A hospital in Ottawa has recorded the longest emergency department wait times in the province for a third year in a row, according to an analysis of national health data.

In 2016, ten per cent of patients at Montfort Hospital’s emergency department would wait an average of nearly six hours before being assessed by a physician, almost twice as a long as the provincial average of three hours.

“We know we need to do better,” spokesperson Geneviéve Picard wrote in a statement.

Picard said the hospital, located along Montreal Rd. just east of Vanier, has made changes to ensure patients are seen quicker. The changes include hiring more nurses and adding physician hours to the emergency department.

The analysis looked at health data collected by the Canadian Institute for Health Information (CIHI) up to 2016.

A lack of available hospital beds has been putting “significant” pressure on emergency departments across the province, according to Dr. Paul Pageau, an emergency department physician at the Ottawa Civic Hospital and the President of the Canadian Association for Emergency Physicians.

Patients who are waiting to get transferred to long-term or community care facilities are often placed in emergency departments until those spaces become available, he said.

“To start off a morning where more than half of your available beds to see patients are occupied by non-emergency patients,” he said, “that’s going to delay that initial physician assessment.”

Ontario has cut the number of hospital beds by 18,000 since 1990 and has just 2.3 beds per 100,000 people, according to data collected by the Ontario Health Coalition. That’s one bed less than the national average.

Hundreds of hospital staff from across the province descended on the grounds of Montfort Hospital at the end of October calling on the government to end cuts and create 3,000 permanent hospital beds. Days before the protest, Health Minister Eric Hoskins had announced the province would make 2,000 beds available within the year.

The time it takes to see an emergency department phyisician is only one part of what CIHI Analyst Nicole Loreti calls a “complex issue”.

A report from the institute found the length of stay for emergency department visits is up by 17 per cent across the country compared to 5 years ago. In the past year, one in ten emergency department visits lasted longer than 32 hours.

“If they see a doctor quickly and then still have to wait for 33 hours to get into a bed, from the patient perspective that’s what they’ll remember,” Loreti said.

She also noted that while patients at Montfort might wait longer to see a doctor in the emergency department, their total length of stay is shorter than national and provincial averages. One in ten patients would be in the department for longer than 21 hours, according to the most recent data.

A lack of available beds has contributed to what the Ontario Hospital Association calls a “crisis” of overcrowding. Nearly half the province’s hospitals exceed 100 per cent capacity, with some as high as 140 per cent.

Ontario’s Auditor General report noted that, in some cases, patients were being kept on uncomfortable stretchers or gurneys in hallways never intended for care.

A lack of available hospital beds has been putting “significant” pressure on emergency departments across the province, said Dr. Paul Pageau, physician at Ottawa Civic Hospital. Source: Jordan Omstead.

“I can’t remember the last time we were under 100 per cent capacity,” Pageau said in a cafe at the civic hospital, as nurses and doctors on their morning break filed in and out of line for coffee.

“We all got into emergency medicine to help people,” he said, “but it can beat you down after fighting for things for so long.”

Suzanne Le, executive director of the Multifaith Housing Initiative (MHI), points at the plans of a recently completed development. As Ottawa struggles to keep up with affordable housing demands, not-for-profit providers such as MHI become increasingly important. Photo by Jordan Omstead

Nearly 9,000 more Ottawa households have a housing affordability problem than five years ago, according to an analysis of recent census data.

Defined by Statistics Canada, an affordability problem is when a household spends more than 30 per cent of its income on shelter. The number of houses in the Ottawa-Gatineau region hitting the 30 per cent mark broke 120,000 in 2016, an 8 per cent rise over 2011.

“When you drive around the city, it would never occur to most people that there is a housing crisis going on, but there is,” says Suzanne Le, the executive director of the Multifaith Housing Initiative (MHI). MHI is a not-for-profit charitable housing provider in Ottawa.

Households in Ottawa-Gatineau Region Spending More Than 30% of Income on Shelter Costs

The map displays the number of houses in each Ottawa-Gatineau census tract that spend more than 30% of their income on housing. The darker the colour, the higher the number. The lighter the colour, the lower the number. Use the ‘+’ and ‘-‘ to zoom, and click on the arrow in the top left of the frame for the legend and more details. Source: StatsCan Census 2016. 

