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SOMBA K'E/YELLOWKNIFE
He was lying in a crimson puddle in the middle of a downtown street when the taxi driver found him.

Stacey Van Metre, social worker with the Salvation Army, stands in front of the bunks where men in the productive choice program stay. To keep their bed the men have to be clean and sober and be doing something whether it be working, going to school or taking a treatment program. From there they can apply to Bailey House. - Miranda Scotland/NNSL photo

At Stanton Territorial Hospital they examined his head wound, treated him and released the intoxicated man into police custody. But Raymond Eagle wasn’t healed and his family would spend the next few years praying their loved one would wake up from a coma.

More than a year ago a coroner’s inquest was held regarding the incident and Eagle’s eventual passing on Jan. 5, 2010. Out of the inquiry in March 2011 came 16 recommendations aimed at providing more care for people with addictions and improving the flow of information between RCMP and staff at Stanton Hospital.

But, no headway has been made in either area.

On that fateful day, back in August 2006, Eagle’s injury started to show itself in jail. Eagle started vomiting and later he became unresponsive. The RCMP took him back to the hospital where he was medevaced to Edmonton, almost 18 hours after initially being treated. Once there a doctor discovered that Eagle was bleeding in his brain. He underwent surgery for a blood clot the next day and from there slipped into a coma.

One of the recommendations made during the inquiry was for Stanton and the RCMP to develop a protocol on sharing medical information about patients released into police custody. Although the RCMP and the Stanton Territorial Health Authority meet regularly to discuss any issues that come up no procedure has been developed, according to RCMP Sgt. Brad Kaeding. At one point, Stanton had agreed to provide patients with a sheet of after treatment follow-up before handing them over to police but that never happened, he said.

“Stanton has advised us they could not provide information directly to the detachment or investigators regarding the condition of a person as that would breach their right to privacy of their health information,” Kaeding said in an e-mail, later expanding on the topic by phone. “Stanton’s interpretation of the privacy legislation does restrict their ability to share a lot of information with us.”

Damien Healy, a spokesperson for the Department of Health and Social Services, echoed Kaeding's comments about the Access to Information and Privacy Act. But, he added, emergency department staff do provide treatment instructions to patients either verbally or on paper “if necessary.”

Healy said Stanton would continue meeting with RCMP to further discuss sharing information.

There has also been some discussion between the two parties over the jury’s suggestion to put up information posters, such as a head trauma symptom sheet, in the cells area. However, Stanton staff wouldn’t help with this because there was concern that it could be construed as them providing medical advice without seeing the patient. Currently, there is a “rouseability” chart in the cell area but the RCMP isn’t sure putting up more posters is a good idea anyway.

“We are not medically-trained and there is a danger in interpretation of such posted information to the extent we could be making medical decisions based on a layman's view of a medical situation,” said Kaeding.

“Our default position is that if we are uncertain about the condition of a person in custody we are to follow the procedures set out in policy, including the rouseability guidelines.”

The jury’s recommendations have prompted the RCMP to review its policy for checking prisoner responsiveness. Meanwhile, Stanton continues to revisit a number of its policies, some of which were mentioned in the inquiry report.

Still, one the biggest recommendations made during the inquest has been left untouched. The jury advised the health department to put together a community consultative group to consider establishing a drug, alcohol and substance rehabilitation centre in Yellowknife and a halfway house for people who are homeless and have substance abuse problems.

According to the 2009 NWT Addictions Survey, 43 per cent of residents in the territory are considered to be heavy drinkers. That’s an increase from 34 per cent in 1996. Also, from 2000 to 2009 45 per cent of unintentional injury deaths were related to alcohol.

Health and Social Services Minister Tom Beaulieu said the inquest’s suggestion for a halfway house and rehab house hasn’t been looked into yet but the topic will be addressed when the government starts moving on the recently tabled Mental Health and Addictions action plan. The plan calls for the creation of a group that would look at ways to approach addiction and mental health.

“The issue is we have many people with addictions in the downtown core of Yellowknife that affects a lot of people and incidents like this happen unfortunately and does that mean that our reaction should be to build a treatment centre in Yellowknife?” he said.

“Maybe, but we’re going to have to take a closer look at that before we make a decision.”

The goals in the 30-page plan are set to be completed by 2015.

Meanwhile, the issues of mental health, addiction and homelessness rage on. The prevalence of these problems in the NWT is gravely concerning, said Lydia Bardak, executive director of the John Howard Society.

“There are probably many, many Canadians across the country who can identify with having an alcoholic uncle or a grandmother addicted to sleeping pills or something but here in the North it’s entire families,” she said. “So when you’ve got multiple siblings who are all troubled who supports who?”

Bardak recalled a conversation she overheard between a young mother and her boyfriend where the girl was boasting about never having custody of her one-year-old child taken away. The girl herself had been in and out of custody growing up and her sisters have struggled to keep their own kids.

“In her context it is normal (to have your kids taken away),” said Bardak.

“It’s so normal for many people and I guess we just have to get them the message that it’s not. Being drunk night after night and waking up not remembering what you did last night is not normal.”

In Yellowknife there are a number of supports for people suffering with addiction but there are some gaps in care that need to be filled, said Bardak.

More dollars have to be put into prevention and a greater effort needs to be made to help people with mental disabilities, such as Fetal Alcohol Syndrome Disorder.

Also, many residents are self-medicating with alcohol and drugs because they have a lot of unresolved pain and rage from their time in residential schools, said Bardak. Once that hurt is addressed and the addiction is addressed there needs to be support for those people until they are back on their feet, she said.

“Think of New Year's resolutions that we all make whether it’s to get more exercise to eat healthier, to quit drinking, whatever we say on New Year's Eve and most of us don’t last a month. And so you can go to your 28-day program and everybody comes out of there truly strengthened and believing that they’re going to turn it around but then you’re right back in the same patterns and habits because it’s very hard to change our behavior no matter who we are.”

Stacey Van Metre, a social worker with the Salvation Army, agreed that more after-treatment support is needed. She said she seen a number of men finish the program at Nats'ejee K'eh Treatment Centre on the Hay River Reserve, come back to Yellowknife and end up back on the street.

“Unfortunately, without a sober place for them to live or a transitional house or a halfway house or a longer treatment they fall right back into their addiction,” she said.

“Being on the street is setting you up for failure.”

Brian Birch, director of programming at the Salvation Army, said although NWT residents can visit the Hay River treatment centre, which is usually about 50 per cent full, it’s not enough. Yellowknife needs a treatment centre and detoxification centre, he said, adding the Salvation Army has two empty floors that could be used for the site.

“This is the capital, this is where everybody is coming,” he said. “There’s no need to open up a 12 or 15 bed treatment centre if you don’t think it’s going to be full but Yellowknife should have something and whatever it may be I think they should get it and I think they should get it soon.”

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