Ontario’s patient ombudsman says stories of people being held in isolation for years at the province’s only maximum-security psychiatric hospital are “deeply troubling,” as his office considers what actions it may take.
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it → say → actions
Craig Thompson has been “closely following” the Star’s investigation into the use of long-term seclusion at Waypoint Centre for Mental Health Care in Penetanguishene, said a statement from his office.
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statement → follow → office
“The patient experiences being shared are deeply troubling.
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experiences → share → ?
All patients should receive safe and appropriate mental health care consistent with recognized, evidence-informed approaches,” said the statement.
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statement → receive → approaches
“We are always assessing what actions the office may take that are consistent with our legislative mandate.
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that → assess → mandate
To maintain the integrity of our investigations, we do not generally comment on current or potential investigations.”
Should Thompson launch an investigation, it wouldn’t be the first.
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it → maintain → investigation
Jake Gordon is being released from seclusion at Waypoint Centre for Mental Health Care.
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Gordon → release → Care
His mom credits the Star’s investigation for the change.
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mom → credit → change
Jake Gordon is being released from seclusion at Waypoint Centre for Mental Health Care.
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Gordon → release → Care
His mom credits the Star’s investigation for the change.
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mom → credit → change
Concerns about prolonged isolation were being flagged more than 40 years ago at Waypoint’s predecessor facility, the Star has learned.
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Star → flag → facility
That year, an outside expert panel found that putting a patient in seclusion beyond even 24 hours should be treated as an “extraordinary” event.
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putting → find → event
The “excessive” use of seclusion is “blatantly unethical as well as untherapeutic,” said a report prepared at the time for the Ministry of Health.
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report → say → Health
The patient ombudsman — an independent office that takes patient complaints about Ontario health institutions — can commence an investigation based on a complaint or on its own initiative, but the probe is done behind closed doors and usually only the findings and recommendations are released to the public.
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findings → take → public
Lawyer Anita Szigeti, an expert on mental health law who has several clients in seclusion at Waypoint and who has written to Thompson directly, said she was pleased with his response, while reiterating that there still needs to be an independent and public investigation.
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she → have → response
“It signals to me that the issue is on their radar,” she said of the patient ombudsman.
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she → signal → ombudsman
“They’re following it, and they’re thoughtfully considering what they can do.”
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they → follow → what
The Star’s investigation has revealed that Waypoint is keeping seriously mentally ill patients in seclusion for years — 20 years and counting in the case of Camelott Hamblett — despite its own policy stipulating that seclusion should be the option of last resort to deal with a patient who poses an imminent risk of bodily harm to themselves or others.
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who → reveal → themselves
It’s also supposed to be used for as brief a time as possible.
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It → suppose → time
Leading experts have described the hospital’s practice as “egregious,” “abusive,” unlike anything seen in other North American hospitals, and akin to torture.
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experts → lead → torture
Lessons from 1984
More than 40 years before the latest controversy, a panel made up of outside psychiatrists, lawyers and other experts were tasked with conducting a review of the operations at Oak Ridge, the maximum-security division of what was then the Penetanguishene Mental Health Centre.
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what → make → Ridge
Oak Ridge was later demolished, and the current facility on the site was renamed Waypoint Centre for Mental Health Care in 2011.
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facility → demolish → 2011
The probe in 1984 was sparked by concerns about staffing levels, the provision of therapeutic services and patients complaining their rights were being violated.
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rights → spark → services
The panel, chaired by forensic psychiatrist Dr. Stephen Hucker, provided dozens of recommendations.
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panel → chair → recommendations
The panel’s report is found within thousands of pages filed as part of a proposed class-action lawsuit against Waypoint by Toronto firm Rochon Genova.
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report → find → Genova
The courts declined to certify the matter as a class-action, finding that seclusion is an individualized process and patients alleging wrongdoing would have to bring individual claims.
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patients → decline → claims
The panel was alarmed to learn that patients in Oak Ridge’s behaviour therapy unit — which housed people exhibiting “dangerous behaviours” — were sometimes being secluded for days.
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which → learn → days
The panel learned that a patient could be secluded for five days for: fighting or trying to fight with staff, possessing a dangerous weapon or making a serious escape attempt.
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patient → learn → attempt
Three days of seclusion could be ordered if the patient was hoarding medication, destroying property or trying to fight with another patient.
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patient → order → patient
It was unclear to the panel why assaulting a patient could get someone less time in seclusion than for assaulting a staff member.
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assaulting → assault → member
“Seclusion for such long periods is extremely hard to justify,” says the panel’s report.
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report → justify → periods
The panel said it was “strongly of the view” that a 24-hour period in seclusion should be the “absolute outer limit” based on “what is fair, reasonable, and humane.”
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what → say → seclusion
Seclusion beyond 24 hours “might be possible only under extraordinary circumstances,” the panel said, but recommended that it only be done with the approval of the hospital administrator, who should also review all instances of seclusion throughout Oak Ridge at least monthly.
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who → say → Ridge
There’s no mention in the report about patients being secluded for years, as is the case now, more than 40 years later.
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patients → ’ → years
Some of the report’s language mirrors the Six Core Strategies, the internationally recognized best practices to reduce the use of seclusion that Waypoint has said it is implementing, but the strategies’ creators believe otherwise.
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creators → mirror → that
The first strategy is that the CEO should be involved in daily seclusion decisions, but Waypoint CEO Dr. Nadiya Sunderji has told the Star that would be inappropriate, citing unspecified provincial legislation.
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that → involve → legislation
Many of the expert panel’s members have since died.
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Many → die → members
Hucker, the chairperson, declined to comment, citing the passage of time.
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Hucker → decline → time
Silence from ministry, patient advocate office
Szigeti said that the patient ombudsman’s response is stronger “than anything we’ve heard from government or organizations with any oversight role.”
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we → say → role
And it calls into question what other bodies could be doing.
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bodies → call → what
…and 22 more, not listed.
The Aporia
