Overhaul Janeway psychiatric unit: report

A St. John's hospital unit designated to treat mentally ill children and adolescents is not appropriately staffed and requires significant help to do its job properly, a report released Friday says.

The office of Newfoundland and Labrador's child and youth advocate launched a probe into the Janeway hospital's psychiatric unit after two adolescents were transferred to the Waterford mental hospital - an adult facility - in December 2008. One of them was transported by police in handcuffs.

The probe was called after CBC News reported on the transfer and temporary shutdown of the unit, which happened because of a lack of available nursing staff.

The move, which put adolescents among mentally ill adults, upset families and drew calls for reform and extra resources at the province's only pediatric hospital.

Acting child advocate John Rorke filed 18 recommendations to the government and Eastern Health. Among other things, he calls for a dedicated team of specialists, a change in management strategies and a new approach to caring for mentally ill young people at the unit, known as J4D.

"One of the key findings of this report was that, as a non-specialized unit, there is no requirement for J4D to hire psychiatric trained nurses," Rorke found.

"Training on the unit is also not a requirement to maintain a nursing staff position. Many staff from various disciplines voiced concerns with the lack of training required for nursing staff in the area of mental health and were of the opinion that J4D should be designated as a specialized unit."

The investigating team also identified "issues of inconsistency, communication challenges, a lack of team cohesiveness and low morale. It also revealed human resource challenges, which included budgetary restraints, programming and treatment gaps, a lack of community wraparound services, as well as concerns surrounding recruitment and retention."

Rorke also said a new approach needs to be taken at the unit, and beyond, to better serve children and adolescents, as well as their families.

"The unit needs to be more patient-centred, flexible, and adaptable. A mindset shift needs to occur," he wrote.

Rorke completed the investigation after the house of assembly fired former advocate Darlene Neville, following complaints about how she managed her office and dealt with confidentiality issues.

Rorke's office said Friday he will not be doing interviews on the report, which it said speaks for itself.