By Marilla Stephenson (pictured)Image credit
What’s the difference between "excited delirium" and "autonomic hyperarousal state?"
Not much. In fact, in the provincial government’s response to the Hyde Inquiry report, the second term is used as a replacement for the first.
The inquiry, headed last year by provincial court Judge Anne Derrick, studied the death of Howard Hyde, a Dartmouth man who died in custody in 2007 at the Central Nova Scotia Correctional Facility in Dartmouth. Hyde suffered from mental illness and the cause of his death was initially identified by a coroner as "excited delirium."
Derrick rejected that as a "red herring." She found that Hyde died as a result of a restraint technique used on him by guards during a struggle.
Hyde had been repeatedly shocked with a stun gun during his 30 hours in custody. Derrick found that while the use of the stun gun did not cause Hyde’s death, the repeated shocks contributed to his deteriorating mental state.
Derrick’s report also strongly called for improved training for law enforcement officers who come in contact with people suffering from mental illness. The judge painted a clear path towards the use of de-escalation techniques in advance of the use of stun guns.
But the province seems to be struggling to find the right balance between public safety issues and the use of stun guns by officers. It has yet to finalize its guidelines for stun gun use, though Justice Minister Ross Landry said Thursday they will be released within a few weeks.
The minister did not explain why there has been a delay in issuing the guidelines or why, if only a few more weeks were needed, the province’s response to the inquiry report was not delayed so the documents could be released together.
But it speaks volumes that the use of the stun guns has already dropped by over 70 per cent since Hyde’s death in 2007, as The Canadian Press reported on Thursday.
In addressing what is now being described as an "autonomic hyperarousal state," the report released Thursday did not rule out using a stun gun on a person who may be mentally ill. But plenty of work remains to be done on the training side of the equation.
"Law enforcement officers must have appropriate tools to assist them in maintaining public safety," says the report. "At the same time, people living with mental illness may already be experiencing a high level of anxiety and the use of restraint could escalate the situation.
"The province and policing partners agree that the use of conducted energy weapons should only occur when a person’s behaviour is aggressive or violent and could harm the person or the public or the police officer. Additional direction is required regarding the restraint of individuals with mental illness."
The delay in providing that direction is not explained but Landry is clearly not comfortable with the current level of knowledge and training.
"It’s very difficult in situations where . . . there’s a high level of disturbance for the police officer to determine whether the person is suffering from mental illness," the minister told reporters on Thursday after the response was released.
In fairness to police, officers are often called on to make very quick decisions about the use of force in highly charged situations. But the death of Howard Hyde, among other cases, provides a reminder of the responsibilities that accompany the use of force, including the use of stun guns and other various forms of restraint.
There are federal guidelines available to help officers make those judgment calls and the province has said its stun gun rules will consider the federal document as well as expert advice provided by a panel of psychiatrists.
Derrick was clearly on the right track in emphasizing the need for much better levels of training. And in fairness to the province, some progress has already been made in addressing areas of concern raised in the inquiry report.
But the wheels continue to grind slowly towards the judge’s most important recommendation, adopting a provincial mental health strategy. The government is still waiting for a report from stakeholders.
It has been nearly two years since the NDP formed government and promises to improve mental health policies and services are growing stale.
(mstephenson@herald.ca)
I am disappointed in the comments in your newspaper of Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, that recommendations from the Hyde report will not be instituted quickly and suggesting a lack of action on my part.
Judge Anne Derrick’s first recommendation in her report was that the provincial government needs to develop a mental health strategy. Before her report was even written, I had appointed a mental health strategy advisory committee representing a board spectrum of people with first hand-knowledge of the justice system, schizophrenia and other mental illnesses and disorders. Work on the strategy is well underway and we will provide for consultation in the New Year. The president of the Schizophrenia Society of Nova Scotia is on this committee.
Additionally, I have visited Mental Health Services at Capital Health and at the IWK Health Centre to discuss what can be done to improve wait times and program outcomes, and steps are being taken on these fronts. Our government’s first budget included funding for an expanded Mobile Crisis Service here in the Capital District.
Is there more to do? Absolutely, and I am committed to seeing that it is done. Mental health services are an integral part of Better Care Sooner, our plan to implement the Ross report. Judge Derrick’s extensive recommendations offer an opportunity for Nova Scotia’s justice and health care systems to make real and positive changes — and we will.
Maureen MacDonald, Minister of Health
In Judge Anne Derrick, Howard Hyde finally has an advocate who sees the bigger picture. Sadly, proper perspective is the very thing he desperately needed from someone — anyone — the day he died three years ago.
That much is obvious from reading Judge Derrick’s findings into the chain of events that led to the death of this emotionally disturbed man. But those who comb through the inquiry report looking to pin blame will be disappointed. Howard Hyde — who suffered from schizophrenia, was off his medications and experiencing psychosis — was not a victim of incompetence. He was a victim of incoherence.
During every step of his odyssey in police, medical, court and correctional custody, Mr. Hyde came across professionals acting professionally. Even the most controversial and publicized episode — which led to Mr. Hyde’s multiple Tasering at a Dartmouth police station — is not a slam-dunk of police misbehaviour.
