And article
posted on December 15th by
MSN News:
By Michael MacDonald, The Canadian Press
Maureen Bilerman [pictured, left] knew something was wrong when her normally shy 13-year-old daughter suddenly became incorrigible, her thoughts and actions disjointed, sometimes destructive.
"It was a light-switch effect," recalls the mother of two, her even tone hinting she has told this story many times before. "She cut our leather chair ... and became really defiant in a way she never was. Her thinking became skewed, distorted. So we right away tried to get her help."
But Bilerman's sense of urgency soon turned to frustration and anger — raw emotions common among parents and critics across Canada who say provincial governments are failing mentally ill children and youth.
"We're the best-case scenario and she's still falling through the cracks," says Bilerman, a newly minted mental health activist who has struggled for the past three years to get her daughter Sarah the help she needs.
Unfortunately, her story is not that unusual.
In a typical Canadian class of 30 students, six will suffer from some form of mental illness, but only one will receive treatment.
"I don't care in what province you're talking about, what town or what service you're looking for, you will find a waiting list that is unacceptable," says pediatrician Diane Sacks, a mental health expert and a member of the Mental Health Commission of Canada.
"There's just not enough services for kids."
For Bilerman, a writer with a background in marketing and broadcasting, that harsh reality became apparent in the spring of 2008, when Sarah overdosed on a bottle of Tylenol.
At the hospital, she was told all six beds at the Child and Adolescent Psychiatric Unit at the Moncton Hospital were full.
"They said, 'There's nothing we can do.' So they sent us home."
But Sarah was still having suicidal thoughts.
For the next six weeks, Bilerman monitored the girl 24 hours a day.
"She would be at the end of her rope, beyond suicidal, in a total state," Bilerman says, adding that the pair would head to the local emergency ward almost every week.
Again and again, they were told the Moncton facility was full and there was no other place for them to go.
The girl was prescribed drugs to stabilize her moods, but they didn't help much.
Bilerman didn't give up. She pushed hard, finally persuading health officials to admit her daughter to the unit, where a month-long stay produced a diagnosis of bipolar disorder, otherwise known as manic-depressive illness.
By that time, it had been almost a year since Sarah started showing signs of mental distress.
The diagnosis represented a big step forward for the Bilerman family, but it was only the beginning of another difficult journey.
Sarah, now 16, has since overdosed three more times.
Doctors have prescribed 20 different combinations of medication, none of which have stabilized her for very long.
The girl often stays out all night long, leaving her mother worried for her safety.
The constant stress has left its mark on the rest of Bilerman's family, which includes husband Shawn and 13-year-old daughter Rachel.
However, Bilerman's life took a sudden, positive turn four months ago when she heard a radio interview with the province's child and youth advocate, Bernard Richard.
The former cabinet minister, who is pushing for creation of a centre for children and youth with "complex needs," inspired Bilerman to take action.
She later learned that Richard has been advocating for a short-term treatment and co-ordination centre ever since he completed a disturbing report in 2008, titled Connecting the Dots.
"It was like the story of our life," says Bilerman, who recently founded DOTS NB, which stands for Development of Treatment Services for mental health in New Brunswick.
Richard's report includes graphic accounts of the challenges faced by children and youth with mental illness, suggesting too many of them are ending up in jail, penalized for behaviour that requires treatment, not punishment.
The proposed centre would offer a safe place for youth in crisis, intensive help for families dealing with mental illness and programs that would help troubled children and youth make the transition back into the community.
"The response has been amazing," Bilerman says, adding that she has been delivering speeches — up to five a day — to universities, churches, service groups and other groups.
Earlier this month, Bilerman led about 1,000 people in an unusual demonstration that grabbed the attention of the provincial government. At one point, the protesters joined hands, creating a kilometre-long human chain linking Fredericton's community mental health centre with the provincial legislature — a symbolic connecting of the dots.
Later, Bilerman presented Premier David Alward with hundreds of letters that tell stories similar to her own.
Bilerman wants Alward to approve Richard's proposal.
"It's integration of services across the province and closing some of the gaps that we know youth are falling through," she said after the rally.
Richard said the government has to act.
