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N.B. government says it will introduce community treatment orders

The head of the New Brunswick Psychiatric Association is calling on the provincial government to firm up its commitment to creating community treatment orders (CTO), a program that would provide expanded treatment for the mentally ill outside of a hospital setting.

The call comes on the heels of a recommendation issued by the jury in the Serena Perry coroner's inquest.

On Tuesday, the inquest deemed her death a homicide and presented 11 recommendations aimed at preventing similar deaths, including the implementation of community treatment order (CTO) legislation in New Brunswick.

The body of Perry, who was an involuntary psychiatric patient at the Saint John Regional Hospital, was discovered in the hospital's amphitheatre on Feb. 14, 2012, with a blue hospital gown wrapped loosely around her neck.

A young male psychiatric patient who was the last person seen with Perry, 22, was considered a suspect in the case, but no charges were ever laid. Perry's exact cause of death could not be determined, police had said.

The coroner's inquest jury recommended CTO legislation be called Serena's law.

New Brunswick and the territories are the only governments in Canada that don't have community treatment legislation to ensure patients, such as Perry, take their medication, under supervision, while living in the community.

"Could we do it? The short answer is yes, we can," said Dr. Nachi Sinha of introducing CTOs.

Sinha says much of what is needed to make such a program work is already in place. He does not expect the number of patients under CTOs to be very large.

He says the changes would allow even the most seriously ill to be monitored closely in a home setting by a team assisting the individual with tasks such as taking medications.

"What's essentially happening is that as much as having a mental illness is an illness, what this is doing in a way is de-medicalizing it. So when I become unwell I don't always have to go to a hospital. Because when I get better, and going back to my home and community, then I have a treatment team looking after me," said Sinha.

"When I do miss my medication, I know there's a treatment team there. So even if I slip, I don't have to wait to get so ill the police have to be called. I don't have to wait to get so ill that I end up hurting myself," he said.

No timeline in place for implementing CTOs

The Gallant Liberal government has promised to introduce CTOs — but there's no timeline for doing that. A spokesperson says they want to consult stakeholders first.

The idea of implementing CTOs isn't new.

Eight years ago, an inquest looked into the May 2005 police tasering death of 34-year-old Kevin Geldart of Moncton. Like Serena Perry, Geldart was mentally ill and often off his medications. Among the recommendations from the coroner's jury then was that the province look into CTOs.

"It is unfortunate that it has taken another tragedy to bring this idea or this concept back to light," said Karen Geldart, Kevin Geldart's sister. "I only hope that there is more success this time in moving the idea forward."

She says that people who have not experienced mental illness themselves or within their family are not aware of the impact it has on a family or the stress involved in trying to keep a loved one safe and healthy.

Karen Geldart says a CTO would have helped her family.

"It would have made a huge difference in the life of my family, but it also would have made a huge difference in Kevin's life. He would have hopefully had better management of his illness and his symptoms and would have had fewer hospitalizations and would not have had some minor legal issues or one would hope that that wouldn't have been the case," she said.

However, Karen Geldart says it is important there be a mechanism in place to appeal treatment order decisions.

"There is often a sense of a loss of freedom and individual rights and I can see how for some individuals, that might be compounded with an involuntary treatment order," she said.