According to Le, people spending more than 30 per cent of their income on shelter in Ottawa are disproportionately from low-income backgrounds. As housing becomes less affordable to those residents, they will be forced to rely on the city’s strained social housing stock.

As of 2016, over 10,000 households are registered on the waitlist for social housing, with families making up roughly a third of the list.

As the city struggles to keep up with the demand for subsidized housing, not-for-profit providers such as MHI will have to step up, according to Le.

In 2014, the City of Ottawa partnered with MHI to build a $20-million affordable housing community in Barrhaven, or ‘The Haven’ as the development is commonly known. Le gestures at the plans on her office wall as she recalls the morning in January when the social housing registry began to process applications for the 98-unit community.

By the time the registry opened at 6 a.m., the lineup wrapped around the building as people braved temperatures of minus 23 degrees celsius.

It was the registry’s single busiest day in 19 years, according to Le.

“You’re looking around at parents with anxious looks on their face, and I knew none of them were going to get a housing offer because by the time 9 a.m. hit they had already processed well over 100 applications,” Le says. “That’s the situation we’re at.”

A person earning minimum wage in Ottawa would spend 41 per cent of their income on the average market bachelor apartment, according to a recent report from Ottawa Alliance to End Homelessness. Someone on Ontario Works social assistance would be spending 115 per cent of their income on the same apartment.

Anissa Grant was on social assistance when she got the letter from MHI confirming her place at The Haven. She spent six years on the waitlist hoping to upsize from her one-bedroom apartment owned by Ottawa Community Housing, which she shared with her husband and three-year-old daughter.

“It was tough because my daughter grew up to walk and run in tight, sharp corners. She’d get injured a lot,” she says.

The lack of affordable housing is not only an issue in Ottawa. In Toronto, the waitlist stands at over 90,000 households. For every household that moves into a subsidized unit, another eight applications are received by the city.

As construction at The Haven neared completion in the spring, Grant says she would drive by to check in on her soon-to-be home, which at the time was just a skeleton of itself.

“I would walk up the makeshift construction ramp and take peeks inside the home and try to envision what was what,” she says.

As Grant looks back on her time in the one-bedroom apartment, she walks through her airy living room towards the window, her daughter’s toys arranged against the wall.

She says MHI offered her the house overlooking the playground, which will be done in time for summer.

(Caption: Ottawa’s bylaw department has received a record number of coyote related calls in 2017. Source: Christopher Bruno [CC BY-SA 3.0])

The number of reported coyote sightings in Ottawa has already hit a record high this year, according to an analysis of 311 call data.

203 sightings were reported to the city’s bylaw department in the first eight months of 2017. That’s a 45 per cent increase over last year’s total and more than any year going back to 2013, the last year of available data.

River Ward, a suburban ward that straddles the Ottawa River just south of downtown, made up nearly a quarter of the calls made so far in 2017.

The ward’s councillor Riley Brockington said he understands why some residents may be wary, but he doesn’t think it’s a cause for concern.

“This is coyote habitat, it’s Eastern Ontario,” he said. “Some people are surprised to see them in an urban setting, but it’s not out of the ordinary.”

The only risk is to pets and livestock, Brockington said. A fatal attack on a small dog in the McCarthy Woods, an area of green space in the southern part of the ward maintained by the National Capital Commission, was reported last October.

Brockington called for warnings signs to be placed at entrances to the park, but the results of a review by the NCC found there was not,  “a natural, compelling need,” spokesperson Jean Wolff told Ottawa Community News.

The number of coyotes in the Ottawa area and across eastern Ontario has remained stable or declined slightly over the past several years, according to Brent Patterson, a research scientist with the Ministry of Natural Resources.

It then makes it hard to explain why Ottawa is seeing the jump in sightings, Patterson said.

With higher than average snowfall in late winter this year, coyotes living close to the city that hunt smaller animals like squirrels and rabbits might have found it hard to find food.

“Snow and deep snow certainly interferes with their hunting behaviour,” Patterson said.

Coyotes have a diverse diet, eating anything from deer to berries to compost, so they might have moved towards human-related food sources to make up for a lack of prey.

