​​Matthew Sarabura, Mental Health Manager, Vladimir Déribert, Mental Health Worker, and Rosalie Roy, Manager of Montfort’s External Health Program, stand in front of the Tree of Hope in Montfort’s Mental Health Unit.

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By: Alexandra Fabre, Communications Officer, Hôpital Montfort

In a landscape of growing mental health challenges, Hôpital Montfort has emerged as a pioneer by implementing SafeWards, an internationally recognized program still rare in Canada. Montfort was also the first Francophone hospital in the world to adopt SafeWards in French, further reinforcing its leadership role. Since October 2023, this innovative initiative has been revolutionizing care delivery in the mental health unit by reducing violent incidents while simultaneously improving experiences for both patients and staff.

A New Care Model Centered on Therapeutic Relationship

At its core, SafeWards is built on a fundamental principle: when genuine connections exist between staff and patients, the risk of conflict diminishes significantly.

"It's a recovery-focused approach that transforms traditional care dynamics," explains Rosalie Roy, Manager of Montfort's External Health Program.

The program revolves around ten strategic interventions that together redefine the care environment, creating a space where communication and mutual understanding take precedence over traditional reactive approaches:

1. Clear Mutual Expectations foster transparency between staff and patients
2. Soft Words encourage compassionate communication throughout interactions
3. Talk-down techniques provide effective de-escalation strategies
4. Positive Words enhance interprofessional reports with constructive language
5. Bad News Mitigation ensures appropriate support during difficult moments
6. Know Each Other activities strengthen therapeutic relationships
7. Mutual Help Meetings create daily opportunities for peer support
8. Calm Down Methods provide practical comfort tools for patients
9. Reassurance practices help rebuild trust after negative events
10. Discharge Messages share hope from departing patients to newcomers

Measurable Results Transforming Clinical Practice

The impact of SafeWards at Montfort extends beyond theory, it's measurable. Comparing incident data from 2023 (pre-implementation) to 2024 (post-implementation), the unit experienced a 12.4% reduction in overall reported incidents, with 15 fewer violent episodes. This represents 15 situations where patients and staff avoided harm, injury, or trauma.

Even more encouraging, the severity of incidents has notably declined. "We've observed fewer events requiring first aid, medical attention or resulting in staff lost time," notes the team. While some fluctuations still occur, the trend is clearly downward in both frequency and intensity, underlining the dual benefit of the program: SafeWards improves day-to-day care experiences while enhancing safety for everyone on the unit.

Strategic and Collaborative Implementation

SafeWards implementation was not a one-time project but rather a thorough process requiring vision and sustained commitment. "We began with progressive implementation, training staff on two or three interventions at a time," explains Rosalie. "We also conducted several training cohorts to reach our 80+ employees."

The project benefited significantly from the expertise of Matthew Sarabura, a mental health manager who completed his master's project on SafeWards. The recent addition of mental health workers serving as program ambassadors has further contributed to its success and integration into daily practices.

Lessons Learned and Sustaining Innovation

Maintaining program momentum remains an ongoing challenge for the Montfort team. "It's not a one-and-done program; we must constantly revisit fundamentals, provide reminders, and keep it top of mind," explains Rosalie Roy.

To ensure sustainability, the team organizes monthly "blitzes" focused on specific interventions, maintaining staff engagement through these regular reinforcement activities, a strategy that has proven crucial to embedding SafeWards principles into routine practice.

"The interventions may appear simple, but they require thoughtfulness and reflection," adds Rosalie.

While the program might be most impactful in the Mental Health Unit, the principles can be applied and beneficial to all care settings and units.

Building a Safer Future for Mental Health Care

For institutions interested in SafeWards, Montfort's team delivers a clear message: "In order to adequately implement these 10 strategies, each individual must really observe their own behaviors and patterns and how these impact the quality of the patient relationship. Only then can the individual be able to adapt and use these Safeward strategies appropriately."

Successful implementation requires strong institutional backing at all levels. "It takes people to launch it and support from management and senior leadership, but it's worth it," affirms Rosalie. "The cultural shift has been remarkable—we've moved from a reactive approach focused on managing incidents to a proactive model centered on prevention and human connection."

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