"When we don't provide the right responses to these kids, they end up in the justice system, in the prison system, over and over again costing millions of dollars over their lifetime," he said. "That's not to mention the hurt and damage they cause to their families, to themselves, and their neighbours and friends."
Alward said the province must do better.
"We have a responsibility, certainly as a people in New Brunswick, to move forward," he said.
The province's social development minister, Sue Stultz, says she is awaiting Richard's final report early next year before deciding how to proceed.
Photograph by David Smith, The Canadian Press
An article
published in today's edition of
The Chronicle Herald:
No psychiatric exam had been set up for Hyde; man didn’t show acute symptoms, woman says
By Michael MacDonald, The Canadian Press
The nurse who admitted a man to a Nova Scotia jail where he later died knew about a doctor’s note requiring the inmate to receive a psychiatric exam, but the nurse told an inquiry Wednesday she didn’t consider it an official physician’s order.
Sandra McLeod was the nurse in charge at the Central Nova Scotia Correctional Facility [pictured] when Howard Hyde — under arrest for an alleged assault — was dropped off there by deputy sheriffs on Nov. 21, 2007.
Hyde, a 45-year-old musician with a long history of mental illness and run-ins with the law, died the next morning as he struggled with guards, yelling there were "demons" in the jail.
McLeod told the inquiry she knew Hyde had not refilled his prescription for an anti-psychotic drug for about four months, and that he had been Tasered by police after his arrest and later sent to a hospital for treatment.
As well, McLeod confirmed she had read a handwritten note on Hyde’s health information transfer form, written by Dr. Janet MacIntyre, that said he had to be returned to hospital if he did not receive a court-ordered psychiatric assessment.
McLeod testified that when she read the note from the emergency room doctor, she called the Mentally Ill Offender Unit to determine if they were expecting Hyde for a court-ordered psychiatric assessment. But she was told nothing had been scheduled.
The form also said Hyde required ongoing treatment for schizophrenia and psychosis. As well, it said he had demonstrated aggression towards others and the potential to hurt himself.
The nurse said she saw no reason to send Hyde back to the hospital because he wasn’t displaying any acute symptoms.
"He wasn’t disoriented, he wasn’t agitated, he wasn’t hallucinating and he was following direction," she testified during her second day in the witness box.
McLeod said MacIntyre’s note did not constitute a physician’s order because it was written on a form she was unfamiliar with and lacked instructions on a specific time and place for an appointment.
"This isn’t the same kind of form that we follow through on," she said.
Still, McLeod said she asked one of the jail’s support clerks, Maureen Walford, to contact the hospital to make sure Hyde had been medically cleared.
Walford, who also testified Wednesday, confirmed Hyde had been cleared and said she also asked the hospital about MacIntyre’s note.
Recalling the conversation, Walford told the inquiry: "(A hospital administrator) just said, "No, he doesn’t have to come back. I have nothing here.’ "
McLeod said she would have contacted an on-call doctor had Hyde started displaying psychotic behaviour.
She also testified that she was not made aware that Hyde had been given an anti-psychotic drug when he was at the hospital.
However, Hyde did not have any prescriptions with him when he arrived at the jail, which McLeod did not find unusual.
Hyde was placed in a health-care cell, which meant guards would check on him every 15 minutes, but McLeod confirmed the guards were not told to watch for anything unusual.
Most of the guards who have testified at the inquiry have said they had little or no training on how to deal with the mentally ill.
The inquiry, which began in July under the direction of provincial court Judge Anne Derrick, is trying to determine why Hyde didn’t get the psychiatric help he needed, and what can be done to prevent similar tragedies in the future.
Earlier in the inquiry, MacIntyre testified that she would not have discharged Hyde if she had known he would be sent to a jail cell rather than a psychiatric hospital. She said police had assured her Hyde would receive a court-ordered assessment.
The inquiry has also heard that the Halifax police officers working on Hyde’s case knew they did not have the authority to follow the doctor’s instructions once he entered the court system.
The deputy sheriffs escorting Hyde to court did not hand the health form to lawyers handling the case because legislation at the time forbade them from sharing such information with anyone but health-care providers, such as McLeod.