Judge Derrick notes that the booking officer who produced a tool with which to cut the lace on Mr. Hyde’s shorts before putting him in a cell did not mean to provoke or panic him.
“S/Cst. MacCormick uttered the words: ‘We’ll have to cut one of those balls off’ innocently, with no appreciation of the effect they would have on Mr. Hyde," she wrote.
Judge Derrick makes it clear that the Tasering did not cause Mr. Hyde’s death. Nor did he die of schizophrenia, as the medical examiner unhelpfully concluded. He did die some 30 hours later as a result of a struggle with Burnside jail correctional officers whose use of force, and of a restraint hold, she determined to be “reasonable and proportionate."
Ultimately, the real problem was not the performance of Mr. Hyde’s custodians per se, but crucial omissions cascading through the chain of custody. From the moment he was first picked up by police on a domestic abuse complaint, a pattern developed whereby relevant facts weren’t passed along. Legal and medical professionals got their wires crossed, made incorrect assumptions, acted on incomplete information. Cops were unaware of mental health resources available to them and guards didn’t know how to de-escalate confrontations with the emotionally disturbed.
Clearly, the province must begin by training its sights on retraining front-line staff.
(edits@herald.ca)
By Clare MellorKaren Ellet [pictured] says she still misses Howard Hyde’s amazing voice.
“I miss his voice, his beautiful singing voice," the Dartmouth woman said Thursday.
Ellet, who was Hyde’s common- law wife, said she has been dealing with her grief since he died on Nov. 22, 2007, after a violent conflict with jail guards at the Central Nova Scotia Correctional Facility in Dartmouth.
But she is taking comfort in the recommendations resulting from the provincial inquiry into his death.
If the suggestions outlined in a report released Wednesday are adopted, they will make a huge difference in the way mentally ill people in crisis are dealt with, Ellet said.
“I am very pleased. She is a very compassionate judge," she said of Anne Derrick, the provincial court judge who helmed the 11-month fatality inquiry.
She said Hyde would be pleased with Derrick’s report, too.
“He would be ecstatic about it," Ellet said. “He would like to see (the recommendations) implemented, so the (report) is not sitting on a library shelf."
In her report, Derrick rejected a medical examiner’s conclusion that Hyde died of excited delirium and found instead that the struggle with the jail guards played a role in his death.
Hyde, a 45-year-old musician who was diagnosed with schizophrenia in his 20s, was having a psychotic episode at the jail when he was forced to lie on his stomach with his hands behind his back. The restraint technique may have interfered with his ability to breathe, Derrick found.
“He did not die because he was mentally ill," she wrote in her report.
Ellet said she still has difficulty thinking of the emotional and physical pain that Hyde endured in the last 30 hours of his life.
On the night of Nov. 21, 2007, Ellet called a crisis hotline to complain that Hyde had assaulted her while in a psychotic state.
Police arrested Hyde, but not before Ellet told them her husband had not been taking his medication and needed psychiatric help.
“Howard didn’t understand why he was in jail," she said. “He couldn’t comprehend his surroundings."
Ellet said she has been keeping a low profile due to her grief, but she believes it is important for her to speak up about the changes she thinks Hyde would have wanted to see in the justice system and in society at large.
“I believe he would want to have a professional such as a mental health provider to be with people who have a mental illness when they are in crisis, to speak on behalf of them," she said.
Ellet said Hyde would want all professionals to be issued handbooks so they could learn more about the signs and symptoms of mental illness and how to handle somebody who is having a psychotic episode. “Howard would want more housing available (for mentally ill people)," she said. “Howard found it horrific to know that people with mental illness are living in shelters and on the streets. It really upset him. He wished he could have done something but he didn’t know what to do."
Ellet said Hyde also would have wanted more research into the development of psychiatric drugs.
“Not all medications agree with each particular person," she said. “There are so many sideeffects."
More mental health funding and clubhouses, support groups and associations in support of the mentally ill would also be on Hyde’s list, Ellet said.
“I believe there is a large amount of fundraising that can make miracles happen to help (prevent) people with mental challenges from living on the streets," she said.
“Mental illness is no different from somebody walking around with diabetes."
Some of Derrick’s recommendations concern stun guns — she said they should not be used on people in a state of agitation due to a psychological disturbance, and changes should be made in the training for how to use them.
The judge also recommended that crisis intervention training be provided to all correctional officers at the Dartmouth jail and that several aspects of training in general be improved for jail guards in the province and for front-line police officers and doctors.
Ellet said it is poignant that the report on Hyde’s death came out on the 30th anniversary of the murder of John Lennon.
Hyde, who sang and played the saxophone, was also an extraordinary musician, she said.
“Howard had the musical ability to play anything," she said. “He had the most astounding voice you can imagine."
Also like Lennon, Hyde despised war. “He just wanted peace in the world," Ellet said.
