The father of a Yellowknifer who died by suicide in 2015 says the N.W.T.'s new Mental Health Act is only "the tip of the iceberg" when it comes to addressing a "broken mental health-care system."
Timothy Henderson died by suicide only days after being released from Stanton Territorial Hospital. The 19-year-old had self-admitted to the hospital, but was discharged on April 17, 2015. The teen died in an Alberta hospital on April 26 that year.
Three years later, as the new Mental Health Act comes into effect Sept. 1, care in the territory has seen some changes that might have helped the struggling youth. But Timothy's family still has concerns.
The act, which oversees care for people with acute psychiatric disorders who are a serious risk to themselves or others, passed in 2015. The related regulations were completed in February this year.
More staff now in place
Ian Henderson, Timothy's father, said his child had a strong support team before turning 17. But the teen floundered in the adult mental health-care system, where a barrage of locum psychiatrists provided care.
"It was like stepping off a cliff," wrote Henderson.
Health Department spokesperson Damien Healy said in an email that things have changed since 2015. The department still uses a locum — or short-term placement — to fill any gaps, but three permanent psychiatrists now work at Stanton Territorial Hospital, compared to one in the year Timothy died.
David Maguire, a representative for the Northwest Territories Health and Social Services Authority, said the authority added a long-term locum to help backfill the full-time positions.
The new act also includes provisions for patient rights, and enshrines into law a patient's right to a second opinion before they are discharged.
"People have always been entitled to a second medical opinion," wrote Healy in an email. "We made a point of adding it to the act to ensure this right to a second opinion was explicit and that patients were aware of their right to ask for this."
Sharing or privacy?
Timothy's stepfather, James Boraski, said one thing that made life difficult for his stepchild was how little information was shared between different parts of the country and different parts of the territorial health-care system.
Timothy had been getting support from a family doctor, said Boraski, but patient information wasn't shared with Stanton Territorial Hospital, where the teen was voluntarily hospitalized.
"Those two entities aren't talking," he said.
Boraski would have liked to see more file sharing between the Northwest Territories and provinces where young people go for university or college, such as Timothy who sought help in Alberta while a student in Edmonton.
A consent form signed by the youth — that allowed the family doctor to share information with immediate family — didn't allow the hospital to do the same thing, said Boraski.
"The onus was on Timothy, who was a mental health sufferer, to figure out the legislation and navigate it," he said.
A coroner's report in 2015 looking into Timothy's death recommended more "sharing of information and team approach for the development of client centred services provided for individuals who leave the Northwest Territories to pursue educational opportunities elsewhere."
Health Minister Glen Abernethy said the department is "trying to find ways to increase the flow of information where appropriate."
Abernethy added relevant information is shared, for example, if patients are sent to Alberta from the Northwest Territories for treatment, but when people move to a new place, their file does not move with them.
"We can always get copies of our medical records and we can always forward our medical records to new jurisdictions if we so choose," he said. "Your health records don't follow you unless you want them to ... patients have rights and that does include a right to privacy."
Family involvement unclear
In a background document, the Government of the Northwest Territories wrote a principle of the new act was that family and community should be involved supporting patients.
Boraski said he would prefer for the act's regulations to be "much clearer" about how family members can be involved, adding he looked at the regulations used to create forms for the act, and they don't stipulate the forms should include a family member or next of kin contact.
"This is a terrible omission in our minds," he wrote in an email.
The health department responded the legislation allows a substitute decision maker to be chosen for the patient if they need one — this person is often a relative of the patient but may also be an adult friend.
"If the patient has the capacity to name a person to be their [decision maker], the physician should respect those wishes," wrote Healy.
If the patient cannot or does not choose a decision maker, the physician would follow a hierarchy laid out in the act, he added. That structure includes asking family members.