A former Prince George resident who has had three close encounters with the mental health care system in northern B.C. over the last two decades is calling for changes to make the system more responsive to patients and their families.
Lisa Jones, whose real name is not being used to protect the privacy of others in this story, has had a brother commit suicide, an ex-husband attempt suicide and has been hospitalized for having suicidal thoughts herself. Each time Jones has felt the system has let her or her family down in one way or another.
Her brother first tried to kill himself more than 20 years ago but was unsuccessful. Only a child herself at the time, Jones felt the healthcare system didn't do enough to help her brother or her family deal with his mental health issues. Four years later, he killed himself at age 20.
"They let him out with really no follow up," Jones said. "My family wasn't given the tools - especially my mom - to try and continue helping him after he was released."
As a teenager, Jones had her own bought of depression - an experience she described as the worst experience of her life. She was admitted into the hospital after telling a school counsellor she was thinking of harming herself.
Unlike her brother, Jones had never attempted suicide and described her situation as trying to reach out for help. She was shocked that the initial response from physicians was to tell her she would be in hospital for months. In fact, she was released about a week later.
Her most recent experience with the system came just four years ago. Shortly after separating from her husband, he attempted suicide by trying to overdose on medication, but was released from hospital a day later.
Jones said his family later found out that it was a communication error between a doctor and a nurse - her ex-husband was supposed to be released from the intensive care unit to the mental health ward, but the orders were misinterpreted and he was able to walk out the door.
"How did the nurse look at someone who was in the ICU the day before for trying to attempt suicide and say, 'Oh, you get to go home, how lucky for you?' " Jones said. "Would she not have thought this doesn't seem right?"
She described her ex-husband's release from hospital so soon after his suicide attempt as "terrifying" for her and other family members as no one knew if he was ready. She said hospital staff told his family the only way he could get further care was to voluntarily come back.
"By no means was he in a mental state to do that," she said. "He was thinking, 'Oh perfect, I'm going home with my ex-wife, everything is going to be great.' "
Fortunately for Jones, her ex-husband and their children he was able to successfully manage his depression and suicidal thoughts and hasn't attempted to kill himself again.
Jones, who sought out mental health care for herself after the incident due to the stress it caused but was told nothing could be done to help her because she was fully functional, said she felt completely letdown by the system.
Northern Health director for mental health and addiction services for the northern interior Mike Simpson said Jones' story was unfortunate, but said mental health services and the supports offered to both patients and families have improved in recent years.
Northern Health conducted a major study in 2006, which looked at access to mental health services and what barriers existed. As a result, Simpson said care levels have gotten better.
"I would say in the last five or six years things have improved and I'd say in the last two or three years we're operating quite differently," he said. "That's not to say there isn't still lots of room for improvement and we need to continue to enhance both the quality of our service as well as our responsiveness."
When someone has attempted suicide and is being released from hospital, Simpson said the goal is to have a conversation with them, their family and other community support members like family doctors. They talk about the services available and what can be done to prevent another suicide attempt if a person begins to experience symptoms.
"We try to equip the person with a relapse prevention plan," he said. "We help them to understand the cues that they need to be watching for in themselves - that could be anything from whether their medication is working properly or just being aware of the stressors that may put them in a difficult situation again."
Following up with patients is also important and Northern Health endeavors to do so 30 days after their release to find out if they're accessing services either through the health authority or in the community.
As for discharge decisions, Simpson said it depends on how the patient is classified. If they are in the hospital voluntarily, medical staff can't compel them to stay and sometimes people leave early without the ideal support plan in place. If someone has been committed under the Mental Health Act, then physicians and the rest of the medical team don't release a patient until they believe they are no longer a risk to harming themselves.
"This is as much an art as a science and you can never say 100 per cent that a person will not try to take their life again," Simpson said.
Despite all the challenges her family has faced over the years dealing with the mental health system, Jones said she knows many of the medical staff are hard working and dedicated to helping patients.
Outside of the medical community, she said more people need to understand how important it is to talk about suicide.
"You're either the type of person that in your mind would consider doing it or you're not," she said. "And for people who don't understand that sort of depression, I think they consider it a weakness,something you can control. But for those people [who do have suicidal intentions], they can't control those emotions, that's why they need help."