(cmellor@herald.ca)
The Honourable Judge Anne S. Derrick (pictured) filed her report from the Fatality Inquiry into the Death of Howard Hyde on Wednesday, December 8th, 2010.Phase one of inquiry into Taser death ends
By Megan O'Toole
Phase one of an inquiry into the death of a Nova Scotia man who was Tasered while in police custody ended yesterday, and experts say the process has underscored a dire need for changes in the treatment of mentally-ill prisoners.
After five weeks of testimony and a number of controversial witnesses, including officers involved in the struggle to subdue Howard Hyde of Dartmouth, N. S., the inquiry has been adjourned for two months.
Testimony to date has shown a number of systemic flaws, observers say, including a severe lack of co-ordination between police and health-care services.
"There were a lot of balls dropped," said Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, noting the case underscores the need for police to be better trained in how to handle mentally-ill prisoners. "Right from the get-go, police didn't give Howard a fair shake."
The paranoid schizophrenic, who reportedly harboured a deep fear of police, was initially arrested for assault after an argument with his girlfriend, who told authorities Mr. Hyde had not been taking his medication.
At that point, Mr. Hyde should have been taken to hospital for assessment and treatment, Mr. Ayer said, but instead he was taken to the Halifax police detachment. Rambling and in a psychotic state, Mr. Hyde apparently attempted to flee after a booking officer took out a knife to cut the drawstring off his shorts.
That prompted a violent struggle, captured on surveillance video and shown during the inquiry, in which a shirtless and frantic Mr. Hyde screams and struggles to escape. Police say they were concerned he would reach for a knife from a nearby drawer of weapons, and shocked him with the Taser to regain control. He collapsed and was taken to hospital.
The use of a Taser on a paranoid schizophrenic person, as an aggressive act, "could have a tendency to make things worse, to have the issue escalate out of control," noted University of Alberta psychiatrist Patrick White.
While hearing testimony from a couple of the officers involved in the scuffle, the inquiry learned -- contrary to earlier official reports -- that Mr. Hyde had not been asked to co-operate as officers struggled to handcuff him, nor was he warned the Taser would be deployed.
Chris Summerville of the Schizophrenia Society of Canada said a better technique would have been attempting to talk Mr. Hyde down from his psychotic state, then handcuffing him once he had calmed down. Police should be trained for such situations, Mr. Summerville said, but in many cases they are not.
Mr. Hyde's girlfriend, Karen Ellet, has said he "was treated as a prisoner, not as a mental-health patient."
After doctors cleared Mr. Hyde to leave the hospital, they requested he have a follow-up psychiatric examination after his morning court hearing, or that he be returned to the emergency room -- something the officers were not authorized to do.
Neither happened, and Mr. Hyde ended up back in his jail cell, where he died about 30 hours after receiving the initial Taser jolt. Nova Scotia's medical examiner pegged the cause of death as "excited delirium" linked to his mental illness.
Carol Tooton, executive director of the Canadian Mental Health Association's Nova Scotia division, says the case could have ended differently had Mr. Hyde received proper treatment for his schizophrenic condition. The inquiry, she noted, has underscored a staggering lack of co-ordination between police, mental-health workers, courts and hospital staff -- resulting in a failure to properly deal with a man travelling between those systems.
"We often talk about working in silos," Ms. Tooton said. "It seems that [those] systems really do operate independent of one another."
The inquiry resumes in October, with recommendations from Judge Anne Derrick expected next year.
A Nova Scotia judge who presided over a controversial case involving the use of a police stun gun on a teen in Dartmouth will conduct a public inquiry into the sudden death of Howard Hyde.
Mr. Hyde is the mentally ill man who died in 2007 about 30 hours after Halifax police used a similar weapon on him.
Judge Anne Derrick will conduct the government-ordered hearing, which is to open in Halifax provincial court Feb. 18. The bulk of the fatality inquiry is set for April 22 to Aug. 14, a release Thursday said.
Cape Breton chief Crown attorney Dan MacRury has been appointed counsel for the inquiry, it said.
Mr. Hyde, 45, had schizophrenia and died not long after collapsing in jail in Dartmouth. He’d been arrested during a domestic dispute and was shocked with a stun gun after a fracas with police at the booking desk at Halifax Regional Police’s headquarters.
The province’s chief medical examiner has said being shocked with the device didn’t kill Mr. Hyde. His death was ruled accidental.
Judge Derrick will make recommendations about "circumstances surrounding (the death), cause and manner of death and on anything else that may arise out of the hearings," the release said.
The inquiry was ordered in September by Justice Minister Cecil Clarke.
Last month, Justice Heather Robertson of Nova Scotia Supreme Court overturned an earlier decision by Judge Derrick, who acquitted a teenaged girl in January 2008 in Halifax youth court. The teen had been charged with assaulting police and resisting arrest. Judge Derrick ruled the girl, whose identity is protected under law, was justified in resisting arrest during a dispute at a townhouse because officers overstepped their authority. The girl was Tasered by police.
The 17-year-old was angry with her sister, who’d taken her purse without asking, and the girl was threatening to damage the house, court heard during the trial.
