Psych patients free to roam

Late Sunday night, Jeff was walking down Lewes Boulevard in a hospital gown and slippers when family friends drove past and recognized the youth.

Late Sunday night, Jeff was walking down Lewes Boulevard in a hospital gown and slippers when family friends drove past and recognized the youth.

The teenager had checked himself out of Whitehorse General Hospital during a psychotic episode.

“It was so lucky,” said his distraught father (who’s asked the family not to be named for fear of jeopardizing their son’s future.)

“In that situation, imagine the other possibilities ….”

There was no one at the hospital to keep an eye on him, said Jeff’s mom.

The hospital has only one psychiatric nurse, said lawyer Shayne Fairman, legal counsel to physicians dealing with the Yukon Mental Health Act.

The other psychiatric nurse left three or four months ago.

“Staffing is an issue,” said Fairman.

The matter came up recently at a Yukon Medical Association meeting, he added.

“We don’t even have a (psychiatric) ward, we just have one secure room.”

Jeff was in the hospital on the weekend.

It wasn’t secure, said his mom.

“The system doesn’t have the support to take care of his safety.”

Jeff was an athletic, artistic student, well loved by the community.

So in February, when he threatened to kill himself, it came as a shock.

His mother, unable to reach her husband, called an ambulance.

“He saw a nurse and a physician,” she said.

And because they didn’t think he would harm himself, or anyone else, the boy was sent home.

At 4 a.m., he woke up shivering and sweating.

“He said, ‘I warned you I’m going to kill myself,’” said his mom.

This time, the hospital admitted him.

“He acted violently — he hit nurses and then hit his head against the sink repeatedly,” she said.

“The nurses didn’t even try to stop him.

“They waited for the RCMP, then sent him for a scan of his head.

“It could all have been prevented if the hospital had kept him in the first place.”

The young man saw a psychiatrist and was prescribed anti-psychotic medication.

However, three months later he is still having trouble.

He wants to run all the time, said Jeff’s mom, who quit her job to care for him.

He’s been seeing the psychiatrist, who upped his meds, but it hasn’t helped.

“He can’t control himself,” she said, mentioning that her son was again out running on Tuesday, when she called.

“He goes for three or four hours,” she said.

“And at odd times, like the middle of the night.”

Jeff can feel these episodes coming.

And on the weekend, he asked his mom for help.

“I stay at home guarding him, but I can’t use force to keep him there,” she said.

When Jeff’s urges got too strong, and he started talking about hitchhiking to BC, the pair went to the hospital.

He was admitted and nurses gave him medicine to calm him down, said his mom.

But at 10 p.m., she got a call; Jeff wanted his shoes and coat to hitchhike to BC.

When she got to the hospital, she found Jeff standing in the entrance.

When she tried to convince him to return to his bed, he resisted.

And when she asked a nurse for help, she was told there was nothing the hospital staff could do.

“They said he can go, because he’s a volunteer patient,” she said.

 “So I stayed at the hospital to guard him.”

But just before midnight, she had to pick up her daughter, who was coming back from a sports event Outside.

When she got home at 1 a.m., she called the hospital to check on Jeff.

The nurse told her Jeff had gone home.

But he wasn’t at home, said his mom.

That’s when she learned friends of the family had found Jeff walking down the road in his hospital gown and slippers.

“I was shocked because that’s very unsafe to let him leave,” she said.

“The system trusts patients who do not have good judgment.

“It makes you wonder who else is out there walking around on the street.

“I just feel helpless. The system failed.”

When a patient is brought to the hospital for an assessment, they often sign a Form 4, which allows the hospital to hold them involuntarily for 24 hours, said Fairman.

“You’re assessed by two doctors within 24 hours of your arrival and if the two doctors agree you should be involuntarily committed then you are from that moment. And that decision to involuntarily commit you must be reviewed by the capability and consent board within seven days.”

It’s not enough for a patient to say they’ll stay voluntarily, said Fairman.

“The doctors need to satisfy themselves that the patient understands the implications of what they’re saying, they understand the illness from which they suffer and they understand the treatment required.

“It’s not just a matter of them promising to stay — it has to be believed.”

And if a patient knows they will decompensate and leave hospital, like Jeff, then they should talk to their family doctor about it, and the doctor could issue an involuntary admission, particularly if there’s been a pattern of this kind of behaviour, said Fairman.

That said, keeping someone at the hospital against their will “is an extraordinary step,” he added.

“It’s a last resort by physicians.”

And there are plenty of safeguards in the act to make sure a patient’s rights are protected, he added.

Before a patient is involuntarily committed they must meet three criteria: they must have a mental disorder, their condition must be serious enough that they could harm themselves or others, and they must not be appropriate for voluntary admission.

The last clause is there to protect patients, said Fairman.

“Even if they are not well, and even if they are so unwell they might harm themselves or others, they might still be dealt with in the hospital on a voluntary basis.”

However, if a patient says, “I want you to involuntarily admit me,” and the doctor feels it’s a legitimate request, the doctor could go ahead, he said. Then it’s evaluated by the patient review board.

Patients are usually seen by a general physician and, as often as possible, the local psychiatrist is also involved.

But for a long time we didn’t have a local psychiatrist, said Fairman.

Dr. Armando Heredia has been the Yukon’s sole psychiatrist for several years. But just recently another psychiatrist arrived, said Fairman.

Another psych nurse has also been hired, said hospital spokesperson Val Pike.

Now there are two nurses, she said.

“One’s been here for many years — the other position has just been filled recently.

“Whether that person is actually physically in town yet, I don’t know.”