from
Riverview/Yalleyview to general hospitals in order to enable each
region of the Province to become relatively self-sufficient in its
ability to handle acute psychiatric presentations. There should be a
continuum of acute care services available to each region, ranging
from the general hospital emergency department, general hospital
psychiatric unit, a designated regional psychiatric unit with extra
resources to support smaller psychiatric units in the area, and a
central Provincial unit for the most severe acute care patients.

General hospitals without psychiatric units should have a secure roca
capability in their emergency department to handle psychiatric
presentations for up to 24 hours. There sheuld be protocols in place
to transfer these patients, if required, to a general hospital with a
psychiatric unit within the region.

Local general hospitals with psychiatric units should maintain a
secure roon capacity within the unit.

Local general hospitals with psychiatric units shoulda be responsible
for the full range of acute services, efther through airect provision,
or by established protocols for referral to the regional hospital.

An intensive acute care psychiatric unit should be establishea in a
major general hospital suitably located to meet the short-term
treatment neads of the Province's most severe acute cases.

More acute ca bed capacity in genera? hospitals is required in many
areas to meet .:rrent and futurs nesds.

TO eRe oN me mee ere et ore ne totem opto Et