Dorchester girl who jumped from school bus visited ER 9 times, inquest hears

A 13-year-old girl who died after she jumped from the emergency exit of her moving school bus in Dorchester, N.B., two years ago visited the emergency department for mental health issues nine times in the months leading up to her death, a coroner's inquest heard Tuesday.

Hailey Pierce suffered a severe brain injury on April 12, 2022, and was pronounced dead at the Moncton Hospital the next morning.

The jury heard testimony from seven more witnesses during the second day of the inquest, which painted a picture of the teen's life, her mental health struggles, and efforts to get help.

Jodi Stilwell, a licensed counselling therapist, who started seeing Hailey in April 2021, said she was bullied "quite a lot" by other students, but switched to Dorchester Consolidated School in September 2021 and seemed to be doing better.

By early March though, that changed.

The teen, who was diagnosed with ADHD and mood disorder, violated her new school's dress code and got into an altercation with another girl that involved police.

She was running away from home, self-cutting and suicidal.

Dr. Syed Sadiq, her psychiatrist since Aug. 9, 2019, had prescribed various medications that he felt were working. He met with her five times up to March 2022, and at no time felt hospitalization was required, based on guidelines psychiatrists follow, his experience and her presentation, he told the Moncton courtroom.

First ER visit in November 2021

Hailey did visit the hospital several times, however, said Jennifer Little, Horizon's chief nursing information officer, who detailed each visit for the jury.

On Nov. 17, 2021, the teen had self-cut her arm and expressed suicidal ideation to the RCMP. She was taken to the Dr. Georges-L.-Dumont University Hospital Centre's ER and transferred the next morning to the Moncton Hospital, where she saw a child psychiatrist.

Little said she was suicidal, but was not admitted.

On Dec. 31, 2021, she went to the ER again with suicidal ideation and was triaged as Level 2 — the second most severe, said Little

The teen was seen by a physician but sent home and asked to return the next morning for a psychiatric evaluation, she said.

That was completed, but she returned by ambulance on Jan. 2.

"She was having thoughts of self-harm and passive thoughts of suicide, with no intent or no plan," said Little. She was "calm and pleasant," and scheduled to start taking a new medication that night, which had been prescribed by a psychiatrist.

On Feb. 2, 2022, Hailey was back in the ER with her mom for suicidal behaviour and borderline personality disorder.

Five days later, she was suicidal and returned to the ER, but left without being seen after waiting more than five hours. She had been triaged as Level 3 that night. "In ideal situations triage level 3 would be [seen within] 30 minutes but it's not something that we attain regularly," said Little, noting it's a problem across the country.

"There's a whole bunch of reasons," she said, including lack of resources.

Asked by Crown prosecutor Chris Titus whether anyone followed up with Hailey, given her history of visits, Little said there was no note indicating they did.

On Feb. 15, Hailey was back in and was experiencing "suicidal depression," said Little.

Again, she was triaged as Level 2, but was on "offload delay" in the hallway, waiting until a bed became available. "It's not comfortable to be in offload delay," said Little. After waiting more than four hours, she and her mother left.

No hospitalization questioned

Her counsellor, Stilwell, got emotional wondering if whether Hailey had been admitted to hospital during one of those visits could have made a difference.

She called Social Development at one point, she said, because the teen was "talking about self-harm a lot and running away and hurting herself."

Her mother "had taken her to the hospital and she would be admitted overnight sometimes but it was never a longer stay and I was concerned for her well-being," said Stilwell.

 "There were times I know Hailey was not a good space and I felt that maybe that was one thing that was not done that could help."

Dr. Brigitte Dandenault, a child and adolescent psychiatrist with Horizon, who saw Hailey at the ER three times as the psychiatrist on-call, said admitting a patient to hospital is not necessarily going to change their mood dysregulation.

Hospitalization only removes the stressors in their life temporarily, she said. "That doesn't make them any more capable two weeks later or a few weeks later to actually face those stressors."

To learn how to better cope takes therapy — and that takes time, she said.

Dandenault did not consider admitting Hailey because she was not suicidal at the time and had "a lot of services in place," including a psychiatrist and therapist.

Inquest resumes Wednesday

The inquest is scheduled to resume Wednesday at 9 a.m., when deputy chief coroner Michael Johnston is expected to give his instructions to the jury.

The five men and two women must determine who the deceased was, how, when, where, and by what means she came to her death.

The jury will also have the opportunity to make recommendations aimed at preventing deaths under similar circumstances.