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Just One More Shocking Example of Canada's Failing Healthcare System

Posted: 08/22/2012 1:11 pm

An article I wrote on Tuesday for this space elicited a lot of reaction. People have asked me about Jacquie Davies and the plight of her father, my dear friend, Fred Davies. Here is the story.

Fred has been friend of mine for 25 years. He was born and raised in Port Colborne, Ontario, a sleepy rural town in between Toronto and London, on the Niagara Peninsula. He has been a businessman and community leader there and in neighbouring Welland for 30 years. From a young age, Fred's daughter Jacquie was different than the other kids her age. By the time she reached high school, it was clear that she had mental health problems, although it was not at all clear what those were.

Jacquie's condition deteriorated into fits of violent behavior and started on a path of recurring hospitalization. They had seen school counselors, and psychologists, physiatrists and physicians at the local hospital. None could provide a diagnosis or help. "Whomever we saw had a different read on Jacquie and it seemed that no one within the health care system could communicate with each other to deal with it," Fred recounted to me.

"As parents we learned, and so did Jacquie, that we have no rights (she has all the rights after the age of 12), no access to information, no authority, and even though we are obliged to support and provide the necessities of life for our daughter, she had the right to shut us out of the process. And she did. Medical support staff was, for the most part, oblivious to our frustration."

The Davies family became experts in navigating the medical bureaucracy and the process of obtaining a "Form 1," which is a forced admission to hospital for up to 72 hours. For it to be duly executed, this form must be signed by a doctor, Justice of the Peace or court order on the basis that the patient is a potential danger to him or herself or others. Jacquie spent several years from the age of about 13 to 18 in and out of what is called "2 South" at the Welland Hospital Site of the Niagara Health System.

She was "formed" at least 15 separate times with stays ranging from 72 hours to eight weeks. "Surely after so many admissions the doctors would recognize that this is a very sick young lady," Fred reflected. "We felt we had ample evidence that Jacquie needed a long term plan that included treatment in a controlled facility." They had the option of applying to a Capacity Review Board, but without a doctor's support, it would cost upwards of $20,000 and with no one willing to step up, their chances of having Jacquie committed to supervised care was non-existent.

Fred finally got Jacquie admitted to St. Joseph's in Hamilton, regarded as the best mental health facility in Ontario. She was there for a few months, only after they managed to find a loophole for admission. Jacquie's mother and Fred met with one of the two resident psychiatrists that always dealt with Jacquie's admissions. They pleaded, begged and cried.

"The doctor told us that unless he saw blood, there is nothing he can do. He said there was no 'proof' that Jacquie was an ongoing danger to herself or others. He said that the health care system is expensive and was unwilling to commit Jacquie beyond a few weeks. Did he know Jacquie was sick? Of course he did. A day later, the doctor called me and told me to come and pick my daughter up. He was releasing her. It was a mission for our daughter's mental health treatment to be sure, but now it seemed that our focus was simply trying to keep her alive."

Fred and Jacquie's mother were told by the doctor that they only way he could see getting help was to get Jacquie into the criminal justice system. "He told us that if Jacquie were charged, it would be easier to get her help." Fred couldn't believe what he was hearing. "I asked him point blank and clearly: 'Let me understand you. Are you counseling me to counsel my daughter to commit a crime in order to receive treatment?' He confirmed that only the Justice system could act now because he would not take responsibility for committing Jacquie as mentally incapacitated."

The Davies were not shocked -- they had seen it all. Not only had they fallen through every crack in a dysfunctional system, they were now listening to a doctor tell them to find another crack to absolve him of responsibility. While Jacquie's doctors knew that she needed a long-term mental health plan, he was abandoning his responsibility to patient care. The only plan that was developed was "putting my 18-year-old daughter into a one bedroom apartment near my house" Fred explained. "We followed the advice, knowing it was doomed to fail, and also knowing that it was only a matter of time before the blood the doctor needed to see would soon flow."