Bold plus italic emphasis is mine.
An article
published in today's edition of
The Chronicle Herald:
Note instructed police to ensure mentally ill man got psychiatric help, inquiry hears
By Michael MacDonald, The Canadian Press
An inquiry into the death of a mentally ill Nova Scotia man who died in jail is zeroing in on a police officer’s flawed interpretation of a form that instructed police to ensure Howard Hyde received psychiatric help.
Hyde, a 45-year-old musician who suffered from schizophrenia, was arrested on Nov. 21, 2007, amid a domestic dispute and was later taken to the Halifax police station, where he was Tasered twice while trying to escape.
The inquiry has heard that Hyde stopped breathing after he was shocked a second time, but he was revived by an officer who performed CPR and then taken to hospital. Const. John Haislip, a rookie officer at the time, testified that his supervisor, Staff Sgt. Don Fox, told him to make sure Hyde was taken to court once he was cleared as medically stable.
Haislip testified that Fox told him Hyde was in hospital for treatment of possible physical injuries, not mental health issues.
"He advised me that he had not been brought there for that; that if he was medically stable and medically cleared, then we had a duty to get him to court," he told the inquiry.
The doctor who examined Hyde, Dr. Janet MacIntyre, determined he was well enough to be discharged, but she included a note on a Health Information Transfer form that made it clear police should return Hyde to hospital if he did not receive a psychiatric assessment.
Haislip testified he was aware that once Hyde was turned over to sheriff’s officers at the court or correctional officers at the jail, he would no longer be in his custody. He admitted that it was unclear to him who would be responsible for getting Hyde to a psychiatrist. He said the doctor’s instructions, which referred specifically to police doing the job, probably should have been changed.
When asked if Fox’s directions had left him confused, he responded: "I guess it’s fair to say, yes."
The transfer form is a key piece of evidence in the inquiry.
Earlier testimony from other Halifax police officers indicates there was a general lack of understanding of how the form was supposed to be used, who was supposed to fill it out and what authority it provided.
Const. Steve Hillier testified that he didn’t even know the form existed until Tuesday, even though he was Haislip’s partner on the day Hyde was released from the Queen Elizabeth II Health Sciences Centre.
Hyde was eventually taken back to the police station for booking.
Haislip said he relayed MacIntyre’s instructions to a senior officer at the station, but he was given no assurances they would be acted on.
The officer said he assumed officials would see the form and get Hyde assessed.
However, Hyde was later transferred to the Central Nova Scotia Correctional Facility in Dartmouth, where he died the following morning after struggling with correctional officers.
Nova Scotia’s chief medical officer listed the cause of death as excited delirium due to paranoid schizophrenia. He concluded the use of the stun gun was not a factor.
In earlier testimony, another officer said he placed his right foot on Hyde’s back for more than 30 seconds as officers struggled to restrain him after the multiple Taserings at the police station.
Const. Christopher MacMahon said he didn’t lift his foot off Hyde until another officer said it appeared he had stopped breathing and was turning blue.
MacMahon insisted he did not place any pressure on Hyde’s back as three other officers struggled to control him in a hallway off the station’s booking room.
He said he wanted to stop Hyde from attacking the officers.
"I placed my right foot on his back should he flip over," he explained. "I put it there as a precautionary measure should he roll over and try to resist."
After watching a surveillance video of the incident, MacMahon estimated he kept his foot on Hyde’s back for 37 seconds.
Outside the hearing room, Kevin MacDonald, a lawyer for the Hyde family, said it would be reasonable to assume Hyde was out of breath after struggling with the officers and any amount of weight placed on his torso could have affected his breathing.
"I believe that is significant," he said.
"Mr. Hyde had just been through quite a struggle and it wouldn’t be unreasonable to say he was out of breath and any amount of weight on Mr. Hyde’s torso when he’s in the prone position, with hands cuffed behind his back and feet up towards his rear end — I think that is a significant issue."
Hyde’s struggle with police began after a special constable told him he had to use a serrated cutting tool to remove the string that was holding up his shorts.
Photograph of the Queen Elizabeth II Health Sciences Centre courtesy of the Capital District Health Authority.
