The nurse thought it was a mistake. A large patient at Ontario Shores Centre for Mental Health Sciences was given a plate with six pieces of ravioli on it as that day’s lunch. The nurse on the unit thought it was not going to be nearly enough. When she contacted the dietary department they said there was no mistake, these are proper portions.
Staff at Ontario Shores tell us that such portions mean the same patients are down at the canteen later on filling up on less healthy foods.
Recently we asked representatives from our mental health sector if they had similar experiences to their colleagues at Ontario Shores. The answer was yes.
By being strict about calorie counts, you would think that patients would be losing weight. However, when the evening meal leaves you hungry, there are other options, unhealthy options that result in patients actually gaining weight.
In another psychiatric hospital we were told of patients ordering in fast food to fill that hunger. While delivering a pizza or Chinese food to a public hospital may appear odd, it is not uncommon.
We were told these hospitals are taking it right to the line with regard to portion size and calorie count.
Given the continual complaints we hear about hospital food – particularly when it has been cooked miles away, frozen and rethermalized at the hospital – it reminds us of the old joke – the food here is terrible, and such small portions too!
Given Ontario’s psychiatric hospitals are run fiscally in the black, we can only conclude that the decision is based on a misplaced fervour for portion control and not about scaling back on food to save money. At least we would hope not.
The fact that this appears to be happening simultaneously at multiple locations would suggest there may be the imprint of the Ministry somewhere on this.
If the Ministry truly believes in evidence-based practice, it should be taking a hard look at the results of such policy. Anecdotal evidence would suggest it is having the opposite result to that which was intended. A lot of pizza, chips, KFC, and Chinese take-out is not going to result in a healthier patient population.
We also hear there is a fair amount of trading going on, bits of one meal traded for another. Concerns were expressed about the choices made by low-functioning mental health patients.
Then again, what would any of us do if forced into a similar situation? We hear all the time about family members bringing food into hospitals to supplement what’s available, or when it is unpalatable, to replace what’s on offer.
Meanwhile in Britain, which we often look to as an advanced view of what to expect in Ontario, the Care Quality Commission has issued 12 hospitals with warnings around meeting the basic nutritional needs of patients.
In the UK the issue is not so much dietary engineering around portions, but having the staff to assist patients with their meals.
According to the UK Telegraph, elderly patients in particular are not being given the assistance they need to eat, are being interrupted during meals, or have their food taken away before the meal is concluded. Sometimes the answer can be as simple as having someone take the lid off the meal container for a frail patient.
All of these things take time, and as health systems run on fewer and fewer staff, it becomes more difficult to attend to such details.
What’s the point of having all the expensive new technology and billion dollar P3 buildings if patients cannot access enough nutrition to sustain themselves while in hospital? Now that’s food for thought.