Flaws in the system represent large-scale problem in Canada’s mental health services

Ciara Dymond, despite going through the traumatic experience of her mother going missing, opens up about what it was like while trying to continue to stay positive. Photo credit: Jackie Graves

Ever since Ciara Dymond was young, she says her mother, Wanda Debuc, struggled to manage her bipolar disorder, even with the help of mental health services. Despite expressing growing concerns for her mother’s condition, Dymond feels the system failed Dubuc when she went missing this past September.

Dymond and her family lived in Oshawa during her youth before moving to Richmond Hill.

Previously, Dubuc went to Lakeridge Health, a local hospital in Oshawa where Dymond says she was in and out of treatment for her bipolar disorder and used the Assertive Community Treatment Team (ACTT).

ACTT is a community-based mental health program which provides direct treatment, rehabilitation and support to adults with severe and persistent mental illness.

Lakeridge Health in Oshawa offers mental health services such as crisis intervention, inpatient care, urgent care and outpatient services. However, patients are also referred to Ontario Shores Centre for Mental Health Sciences in Whitby when resources are unavailable or if they require specific services.

However, Dymond says while the treatments helped at the time, they weren’t enough to help her mother in the long-term.

“My mother was at Lakeridge Health a lot in my childhood. I can’t really count how many times because it’s so many,” says Dymond. “She was able to be okay for a time, one or two years, before having an episode again.”

Ciara and Wanda
Ciara and her mother, Wanda Debuc. Photo credit: Ciara Dymond

Those with bipolar disorder experience extreme mood swings, including “highs” and “lows” known as mania and depression, respectively. This can cause an individual to be unusually upbeat, experience insomnia, make poor and potentially harmful decisions, and even experience delusions, according to the verywellmind.com.

Dymond says she noticed that Dubuc was having increasingly bad delusions a couple of months before she disappeared in September. She says her mother believed her ex-husband was somewhere in the house, despite him not living there.

Dymond became concerned when her mother refused to sleep or eat. She says her mother eventually agreed to stay in a local Richmond Hill hospital from September 2-5. After that, Dymond says her mother was released because there were no available beds in the health unit for her.

According to Measuring Up 2018 – A Yearly Report on How Ontario’s Health System is Performing, in 2016-2017, an average of 4,233 Ontario Hospital beds were occupied every day by patient’s waiting to receive care somewhere else, such as a long-term care home or rehab.

The report also says 34.2 per cent of people also waited 30-89 days to see a specialist and 33.5 per cent said they waited 90 days or longer.

She says her and her family were outraged, so they reached out to their family doctor on September 8 to see if Dubuc could be admitted on a Form 1.

A Form 1 is an application submitted by a physician for a person to undergo a psychiatric assessment to determine if that person needs to be admitted for further care.

Instead, Dymond says her mother was simply sent home, so she tried more drastic measures to help get her the help she needed. She went to the Justice of Peace on September 9 to try and issue a Form 2, which allows the police to bring a person in for psychiatric assessment.

“I didn’t give up there. I went to the Justice of Peace to try and get her a Form 2 and allow them to see [that] she needed to be apprehended to receive treatment,” says Dymond. “They did not process my request.”

According to Dymond, her request wasn’t processed because her mother wasn’t deemed to be a threat to her or anyone else. In between this time, from September 7-9, she also reached out to local police as her mother’s behaviour became worse.

Dymond says the police could not apprehend her under The Health Act.

“I called again because she had threatened me, but because there wasn’t a weapon in the household, it wasn’t enough for them to take her,” she says.

After the incident, Dubuc went missing from her home in Richmond Hill on September 10.

“We saw her leave on the security camera early morning and never return home,” says Dymond. “The police were finally there at my house. They did the missing person’s report – they tried to do everything that they could.”

Dubuc was missing for four days before finally returning home.

Dymond says Dubuc was having a delusional episode where she believed she was staying in a house that her father was paying for. She only left after Dymond’s father didn’t show up to join her.

According to Dymond, Dubuc had no concept of why her family was on the news or why they were so concerned.

“I’ve kind of been dealing with this my whole life with my mother due to her bipolar disorder,” says Dymond. “Up until recently, I think this is probably the worst episode I’ve ever seen.”

Finally, her mother was admitted to hospital for one month before she was released again. Dymond says it wasn’t enough time to address the full scope of her mother’s issues.

“She wasn’t well enough to come home, but they released her anyway,” says Dymond. “Honestly, I think they did what they could, but there could have been a lot more done. I think because my mother wasn’t suicidal, they didn’t take her threats seriously.”

Dymond says her mother’s bipolar disorder impacted more than just herself. Their family struggled financially because Dubuc sometimes couldn’t maintain a job. Dymond says she often moved between family members when her mother’s illness became “too much for her to take on.”

