Article by Geoff Chaulk
Chloe and Elle lived on an all female unlocked unit on the first floor of the Waterford. They both appeared to have more by way of disabilities than psychiatric. Both women had a pronounced and staggering gait when walking, little by way of understandable speech, and Chloe needed to wear a hockey helmet to prevent head injuries should she fall, which she was prone to doing.
Chloe would regularly greet me when I came unto the unit, always smiling and jovial. Elle looked like she carried the weight of the world on her shoulders.
I recall the unit on which these women lived as having a positive and caring vibe – the patients were always well-dressed and groomed, the unit was bright and clean, and nurses were very involved with the patients day to day.
At this time during my Waterford experience I was covering for the social worker who was on holidays and I had an office on the unit where Chloe and Elle lived. At the time there was an interest on the part of nursing staff to see which of the women on the unit could return home to their families.
Somehow, Chloe was identified as someone who could return to her family and home community. I was asked to contact the family to begin discussions. The nurses had some discussion with Chloe about this move, as did I, but it was a limited discussion given Chloe’s difficulty with communication.
The family came to the hospital from their home in the central part of the island of Newfoundland. They seemed somewhat timid and perhaps a bit overwhelmed by the hospital, and what was being considered. Members of Chloe’s treatment team met with the parents to discuss Chloe’s day to day needs, her routine, and how to help Chloe adjust to life at home.
A big missing piece of the plan to have Chloe return home was the community support, or lack of, that would have helped Chloe and her family make such a big adjustment and transition. I recall Chloe and her family being so happy to see each other and Chloe seemed to be enjoying all the attention that she was getting.
The next thing that I remember after Chloe was discharged home was a frantic call from her mother. The family lived many miles from the hospital and it would have taken about a day to get from where they lived to the Waterford.
Therefore, they could not avail of face to face support from the treatment team who had known and worked with Chloe for a long time. The family had been assured that if moving home did not work out then Chloe could return to the hospital. Without community support services to help Chloe and her family make the transition that was the best we could offer.
Meanwhile, Elle was aware that Chloe’s family had taken Chloe home. Elle started to come to my office or approach me when I came to work with the simple but heartbreaking words, “me go home,” and the gentle gesture of pointing to herself.
Those words stay with me to this day as does the sad and mournful expression on Elle’s face. I wrote to Elle’s family to see if they would like to discuss Elle moving back home. They lived in a remote coastal community where, like Chloe and her community, there was no community support site for those with mental illness.
I’m hazy on the details, but after one conversation with Elle’s mother, who didn’t have a phone of her own, efforts to call back and contact the mother again proved fruitless.
Chloe’s move home did not work out and this was difficult for her and her family. She returned to the hospital. Elle did not get her wish at that time to go home. I and the treatment team were naïve in our understanding of what a big change moving home meant for the patient and family and we did not seem to consider the lack of community support and how this would make challenging situations all the more so.
One of the many things that stayed with me these 30 years later is the need for a robust community mental health service system to support people and their families as transition from inpatient care to community is made. I have worked in this province and in Ontario on exactly this issue, perhaps in an effort to not repeat the failures that Chloe and Elle experienced – they both taught me a lot.