A leading physician in the Northwest Territories believes it will never be possible to prevent some tragedies related to mental health.
Last month, Yellowknife teenager Timothy Henderson accidentally died while acting out what the 19-year-old’s family termed a “suicide scenario”.
Timothy had been diagnosed with ADHD and Asperger syndrome, and had asked for help at a psych ward several times before the accident.
Speaking to Moose FM, Timothy’s family asked what more their child could have done to attract attention and receive the right help.
“I don’t know how anybody could reach out more than Timothy did to get help, and be frustrated, and dismissed, and invalidated,” said Ian Henderson, Timothy’s father, at the time.
This week, we put some of the family’s questions to the Department of Health in the Northwest Territories.
With health minister Glen Abernethy unavailable, the department provided Dr Bing Guthrie – medical director at the Stanton Territorial Health Authority, and a gynecologist – to speak to the issue of mental health services.
Guthrie told Moose FM he believes the territory offers all the mental health services it can.
“We do have mental health facilities and counsellors available to help talk about these issues,” he said.
“We do have hospital facilities if we think [patients] are at risk of harming themselves, and there are services available through that. There’s an NWT Help Line number we encourage people to use.
“[But] I don’t think, even in the most perfect mental health society, we can avoid these tragedies. We can try our best but, despite that, it’s still going to happen.”
Guthrie believes “resources are poor” for the provision of mental health services throughout the world, let alone in Canada or the NWT.
Addressing the Henderson family’s concern that their teenager reached out repeatedly for help, Guthrie said there is only so much healthcare professionals can do.
“Obviously, if someone is at risk of harming themselves, they will be admitted for observation and a decision needs to be made as to whether it’s safe to release them or not,” he said.
“At the time of release, there are always arrangements made for follow-up – so that there are resources available and services they can use to reach out, if they need it.
“Unfortunately, [while] we make these arrangements and try to put these safeguards in – they’ll always have them when they leave the hospital – whether they follow through with them is another story.”
Guthrie said he understood the Henderson family’s concerns that Timothy’s treatment – and parental access to information about that treatment – had changed dramatically after the age of 17, in the adult healthcare system.
“It is a tough transition,” he acknowledged, though he saw no easy fix. He also believed Timothy’s use of many Facebook messages with friends as a form of support was probably helpful, and not a cause for concern.
“It’s probably a good thing. Suicide, in itself? We don’t talk about it very much,” said Guthrie.
“I think [Facebook messages] are a good way for people to express themselves and maybe help each other, through chatting and sharing – and maybe, if they need other supports, to access that.”
Timothy’s father had interpreted the thousands of messages between Timothy and other teenagers as a sign of young people covering for the absence of formal supports.
‘Health professionals do their best’
The Mental Health Act in the NWT governs much of what happens when individuals require mental health supports.
While much-amended in recent years, the original act dates to 1985. It has been described by health minister Abernethy as ‘archaic’ and an obstacle to progress, and is – slowly – being updated.
In 2013, a discussion paper drawn up by the Department of Health criticized the narrow focus of the current act, and called for more to be done to protect and expand the rights of patients.
Read: What’s wrong with the NWT Mental Health Act? (pdf)
However, Guthrie told Moose FM that in the case of many patients requiring mental health services, the act does play a useful role by enabling healthcare professionals to intervene if they believe a patient may come to harm – even if the individual changes their mind and insists they are fine.
“It’s not that easy to assess that risk,” said Guthrie. “I think health professionals do their best to do that.
“If we’re sure that they’re going to be a harm to themselves or other people, we can use the Mental Health Act. But if we don’t have that certainty, we provide the resources and say, ‘Look, this is what’s available. If you feel you’re going to harm yourself again, here they are.’
“You have to walk the tightrope between the patient’s rights and choices, and their risk of harm to themselves. The Mental Health Act is a particularly challenging act to create.
“I think the fundamental ability to take away a person’s rights, the implementation of it, is always the challenge.”
Guthrie admitted that, as a gynecologist, he “did not deal with the Mental Health Act very often”.
However, he can draw on his own experiences. Guthrie’s father committed suicide when Guthrie was a teenager, and his uncle died “in a similar way”.
He told Moose FM: “I feel for the Henderson family. We always think of what we could and couldn’t have done, should and shouldn’t have done – as parents, friends, family, and even as professionals, too.
“It’s such a complex and difficult issue.”