PATHWAYS: Evaluating the Transition of Psychiatric Services from Hospital to Community

The Riverview Hospital Decentralization Study will capture a rare moment in time in Canadian mental health history by documenting the closure of Riverview Hospital (RVH) and evaluating the implications of decentralizing psychiatric services in British Columbia. This study is unique from some of the other projects that are examining RVH patients because it will examine patients’ strengths and risks, document changes in dynamic, treatment-friendly variables, and examine positive and negative outcomes across multiple domains. The researchers have funding to track the impact of decentralization of patients and clinical services every 3 months over a one-year-period beginning 2007. Ultimately, the goal is to follow-up the patients annually for several years, thus evaluating the short-term and long-term implications of the restructuring of services.   
 

Overview of the study

The study will focus on the remaining patients at Riverview Hospital as they undergo the transition to tertiary regional psychiatric facilities within the community. Through file reviews and patient interviews, the study will capture the baseline mental health status and well-being of patients being transferred from RVH. Researchers will document possible therapeutic improvements, changes in quality of life and details about adverse incidents (e.g. suicide, self-harm, victimization, violence) by conducting follow-up assessments with patients every three months for one year. In addition, researchers will also collect relevant supplementary information by examining official databases and by interviewing staff and family members.

Who is conducting this study?

The principal investigator, Dr. Tonia Nicholls, Senior Research Fellow at BC Mental Health & Addiction Services, has a PhD in psychology with specialized training in forensic psychology and the law. The study is a collaboration between clinicians (Drs. Soma Ganesan, Johann Brink), senior administrators (Leslie Arnold, Patrick Smith, Peter Coleridge, Lynda Bond), and researchers from BCMHS (RVH and the Forensic Psychiatric Hospital), SFU, and UBC. This partnership between researchers and decision-makers at BCMHAS and within the Provincial Health Services Authority(PHSA) will help to ensure that the study is relevant to the patients and that it provides empirical evidence that will inform evidence-based practice.

How will the study affect patients and staff?

Patients will be asked to take part in a series of 5 interviews. The baseline interview will take place at RVH before the patient leaves; the others will take place in tertiary regional psychiatric facilities within the community. Participants will also be requested to grant the researchers access to their files and official records and to seek the approval of a family member or friend who is willing to take part in the study. Over the course of the study, research assistants will need access to files, interview rooms and some staff assistance (e.g., arranging interviews). In order to obtain supplementary details on patients’ mental health and behaviors over the last few months, staff will also be asked to participate in brief interviews.

Potential benefits of the study

By documenting the practical, clinical, and social implications of this restructuring of health care delivery, this research will capture a rare moment in Canadian mental health history and this study will have broad implications for the immediate future of mental health care delivery in BC and may further establish the PHSA as a leading organization in health care delivery.

For more information contact:

Tonia L. Nicholls, PhD
Senior Research Fellow