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Coroner wants changes to Mental Health Act

Kassina Ryder
Northern News Services
Published Monday, March 22, 2010

NUNAVUT - The NWT chief coroner says there should be a provision whereby people in the NWT and Nunavut with serious mental disorders living in the community can be legally required to take their prescribed medication.

Garth Eggenberger made the recommendation following his investigation into the death of a Kugluktuk man diagnosed with schizophrenia. The man, who had stopped taking his prescribed medication, attempted suicide at his home last April and was medevaced to Yellowknife. He died at Stanton Territorial Hospital a month later from his injuries.

"Under both the Nunavut and the Northwest Territories Mental Health Act, there is no provision that the patient has to continue taking their medication," Eggenberger said.

He is suggesting changes to the Mental Health Acts of both the NWT and Nunavut that would introduce Community Treatment Orders to the territories.

The orders are issued by a doctor and require a person diagnosed with a serious mental disorder to agree to follow a treatment program in their community instead of being hospitalized, according to the federal Ministry of Health and Long-Term Care.

If the individual fails to comply with the order, including not taking his or her medication, a doctor or family members can call the police to bring the individual to a doctor.

The doctor can then decide whether the person can continue living in the community or if he or she should be hospitalized.

"A doctor would say 'this patient can be released back into the community provided he continues with medication,'" Eggenberger said. "We want to give the medical practitioners and the families an option that is not available right now."

The person must be able to give consent to treatment and agree to a community treatment order, but a substitute decision maker can consent on their behalf if the person is deemed incapable of giving informed consent.

The orders expire after six months unless they are renewed and must be regularly reviewed by the person's doctor, who can choose to renew or deny it.

Under current legislation, family members must get a judge to issue a court order if a person stops taking his or her medication, Eggenberger said.

Alternatively, the person must demonstrate that they are a threat to themselves or others.

"Under Nunavut's Mental Health Act, there is no action that can be taken just because a person has ceased taking medication," according to an e-mailed statement from Nunavut's Department of Health and Social Services.

"The person's right to choose can only be removed at such time that they become a danger to themselves or others."

Eggenberger said requiring people with serious mental disorders to take their medication under the Mental Health Act would reduce the chances of them becoming dangerous.

"We're saying we need to stop it before it gets that far," he said.

"Most people, once they're on medication, they're not a problem. Problems arise when they quit taking their medication."

Community Treatment Orders have been implemented in other Canadian jurisdictions including Saskatchewan, British Columbia and Manitoba.

No one from Nunavut's Department of Health and Social Services was available for further comment as of press time.