Editor’s note: this is a continuation in a series of articles examining the workload and struggles inside Vernon’s hospital following the death of 22-year-old Ezra Cool
As psychiatric cases become more numerous and complex locally, the psychiatrists at Vernon Jubilee Hospital have become fewer in number.
And while Interior Health has previously said that the resignations of four Vernon psychiatrists last year were not connected to one another, a pair of the hospital’s few remaining psychiatrists contend that there is an underlying commonality running through all of these departures.
That commonality, they say, is the severe workload strain they’re faced with on a daily basis — an overwhelming body of mental health cases divvied up by too few psychiatrists, which pushed nearly half of those psychiatrists out the door.
The two psychiatrists who spoke to The Morning Star did so on the condition of anonymity out of concern for their job security.
They chose to speak up after hearing the accounts of three nurses who described their trials and tribulations at the Vernon hospital to The Morning Star earlier this spring in the aftermath of the death of Ezra Cool. The young man languished in the emergency department for nearly a week in February without making it to the hospital’s psychiatric unit, and ultimately escaped wraparound supervision under the Mental Health Act and became the victim of a fatal highway collision hours later.
The psychiatrists couldn’t speak to Cool’s individual case, but the workload struggles they described mirror those of the nurses in the emergency department.
“Most of us are already working far beyond full-time to begin with, and then now we’re working much further beyond that, to the point of really significant burnout,” Psychiatrist One said, in light of the resignations. “It’s just not healthy and safe to be working at this pace and at this level.”
“We know that there’s been a dramatic increase in the number of adolescents that are experiencing significant mental health challenges, and we have had just more and more consults on call on the weekend,” added Psychiatrist Two. “It’s just not manageable with the number of people that we have.”
With their numbers cut nearly in half in the wake of the resignations, and with a new psychiatry unit no longer appearing to be on the horizon, the psychiatrists believe something has to give. They hope it won’t be themselves or their colleagues.
Resignations not a pure coincidence, sources say
The psychiatrists said the four resignations were not merely a cluster of personal decisions, instead suggesting an untenable work environment underpins them.
The psychiatrists know their former colleagues well, and heard them say the pace was unsustainable on their way to resigning.
They said some of the psychiatrists who resigned didn’t in fact leave the hospital outright; rather, they are significantly scaling back their hospital loads because their heads were underwater. This, to the psychiatrists, indicates that these colleagues still want to be involved in working at the hospital, but it was just too much.
They agree there may have been a domino effect at play in which one resignation worsened the working environment, and that then led to other resignations.
What’s clear is they don’t believe the resignations were purely coincidental; instead they were circumstantial, and the circumstances at Vernon Jubilee Hospital amount to an understaffed psychiatry unit where the morale is sinking.
“I think more than downplaying it, (Interior Health is) potentially diverting the real issues that are at play there,” Psychiatrist One said.
Chris Simms, Interior Health executive director of clinical operations, previously told The Morning Star that help is on the way. A new psychiatrist is expected to start in June, and the psychiatrists confirmed it appears that will happen. Simms said another six psychiatry candidates are looking into positions at the Vernon hospital as well, though on that front the psychiatrists The Morning Star spoke said they’re tempering expectations.
“Many of these people are looking at multiple sites,” said Psychiatrist One, adding those recruits will likely tour hospitals in Kelowna, Kamloops, Penticton and perhaps even the Lower Mainland.
Meanwhile, the psychiatrists believe Interior Health’s compensation for locums isn’t competitive enough, leaving the hospital without enough temporary psychiatrist fill-ins from other areas to “keep the boat afloat until we can get some more people,” said Psychiatrist One.
“We certainly haven’t had anybody come in knocking on our door wanting to join us,” said Psychiatrist Two. “We don’t think it is competitive enough to attract people.”
There is even a shortage of care aides at the hospital, the psychiatrists said, and this leaves the psychiatrists without an essential component of psychiatric treatment, as care aides are heavily relied upon to help patients who require one-to-one care.
A field with growing challenges in a hospital with fading resources
Psychiatrists spend a minimum of 13 years in higher education to prepare themselves for what amounts to a highly intricate task. Trained as medical doctors who specialize in mental health, they must navigate the incredibly elaborate relationship between the body and the brain, picking up on subtle corporeal and behavioural clues to ascertain that which can’t be directly seen.
The job isn’t getting any easier.
“It’s become much more complex over the years,” said Psychiatrist One.
He figures the Vernon hospital has gone from 18 psychiatric beds to 35 in 10 to 15 years, and they’re full all the time. Beyond that, the individual cases in Vernon are becoming more difficult to work through.
“We’re just seeing significantly more complex patients,” said Psychiatrist One, explaining Vernon’s aging population is one reason for that; another is the recent “doubling to tripling” of youth mental health cases seen throughout the Western world; and another is the toxic drug supply and overdose crisis that has taken hold in Vernon and well beyond, and has left people with acquired brain injuries secondary to overdoses.
It’s been about a 15-year run of increasing case complexity, and as Psychiatrist Two pointed out, the result today is a lot more aggression and violence in hospitals.
Fentanyl has taken the spotlight in the toxic drug crisis discourse, but Psychiatrist Two said the growing prevalence of methamphetamine is the bigger issue when it comes to violence in hospital settings.
One psychiatrist was assaulted in hospital’s lower psych ward, where patients in more acute stages of mental illness are kept, the psychiatrists said.
The hope is that the psych ward, which both specialists described as dangerous, will eventually be phased out — though it appears ‘eventually’ is the operative word.
