Annapolis Valley mom says mentally ill son sent home from hospital in pyjamas

A Kentville woman says her mentally ill son was distressed, agitated and wearing pyjamas when he left the Valley Regional Hospital this March and walked five kilometres in snow and slush.

The woman, who CBC News has agreed not to identify, says her son, who is in his early 20s, walked out of hospital about four hours after police delivered him to the emergency department. She says family members were not informed he was leaving.

She says her son had been been pacing the floor for three days, hallucinating and hearing voices.  

"He was threatening to do things like snap my neck and kill me and he was going to become a serial killer and I was going to be his first victim," she said.

"I felt that I just had to take action and he had to be somewhere that he could be safe but that, you know, he couldn't hurt someone else."

She says she's been told he was given a sedative at the hospital and told to leave. Although she is listed as his primary caregiver and decision-maker, she says hospital officials did not inform her he was being sent home.

Her son ended up outside a gas station in New Minas, demanding cigarettes from customers. RCMP were called and the same officer who had delivered him to the emergency department picked him up and brought him home.

He was wearing the pyjamas he arrived in, sneakers and a coat.

'Still in a very agitated state"

"Still in a very agitated state, still not in his right mind, not making any sense and making verbal threats to me and so I had to call 911 about 20 minutes later," she said.

"This time, the constable and myself attended to him at the hospital, we waited with him until the medical team came to see him — the mental health team."

The second time the young man was taken to hospital, he was admitted as an involuntary patient.

Last month, the same hospital came under fire for discharging a mental health patient who then walked 15 kilometers, showing up in a resident's yard in his sock feet. The patient's family was not notified he was being discharged.

Brenda Main, executive director of the Kings County branch of the Canadian Mental Health Association, says the recent cases point to a need for more funding for mental health care in the Valley region.

More people seeking help

She says there's a lack of training and resources. But she also suspects the increase in public awareness means more people are seeking help for mental health problems.

"I think that what's happened is that people are more willing to step out and ask for it and the system just cannot react to it. There are just not enough bodies on the ground," she said.

"When you have to wait three months — which is what people were waiting for this winter for an appointment at the publically funded services — that's far too long. If you're in crisis or you see a crisis coming and you ask for help you should be given help sooner than that."

Main says there is a crisis response team in the Annapolis Valley but she says that team is only available from Monday to Friday, between 8:30 a.m. and 4:30 p.m.

"There's a process to refer people who come into [emergency] after those hours into it the next day in order to prioritize it. But it's still an under resourcing."

In a statement, the Nova Scotia Health Authority declined to respond publicly to the mother's concerns, citing patient confidentiality.

It said patients who arrive at the emergency room are triaged according to provincial standards and they may leave the hospital for various reasons, including when discharged or by their own choice.    

AG report in 2010 raised concerns

A report from provincial Auditor General Jacques Lapointe in 2010 examined mental health care at the Valley Regional Hospital, looking at key service standards. It found only 11 per cent of files examined met all the standards reviewed.

Lapointe specifically raised concerns the health authority was not tracking how adult outpatients were triaged.

"We were informed patients are triaged but the results are not recorded in the patient file. Without a record of the triage category, there is no way to review files later to ensure standards were met and individuals received services in a timely manner," the report said.

In its statement, the health authority says it has responded to the auditor general's recommendations and other internal reviews.

It says it has "undertaken many initiatives to continually improve the quality of mental health and addiction services."

Authority says it's meeting provincial standards

It says triage assessments are included in client files, according to provincial standards.

The health authority also says that, since 2011, it has been "meeting the provincial standard for adult mental health services of 90 days or less from intake to first clinician appointment."

The mother says her son was well known to hospital staff.

"I wish that they had taken it more seriously and tried to get to the bottom of the root cause of his issues," the mother said about her son's first trip to the emergency room that day.

"He's a young man with a troubled past and I wish they had done more to find somebody who could help him with that."

Despite that experience, she says her son has overall received good care at the Valley Regional Hospital. She says many nurses were "fabulous" and "treated us both with respect and care."

She says her son's health is improving, but only after he was criminally charged and sent to East Coast Forensic Hospital, where he was given a 30-day psychiatric assessment.

Since then, he's been to mental health court and is now taking anger management and addiction services counseling.