Jacquie's new apartment was about 300 yards from Fred's house. She was now legally an adult at the age of 18. It didn't take long for what would be the final straw in Jacquie's tortured and tragic life to take place. "She was spooked by a neighbour on the balcony next door and thought she was being threatened. She grabbed a small collapsible saw that she was using to cut twigs, ran out of her apartment and down the stairs." Tragically, a 12-year-old girl and her mother were in her pathway. She slashed the mother across the face and the daughter on her head. It was a horrific attack. Both the mother and daughter who happened to have the grave misfortune of being at the wrong place at the wrong time, almost died that night.

Fred was at dinner and received a call from Jacquie: "Daddy, I think I killed someone." Jacquie was charged with aggravated assault and aggravated assault with a weapon. She was taken to the women's prison in Milton, Ontario, where she degenerated further into psychosis. This was prison, and there was no mental health program and even less compassion. This was a place for criminals and they were treated like criminals whether convicted or not. Fred reflected on his mindset at the time: "Where once we were afraid she would die if not institutionalized, we now thought she would die inside an institution."

After long court delays, the presiding judge finally ordered a psychological evaluation by St. Joseph's in Hamilton through the forensic psychiatric unit. Jacquie was sent back to St. Joe's to the forensic ward with much needed restrictions. By the time the trial was to take place, and after the continued intervention and pressure put on the two lawyers involved, and finally with a comprehensive psychological evaluation now available, Jacquie was found criminally not responsible for the attacks. She was remanded to the St. Joseph's Mountain Health Care Facility where she would receive a minimum of one year treatment at a time, after which and required by law, a yearly Capacity Review Hearing would take place to review Jacquie's ability to live in society, either supervised or on her own.

It has been three years since that decision has been made. With the lines on his face ample testament to what he and his family had lived through, and with a sigh my friend Fred Davies said: "But today, Jacquie is alive. She is not well, but she is alive."

Whenever stories like this surface -- and there are many -- the refrain is numbingly similar: Health care professionals are overworked, underpaid and certainly undervalued. There are caps on doctor's salaries and they are forced to work in terrible conditions on unreasonable shifts, and in various wards. The two doctors that refused to deal with and treat a severely ill young lady remain in place today. They are hidden deep in a broken medical system that protects them, but also sucks them in as a new kind of unintended victim of a sick health care bureaucracy.

A lawsuit was launched by the defenseless victims of Jacquie's uncontrolled violence -- a mother and her daughter. The defendant is the Niagara Health System. The Davies family offered their complete support to their daughter's victims for this action and did whatever they could to assist the claim against the NHS. They had hoped that the nightmare they suffered through would not be repeated if the fatal flaws in the system were exposed. That never happened. The NHS settled the case with the victims out of court.

 

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An article I wrote on Tuesday for this space elicited a lot of reaction. People have asked me about Jacquie Davies and the plight of her father, my dear friend, Fred Davies. Here is the story. Fred h...
An article I wrote on Tuesday for this space elicited a lot of reaction. People have asked me about Jacquie Davies and the plight of her father, my dear friend, Fred Davies. Here is the story. Fred h...
 
 
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09:29 PM on 08/24/2012
What is really shocking is that Mr Veniez was ever a Liberal Party candidate. He, obviously, opposes a core party principle. Did he not realizes that this is the party that made Medicare a national reality. It seems that he was a 5th columnist and we can only rejoice that he was a FAILED candidate.

As for the issue of violence and madness -- how did the wonderful American system work in Aurora Colorado, Mr Veniez?
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HUFFPOST SUPER USER
richard in obihiro
translator
05:12 AM on 08/24/2012
Just a cursory reading of this article moves me to say that doctors, psychologists, psychiatrists, or whatever their degrees allow them to call themselves, simply do not merit being allowed to call themselves 'professionals'. The parents of this poor child are the only real professionals in this story.
This is not just an indictment of the health-care system, it's an indictment of the un-professionals that make up that system and are ultimately responsible for its failings.
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Richard Bartholomew
My micro-bio isn't empty.
05:04 AM on 08/24/2012
'Just One More Shocking Example of Canada's Failing Healthcare System'