Vernon’s ‘repaced’ psychiatric unit
Despite the working environment and facilities that the psychiatrists agree are substandard at Vernon Jubilee, in recent years there was always a glimmer of optimism that recruitment of new specialists would be successful. That’s because there was — to repurpose an old Reaganism — a shining psych unit on a hill that was just around the corner.
In 2024 premier David Eby came to the hospital to announce the province’s investment in building a new, state-of-the-art psychiatric unit there. Out came plans for 44 single-occupancy patient rooms with a more modern environment for patients. Eby said at the time the $110 million-plus facility could be expected to open its doors in 2029. Construction was meant to begin this year.
As folks in Vernon can readily see, shovels have yet to hit the ground. And as the psychiatrists can attest, that likely won’t happen for years.
The psychiatrists said they were told in mid-April that because the province is fiscally restrained, it’s going to have to “repace” the build of the new unit.
It’s a word that was grating to both of them.
“Some have suggested that we’re going to have to go back and develop a new set of blueprints, revise numbers and revise builds,” Psychiatrist One said. “Those all take two or three years to happen.”
Other subtle changes in messaging portend significant delays with the project.
“We were told for the last couple of years that this is the number one capital project for Interior Health,” the psychiatrist said.
“Now we’re being told that it’s amongst the top projects. And even with that, we’re hearing that it’s being dropped in priority with Interior Health. It didn’t make it into the budget this year.”
It’s a huge issue for the psychiatrists, who don’t know if they can wait years on end for construction to start on a new psych unit.
The current psych unit was built in 1972, and the psychiatrists say 54 years of advancements in mental health treatments leave much to be desired at the aging facility, which is drab, under-equipped, and has poor sightlines for staff to keep an eye out for safety concerns.
“There’s nowhere where you can exercise, really. There’s one shower on there, as far as I know, for 18 beds,” said Psychiatrist Two. “It’s dismal and its unsafe and inadequate in so many ways.”
In an email to The Morning Star, the Ministry of Infrastructure said the most recent proposal it’s received from Interior Health on the psych unit project included a substantial cost increase and would require significantly more funding than originally anticipated.
“Like other governments across Canada, we are facing fiscal pressures that require realistic and disciplined decisions to protect the services people rely on and maintain long-term stability,” the ministry said. “These financial pressures, combined with broader economic uncertainty, have driven up costs and affected supply chains, which is especially challenging for large provincial capital projects.”
The project will move forward, according to the ministry, though the pace at which it will move and the stage it’s currently in remain unclear.
“We are taking the necessary time to work together with Interior Health to identify a path forward that is both financially sustainable, and ensures the project meets the needs of the community and patients for generations to come,” the ministry said.
As things stand, the psychiatrists say the current psych unit can’t offer what they need.
Psychiatrist One pointed to the simple aesthetics of the unit. One may think a bland, institutionalized look isn’t a big deal for a hospital, but for health care specialists hoping to turn someone’s mental health around, it’s a massive barrier.
“For us, the milieu, the environment, is the tools of the trade,” he said, adding he’s working with 50-plus-year-old tools in this respect.
The adverse effects of this environment come into focus when patients enter the unit.
“You can just see that they are completely disheartened and shocked and dismayed that they’re expected to get better in this environment,” Psychiatrist One said.
All this would be stomachable if in fact there was a new, shining psych ward on Hospital Hill to look forward to in the near future.
“It’s just incredibly demoralizing and disheartening as we’re trying to recruit new team members here, to be in this situation where we can’t even promise that we’ve got a new build coming,” the psychiatrist added.
The psychiatrists aren’t overly hopeful about the six recruits that are looking into Vernon in part because they themselves have seen the other psychiatry units that exist in the area which offer a better environment for those candidates.
Psychiatrist Two described Kelowna’s psych unit.
“Individual rooms, own shower in the room, privacy so you don’t have to worry about the patient beside you, and it’s on the fourth floor with a beautiful view of the lake, a big space … a calming room and a recreational area,” he said. “It’s a bigger unit but it’s really nice, they brought modern features into the design of these units.”
Over time, much has been learned about healthy spaces for recovery: the lighting of a unit, the collective spaces, physical exercise, spaces for group activities and group therapy, room for training and education and so on.
“All those features are part of a modern mental health psychiatric unit that were never dreamed of at the stage this unit was created,” Psychiatrist One said.
What the future holds
It’s unclear what will become of Vernon’s psychiatric unit project given the province’s financial situation and the changing language around the project’s priority status. Beyond that, the psychiatrists are worried about the next generation of health care professionals in Vernon.
Psychiatrist Two said safety for medical learners at Vernon Jubilee is something that has been questioned. He believes the unit isn’t a safe environment for residents and medical students to learn on the job.
“If we can’t get medical learners here, including residents, then it’s harder to build recruits from the grassroots,” Psychiatrist One added.
The Ministry of Health told The Morning Star on May 12 that improvements are being made at Vernon Jubilee. Secure room safety upgrades within the psychiatric unit are nearing completion, the ministry said, “including enhanced security access, nursing station enclosure, secure patient spaces, and improved camera coverage.”
These upgrades may serve as a safeguard in cases such as Ezra Cool’s. They come months too late for Cool, who nurses said could have been saved had there been an available and staffed secure space for him.
The addition of a new mental health pod that opened at Vernon Jubilee last October to provide acute care for youth aged 12 to 18 is a positive step.
Improvement efforts will continue, the ministry assured.
“This work will include engagement with staff, physicians, and community partners as next steps and potential site improvements are considered,” the ministry said.
Interior Health did not respond by deadline to a question about the degree to which it is lobbying to make the psych unit project a top priority.