Another theory Patterson offered was that as coyote populations decline, they tend to move closer to urban areas. “We don’t have the hard data for Ottawa,” Patterson said, “but we have some evidence of that sort of thing happening around the burrows in [Toronto].”

What is more likely is that multiple people are reporting the same coyote, he said. The city groups sightings by ward, but other cities like Toronto have taken to recording specific locations to help clarify the number of calls.

Other reports have suggested the presence of so-called “coywolves”, a hybrid between wolf and coyote, around Ottawa are to blame for spikes in sightings, such as those recorded in 2015 . Patterson dismissed the idea, saying nearly every coyote in eastern Ontario carries some wolf DNA.

“Genetically, the coyote you see in a rural area outside Ottawa in 2017 is the same coyote that used to live there in 1950,” he said.

Until there is a clear explanation for the rise in sightings, Brockington said it’s up to councillors to “take the temperature” of residents and make sure the community is well-informed.

Brockington will hold a coyote information meeting with his constituents on January 8.

“Coyotes have every right to live in this environment than humans do,” he said. “So, it’s about having a better understanding of how to coexist in the same community, in the same environment.”

When Sean Hopkins reads about a suicide in Whitehorse, he braces for the worst. “It’s highly possible that I know or have even looked after that person,” he said.

Canadians in the territories are nearly three times more likely to be hospitalized for intentionally cutting, poisoning, or harming themselves compared to those in the provinces, according to an analysis of national health data.

Hopkins has worked as a mental health counsellor in Whitehorse for the past 18 years. He’s no longer surprised by the number of self-injury hospitalizations, but he can see the effect on the community.

“It’s a difficult reality and there’s a kind of intimacy here because we’re such a small population,” he said.

Nearly all of the Yukon’s mental health services are located in Whitehorse, leaving nearly 14,000 people who live outside the city with “a poverty of services”, according to Hopkins. He said a lack of mental health supports in remote communities across the territories could help explain the high rates of self-injury.

The analysis looked at data from the Canadian Institute for Health Information (CIHI). CIHI tracks self-injury hospitalizations that are deemed intentional, reflecting suicidal behaviour.

Northwest Territories suffered the highest rate of self-injury hospitalizations in 2015-2016, with 194 hospitalizations per 100,000 people. Manitoba recorded the lowest rate at 54 per 100,000.

Despite years of experience, Hopkins struggles to understand why the numbers remain so high in the territories.

“Is it isolation? Is it hopelessness? Is it the legacy of residential schools? We don’t actually know,” he said.

Mary Bartram is a health policy expert at Carleton University. If the country is serious about reducing numbers in the North, governments need to deal with issues such as housing shortages and food insecurity, she said.

Nunavut often has the highest rate of self-injury and is plagued with housing shortages. More than half of the population depends on social housing, yet the Nunavut Housing Corporation needs 3,500 new units.

Households in Nunavut are also nearly four times more likely to suffer from food insecurity compared to the provinces, according to a study by the Canadian Institute for Health Research. Food insecurity is defined as insufficient access to nutritious and affordable food.

Bartram said a chronic lack of social workers in Northern communities has led to higher rates of self-injury. 37 per cent of the social worker positions in Nunavut remain unfilled on a month-to-month basis, according to an Auditor-General report from 2011.

Stress levels among care workers who remain in the territories is a “very real issue”, Hopkins said. Many of his patients are paramedics and social workers, people who are intimately familiar with the number of self-injury and suicide victims in the Yukon.

“These are people who have experienced vicarious trauma from constantly, constantly dealing with these things,” Hopkins said. “It’s difficult to get any respite from that.”

Bartram and Hopkins both said conversations about self-injury in the North must also recognize Canada’s history of colonialism.

Indigenous peoples make up more than 50 per cent of the territorial population.  Bartram said the legacy of residential schools and forced relocations contribute to a suicide rate that is five times higher among Indigenous youth compared to non-Indigenous youth.

Any effort to lower the rate of self-injury must “stress the importance of supporting Indigenous peoples, communities and governments to set their own priorities and implement them,” Bartram said.

$36 million in new funding for mental health for the territories has already started to flow, but the federal government has yet to disclose exactly where it’s going. Bartram called on the government to make those decisions public, to ensure the country is closing the gap in mental health outcomes between the provinces and territories.