The Child and Youth Advocate (Acting), John Rorke, today released the Report on the Investigation into Janeway Psychiatry Unit J4D Programs and Services.

On December 13, 2008, Eastern Regional Integrated Health Authority made the decision to shut down Janeway Psychiatry Unit J4D, the province's only mental health facility providing services to children and youth. This closure resulted in the subsequent transfer of two adolescent inpatients to the adult Waterford Hospital, which was the only available facility at that time. The safety and protection of the two patients were the main concern and the Royal Newfoundland Constabulary (RNC), as required under the Mental Health Care and Treatment Act, provided escort for the transfer as this was deemed to be the safest mode of transportation. The law requires some measure of restraint to be used. Consequently, handcuffs were used to restrain the patients as this was considered to be the least restrictive device. While the transfer to the adult hospital under police escort was not viewed as ideal, it was determined to be the best choice available at the time.

On December 15, 2008, the Office of the Child and Youth Advocate provided notice of the intention to conduct an investigation into the psychiatric services and programs provided by the Janeway Children's Health and Rehabilitation Centre during the period January 1, 2008, to December 31, 2008. It applied to all patients who were either assessed by, or admitted to, the Janeway Psychiatry Unit J4D for reasons of self-harm, suicidal risk and/or behaviour which presented risk of harm to others.

The investigation identified several concerns which, in our analysis, led to the closure of J4D, including the need for policies relevant to the patient population served, consistent interpretation and implementation of policies and procedures, communications issues, a lack of team cohesiveness and low morale. It also revealed human resource challenges including budget restraints, programming and treatment gaps, a lack of community wraparound services and concerns regarding recruitment and retention. One of the key findings was that, as a non-specialized Unit, there is no requirement for J4D to hire psychiatric trained nurses.

All children of Newfoundland and Labrador have the right to an efficient and fully operational mental health facility developmentally designed to address their specific needs. As a result of the Investigation, the Office of the Child and Youth Advocate is making 18 recommendations which, if implemented, will assist in providing the best possible mental health services for the children and youth of our province.

Mr. Rorke said, " We hope that our investigation and recommendations clarify for the public the problems faced by those attempting to provide psychiatric services to children and youth in Newfoundland and Labrador, and lead to improved services and resources to assist those charged with the responsibility of caring for the most vulnerable group of persons in our society."

The Office of the Child and Youth Advocate would like to thank the many patients, families, health professionals and administrators responsible for the care of patients admitted to J4D for their participation in the formal Investigation. The Advocate also thanks the employees of the office for their participation in the investigation and for the preparation of the report.

The Report on the Investigation into Janeway Psychiatry Unit J4D Programs and Services is available online at www.childandyouthadvocate.nl.ca/resources.html

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Media contact:

Colleen Meaney
Office of the Child and Youth Advocate
709-753-3636
colleenmeaney@ocya.nl.ca