When Stephanie McCabe goes to an appointment with her psychiatrist at London’s Victoria Hospital, she’s supposed to wear a purple armband. It’s to alert hospital staff that she’s a potential threat to herself and others.
It all stems from a psychiatric episode she had last summer that required a stay in hospital.
“The fact that they said I could be violent upset me very much. I’ve never been violent,” said McCabe, a mother of two.
McCabe is one of the almost 100 people who have filed appeals to the London Health Sciences Centre (LHSC) after the hospital started flagging patients as potentially violent and forcing them to wear the armbands when they visit the hospital.
Patients who refuse to wear the armband — a visual signal to doctors, nurses and others — are required to have an escort with them wherever they go in the hospital, including the bathroom, or seek treatment elsewhere.
In May of 2018, a settlement with the Ontario Nurses Association led to a new violence assessment tool being used at LHSC to flag patients with a history of violence or a potential for violence. That’s when the purple armbands came into use.
To protect patient confidentiality, we are unable to provide a breakdown of appeal decisions– Kathy LeBlanc, spokesperson for LHSC
Since then, 95 appeals have been filed with the patient relations department at the LHSC, including the one from Stephanie McCabe.
Four of those appeals were filed just in the past week, a spokesperson for the hospital told CBC News.
But how many of those appeals have been resolved, and how many patients managed to reverse their designation, won’t be made public, the spokesperson said.
“To protect patient confidentiality, we are unable to provide a breakdown of appeal decisions,” Kathy Leblanc wrote in an email to CBC News.
“Patient confidentiality” is also cited as the reason the hospital won’t say how many of the appeals are ongoing.
‘I don’t think it’s right to label people’
McCabe, 44, filed her appeal in October and has called once a month since to find out how her appeal is going, but has been told it hasn’t been looked at yet. Her most recent call was last week.
She isn’t even sure who makes the decision.
McCabe says her psychiatrist supports her appeal. Some psychiatrists at LHSC have been wearing pink wristbands with the words “stop the stigma” on them to protest the policy which they say unfairly targets mental health patients.
McCabe refuses to wear her armband. She says, when she goes to the hospital for a session, she has to wait in a chair — away from everyone else — until she is escorted to see her doctor or to attend group sessions.
Episode that led to McCabe’s designation
In August 2018, McCabe started experiencing hallucinations and paranoia. After calling Telehealth Ontario, she went to the emergency room at University Hospital in London, part of the LHSC.
She had dealt with depression before, but never symptoms like the ones she had then.
“I thought I was going to make other people sick. I was very emotionally upset, sitting in a chair, crying,” McCabe said. “The one nurse who was taking my blood was pregnant and I told her she didn’t want to touch me because I didn’t want to infect her.”
McCabe says she was sedated and, after a few hours, a doctor was able to convince her that the hallucinations were part of her mental illness.
She agreed to be admitted into psychiatric care and was taken to Victoria Hospital.
But, as per the new screening protocol, her paranoia gave her a flag of “potentially violent,” and she was put in a room at Victoria Hospital with security guards. The nurses and orderlies who dropped off her food approached her tentatively, McCabe said.
“I get it. I would probably approach someone with caution who was flagged like that. They don’t know why you’re flagged, they don’t know if it’s because you hit people or if it’s because you were experiencing paranoia.”
McCabe says she was never told she’d been flagged as being potentially violent, and she was not asked to wear an armband.
I was shocked. Even before I knew I was one of the people who were flagged, I was against it– Stephanie McCabe
It wasn’t until about a month later, after she was discharged and came back to the hospital for an outpatient therapy program called Track to Wellness, that she was told about the purple armbands.
The person running a group session explained the new policy, and told the group some would have to wear armbands on each subsequent visits.
McCabe was taken aside and told she was one of those patients.
“I was shocked. Even before I knew I was one of the people who were flagged, I was against it. I don’t think it’s right to label people.”
McCabe asked her psychiatrist to check her file. She was told she had been rated a “1” on a six-point violence assessment scale, the lowest rating for a threat. But that nuance isn’t communicated to hospital staff.
“This impacts my mental health because I refuse to wear the armband, so I can’t access some of the outpatient programs,” McCabe said.
Instead, McCabe has been getting help from agencies and resources in the community.
“I know some people will say I should suck it up and wear the armband, but I feel very strongly about this.