Why, whatever do you mean Veniez? Canada's healthcare system couldn't possibly be failing---only greedy, for-profit, capitalist-pig healthcare systems fail. Everyone knows that near-universal, government-controlled health care systems like Canada's are medical nirvanas where everything is sweetness and light.
12:17 AM on 08/24/2012
My heart goes out to the family of this young woman and the woman herself. I also hope the victims of her violent attack have recovered psychologically as well as physically, and are able to move past the trauma of being attacked.
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weagree
12:02 AM on 08/24/2012
That is a very sad and moving tale. The rural communities are often without support when it comes to medical care that goes much beyond first aid. Sure there are clinics, and doctors with full schedules, and hospitals somewhere distant, but often the locals have few nearby professional and responsible resources. The population that moves outside the normal social ranges gets soaked with pharmaceuticals and everyone remains calm and blissful about their troubled communities. Alcohol is an easy fix and many people find solace from their discomfort or pain using common solvents or whatever is near at hand. Great for the handfuls of prosperous doctors in the small communities who prescribe, and for the pharmacies there, and the pharma industry, as there are a lot of towns and villages whose "needs" (beginning with pacifiers like Ritilin for young students) can be fulfilled this way. Meanwhile, those citizens pay taxes for medical care just like every other Ontario person but sometimes, as in the case of this young lady, their tax contributions go to the prison side of the ledger.
07:11 PM on 08/23/2012
So very sad, but not at all surprising. The system has failed my daughter and family multiple times in ways you would not believe.
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newshoundmama
My bite's worse than my bark
04:01 PM on 08/23/2012
Could someone please cite the legislation that keeps parents from being able to make healthcare decisions for their children past the age of 12? We're certainly held responsible for their care well past that age. . .
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MJinCanada
Safe from zombies until my 2nd cup of coffee
10:56 PM on 08/23/2012
Yes, I've never heard of that either. Plus any series of violent incidents at school or at home -- there doesn't have to be "blood" or even bruising -- can be enough to get a child taken into care for counselling or into a group home or something where I live.
02:54 PM on 08/23/2012
Is there is any country on earth today that handles these sorts of cases any better than Canada does? That's not to say that Jacquie's case was handled well, but there are many contributing issues, including the fact that as an adult, Jacquie did not think she needed treatment.

There was some mention of "violent behaviour", but throwing a book across the room is a violent outburst. It's entirely possible that the first moment when she seriously hurt someone, and could then legally be seen as a danger to society, was the moment when she attacked the 12-year-old girl and her mother. There is no reliable way to predict whether mentally ill people will or will not commit violent acts, and as a society we don't lock people up based on crimes they've yet to commit.

Should it be easier to have someone committed against their will? Perhaps, but one has to keep in mind that the toughening of the rules for commitment was because of historically terrible abuses of power.

When we recognize the rights of the individual, we have to acknowledge that this sometimes comes at a price, and that we can't always help adults exercising the right to refuse treatment.
03:48 PM on 08/23/2012
Terribly sick adults with a track record of violence and being a danger to themselves and others - as Fred Davies said for years - is a "risk" that the rest of us should take? No way!
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MJinCanada
Safe from zombies until my 2nd cup of coffee
10:58 PM on 08/23/2012
We aren't even being told what Jacquie's eventual diagnosis was, which makes me just a touch suspicious about this whole article.
12:47 PM on 08/23/2012
Geography Lesson: Port Colborne is a town on Lake Erie about 20 minutes from Buffalo. Describing it as 'between Toronto and London' is more than a little wrong - unless you include a 200 km. detour on the drive.
12:31 PM on 08/23/2012
Canada does not have a failing medical system but it does have a failed political system where politicians, acting for the rich, fail to fund healthcare adequately. All that is needed is more money collected from rich individuals & the corporations they hide behind. Tax rates need to be returned to the levels they were at prior to 1980.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
10:59 PM on 08/23/2012
F&F for the correct diagnosis.
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rotary
canucklehead
12:20 PM on 08/23/2012
This has more to do with the provincial mental health act than it does with the entire national health system. You're confusing legislation with front line delivery. You're a former liberal party candidate, shouldn't you have offered up ideas for change and improvement?
03:49 PM on 08/23/2012
Mr. Veniez is taking about the health system, generally, not "front line" delivery per say. This is one example among thousands of a broken and dysfunctional system. If you take the time to read Veniez on a variety of issues, he always offers solutions. Health care has been no exception.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
11:02 PM on 08/23/2012
Veniez is a shill for privatized medicine -- an option that the Davies family actually had and couldn't afford.
11:37 AM on 08/23/2012
As an advocate for improved mental health services, I sympathize with the parents and understand their frustration. But, the part of our healthcare system that is truly broken is the mental health component. Governments just do not care and, despite all the reports that are done on how to turn a non system into a functioning system, there is no progress.

