Several families with loved ones who are mentally ill are speaking out about what they call a decrepit, overcrowded, ineffective psychiatric facility at Vancouver General Hospital.
"It's a horrible place," said Shraga Dachner, whose stepdaughter is a former patient. "I would not put my dog in there."
"It's a place you would have difficulty healing in," said Ellen Wiebe, a medical doctor whose stepson was also a patient at VGH. "When he was in there … he got worse."
The building is 70 years old – and the director confirmed it is "falling apart."
"Even renovations at this stage aren't viable," said Lorna Howes, director of mental health services for the Vancouver Coastal Health Authority, which runs the hospital.
"The building is actually starting to deteriorate to the point that we cannot use it."
Howe said patients in crisis are crammed four to a room – with 10 sharing a bathroom – and have no privacy.
They are frightened and potentially dangerous people in crisis, she said, adding they should be in private rooms for proper treatment.
"A [patient] who is 18 — with a first psychotic break — may end up in a room with two or three other people who have had symptoms for even as long as decades … people that he may or may not get along with," Howe said.
"That room may change over with other new patients five times while he is there," she added. "We need something new. We need something better."
The hospital has 74 psychiatric beds in its four psychiatric treatment units, while the director said 100 beds are needed.
The B.C. Nurses' Union, which represents staff at the hospital, said patients are routinely given more medication than they would normally receive just to maintain control.
"They get more drugs because they're angry," said BCNU provincial council member Judy McGrath.
"It is overmedicating. We call it chemical restraints."
Hospital figures show prescription drug dispensing in VGH psychiatric units doubled in the last couple of years.
The figures show 40,324 doses of powerful anti-psychotic drugs were given to patients last year — up from 16,849 the year before — with no increase in patient beds. Those drugs are over and above each patient's usual prescriptions.
"Because they are in such close quarters … there's a lot of escalating behaviour between the patients as well as with the staff, so that is why they end up being medicated," said McGrath.
Ackerman said her mentally-ill daughter was over-medicated one of the many times she was admitted to VGH. Police had brought here there, suffering from a psychotic breakdown.
'They overdosed her," said Ackerman. "She was strapped down so she couldn't run away because she was on one of these beds in the hallway ... and the next day she had terrible bruises on her body."
Ackerman said her daughter was often put in isolation — in the only private room the facility has — which she said is like a prison cell.
"It is so terrible to see her in there, because all there is is a metal toilet and a low bed on the floor, no windows in the room — and she is locked in," she said.
'Inhumane' treatment, mother says
"She's been in there up to five days and I thought that was inhumane. One day might have been enough to find her a bed somewhere."
Howes said there would be less of that kind of treatment in the proposed new facility.
"The chances of needing to seclude people, which sometimes we need to do for their safety, will reduce," she said.
Wiebe said being in the VGH made her mentally ill stepson even more frightened than he was during his initial crisis.
"When he was acutely paranoid, he would get worse when there was suddenly a new person in his [hospital] room … that's a really scary thing for somebody who is so scared already."
"After three days on medication, their symptoms go away and they say, 'Oh you are better now you are done' and they want to release you," said her husband, Allan Oas.
"It's a revolving door and it doesn't do any good."
Howes admitted patients have been given increasingly intensive drug treatments, because they are cycled in and out of the hospital quickly.
"We need spaces that people can be looked after in," she said. "This is a vulnerable population and when they are psychotic they are even more vulnerable."
McGrath added the place is often filled to overcapacity, so temporary beds have to be added to the already crowded rooms.
One patient talked to CBC News while he was out having a cigarette in front of the building. His complaint was the noise from other patients.
"People keep laughing and laughing and laughing. It drives me crazy," the patient said. "There's one guy on the ward, he was on the floor laughing. He was going hysterical."
He said had been committed to VGH, after threatening to kill his psychiatrist.
The nurses union said psychiatric unit staff members are increasingly worried about their health and safety.
There were seven critical incidents on VGH psychiatric units in the last three years — defined as "unforeseen or unexpected occurrences that causes serious harm [loss of life, limb or vital organ] to the patient or had a significant risk of causing serious harm."
With the building's poor ventilation, the union said nurses are also concerned about air quality.
Asbestos worries staff
"The [biggest] concern is of course asbestos," said McGrath.
She said a nurse who worked in at the old UBC hospital in the 1980s recently died from mesothelioma, a lung cancer caused by asbestos exposure. Although precautions have been taken to make sure staff are not exposed in the old VGH building, she said the death of a colleague makes them nervous.
"Staff don't trust that the employer will be honest with them," said McGrath.
Howes said asbestos is one reason upgrades or repairs to the building would be a waste of taxpayers' money.
"You go into any of these walls, that's where you are going to find the asbestos," she said.
"So any task that has to be done — like removing pipes — you actually needed a complete asbestos removal or at least an asbestos protection piece."
The foundation that raises money for Vancouver General Hospital has been lobbying the province to contribute $42 million for a new $74-million facility, which Howe said would drastically improve conditions for patients and staff.
Although plans for the new building have been in the works since 2002, the province has yet to come through with funding. The current building is set to be demolished.