Today, Dymond is a fourth-year university student studying forensic psychology at Ontario Tech University in Oshawa and also works at the YMCA’s childcare centre.

Dymond’s story represents a larger problem in Canada’s mental health system, which leaves many like Dubuc with inadequate access to services.

According to the Canadian Mental Health Association (CHMA), which has a facility in Durham Region, a 2016 report showed the wait times to see a specialist of any kind left 56 per cent of Canadian’s waiting four weeks or longer. In regards to mental health care, some Canadian’s could wait up to a year or longer for any kind of mental health treatment with one-third of those Canadian’s saying they did not receive adequate assistance, if any.

This bodes as a concern as the Mental Illness At a Glance report in Durham Region shows that from 2007 to 2015, youth aged 15-19 accounted for 13 per cent (478 of 3,723) of the total individuals hospitalized at least once due to mental illness. According to the report, the prevalence rates of mental illness hospitalizations in Durham Region for men and women were higher than Ontario. It also says women were more likely to be hospitalized than men.

The prevalence rates of mental illness hospitalizations in adults 65 and older did decrease over the same period, but still accounted for 22 per cent (809 out of 3,723) of the total number of hospitalizations for mental illness in 2015.

It’s a problem mayor of Oshawa Dan Carter says needs to change.

“Mental services, especially [for] those people that are in crisis — unfortunately, I don’t believe that capacity is available,” says Carter. “I think it’s a focus of attention that the provincial government has to really understand.”

Carter says he feels Lakeridge Health shouldn’t be a Schedule 1 mental health facility. A schedule 1 facility is determined by the Ministry of Health and Long Term Care and refers to hospitals and other health facilities that provide observation, care and treatment for those experiencing mental health disorders.

Carter says patients struggling with their mental health should be treated at Ontario Shores because the facility is catered to deal with mental health.

He also says the system has to stop looking for a “quick fix” to a big problem.

“At some point, we have to stop saying: ‘Well, you know, we don’t have the resources. You know, well, we don’t have the money,’” he says.

The issue of mental health is something mayor of Oshawa Dan Carter says he understands.

According to an article written by the CBC, Carter had severe dyslexia as a child and was sexually abused by a stranger at the age of eight. By the time he was 13, his older brother, Michael, was killed in a motorcycle accident. Shortly after this, Carter fell into drugs and alcohol, leaving him homeless in his teens and 20s.

It wasn’t until his sister, Maureen, told him when he was 31 to sober up or die, inspiring him to enter rehab and turn his life around.

Even though Carter received treatment and has since recovered, his sister, who Carter says he looked up to, died by suicide in the 2000s.

Carter says his sister didn’t believe she could receive treatment at the hospital, so she simply stopped going.

“There’s a whole bunch of systematic issues that we have to kind of go back and have a conversation about,” says Carter. “What’s happening in society that people feel so overwhelmed, so full of anxiety?”

While some services come with long waitlists and mandatory referrals, Creating Opportunity for Personal Excellence (COPE) offers an alternative to clinical support.

COPE is a community program within Community Care Durham offering support to adults aged 16 and older with emotional and mental health problems. COPE accepts referrals from Ontario Shores as well as other resources and even allows clients to submit a personal referral through a form found on their website.

COPE provides free care to those struggling with anxiety, depression and other mental health problems.

Program manager Carolyne Pennell oversees two municipalities, including Oshawa and Whitby. She says COPE offers about 60 different support groups, as well as individual care with an aim to allow patients to receive help in their community.

“We’re not clinical, so we’re not hospital-based,” Pennell explains. “We bring in education because we want the client to have the opportunity to move forward and acquire some coping skills and relapse prevention techniques.”

COPE doesn’t just focus on their client’s mental health needs, according to Pennell. They also do a needs assessment to make sure they have enough food and access to what they need in order to succeed, even if it means connecting them to other resources.

“I kind of look at it like a swiss-cheese analogy because we try and hone-in on the holes, and patch them up together with the client,” says Pennell. “But if people do require more, we understand that COPE isn’t the answer for everything. We want to make sure that they are connected with appropriate services.”

COPE also receives referrals from Ontario Shores’ outpatient services while they also send clients in crisis there for specialized treatment.

While Durham Region has services to address mental health issues, Dymond says it still isn’t treated with the level of seriousness it deserves. She says her mother’s disappearance is an example of what happens as a result of her concerns not being taken seriously.

“I feel like people don’t take it seriously enough, even in this society. I mean it’s 2019,” she says. “I feel that the system has failed her because all of this could have been prevented if they just admitted her if they really just took my concern and they and they listen.”