In Ontario, we've had report after report and nothing. The implementation Task force done under the Tories was ignored by the Liberals when they took over. They then brought out their own report under David Caplan - mostly ignored. We then had the all party Select Committee and very little was done.

It is time to make progress.

Our health system works reasonably well for most if not all other health areas. But, we continue to ignore those with mental illness and, in particular, the sickest of them.
11:26 AM on 08/23/2012
The mental health system is increasingly becoming unable to treat people with the most severe mental illnesses. Jacquie's physician explained how the system limited the ways he could respond to this dangerous situation.
I explore relevant issues in my recent huffpo blog on untreated psychosis and violence.
http://www.huffingtonpost.ca/susan-inman/mental-illness-and-violence_b_1771229.html
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Jay from Ottawa
sovereignty sale, 1.3T OBO
10:06 AM on 08/23/2012
So you dont like a public funded health system, but then bring up the fact that the parents couldnt afford to keep their daughter committed... i mean all they needed was a system that would take their daughter and lock her up out of sight and away from society free of charge. And im also guessing you would cry foul if a couple had a abortion because they got the fetus tested and found out it was missing a few critical screws.
03:50 PM on 08/23/2012
That has to be one of the weirdest comments I have ever read. Wow!
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MJinCanada
Safe from zombies until my 2nd cup of coffee
11:30 PM on 08/23/2012
If you don't like it, it must have merit.
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weagree
12:08 AM on 08/24/2012
This is not 1850 and we don't have those kinds of hospitals anymore. She may not have required anything like being locked away if someone upon whom she was relying upon in her medical care community actually took care of her properly at the very beginning. Everyone in society benefits from the good health of the most numbers of people. That's why we have socialized medicine and that's what we pay for.
09:38 AM on 08/23/2012
Specific examples are good for reference when in the context of a study or general review of a system to highlight patterns or trends.

What I don't see in the article is any supporting evidence regarding the mental health system; no interviews with staff or health ministers; no comparitive analysis to suggest that this is a trend or significant issue.

While the story is traumatic for all involved, it is a single event. Even with a few recent stories about mental health patients, these are anecdotal in nature & can occur with any system.

The article does nothing to address the current, specific issues within mental healthcare nor address what should be done to remedy them.

Like many, I think there is a problem with our healthcare system, especially with mental healthcare but we need specific information before addressing a problem.
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05:48 PM on 08/23/2012
I reread your comment. Man, did you ever get to the curx of this issue as it pertains to this post. That is my big complaint with the writings of this blogger. He presents premises as fact and then says we need, no must, completely change things instead of dicussing how to fix what we have. I think you make a better argument regarding what is wrong with the blogger's post then I could. My compliments to you. I wish I had your ability to analyze and communicate so clearly. You make very reasonable arguments and make the central issues rise for consideration.
08:08 PM on 08/23/2012
I wish you just HAD ANY ability to analyze clearly, Cramer.
09:03 PM on 08/23/2012
I'm not always so coherent :-) And like you, get angry at some things where people do not always present all sides or listen to differing views. I have noticed Cdn posts/comments becoming more US like - us vs them / left vs. right - I don't like it. We all need to listen more - but especially our elected officials!
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MJinCanada
Safe from zombies until my 2nd cup of coffee
11:21 PM on 08/23/2012
Indeed. It is a single case and I don't think we're getting the full story. Was Jacquie really mentally ill as a child or ADD or just wilfull? At what age did they try to get her committed or medicated? Schizophrenia normally shows up in later teens, young adults. Very rarely in children.