Patients who had been conditionally released from a Halifax forensic psychiatric hospital weren’t allowed to leave because they were stuck on waiting lists for up to six years for a supported community home, a human rights inquiry heard Tuesday.
The East Coast Forensic Hospital primarily houses adults who have committed crimes, but have been found not criminally responsible on account of a mental disorder, or NCR.
Statistician Patryk Simon testified Tuesday at an inquiry into housing for people with disabilities, and gave a statistical snapshot of those NCR patients. His work showed that on April 24 about one third of those surveyed – or 19 people out of about 57 – had been waiting for an average of over two years for a community placement.
Among the 19, there were two people who’d been waiting four to five years, and one for over six years.
“What jumps out for me is the length of time people are waiting,” said Claire McNeil, a lawyer with the Disability Rights Coalition who had requested the statistics.
“They’re under significant restrictions. They can’t move forward. The professionals involved with them have said they’re ready to be in community and yet they’re spending time unnecessarily in the forensic hospital.”
McNeil’s organization is a complainant in the human rights inquiry considering whether the Department of Community Services violated the Human Rights Act by housing Joseph Delaney and Beth MacLean in a hospital-like, institutional setting at the Emerald Hall psychiatric ward in Halifax for over a decade.
MacLean and Delaney have dual diagnoses of mental illnesses and intellectual disabilities, and they have been kept in a regular psychiatric hospital on a special unit for people with intellectual disabilities.
Still, McNeil argues the issues at the East Coast Forensic Hospital are similar to those at Emerald Hall, as both instances reflect the shortage of suitable housing provided by the Department of Community Services.
“From our point of view, it’s been going on since 1995,” she said, referring to the year Nova Scotia froze funding for small supported housing for people with intellectual disabilities and mental illnesses.
James MacLean, program leader at the East Coast Forensic Hospital, said in an interview that the average waiting time of over two years fluctuates from month to month.
However, he also said the primary cause is the lack of Community Services facilities where patients can be located.
He added that the stigma associated with NCR patients may also be playing a secondary role.
“Ideally somebody with a mental illness that is now stabilized should be living in the community with the appropriate supports … There’s lot of evidence to suggest it’s not healthy for them to live in an institutional setting when they’re quite capable of living in a community setting,” he said in a telephone interview.
“We’re concerned the longer the wait, it does have an impact on their mental health.”
MacLean also said the situation means that the hospital must cope with a higher patient load than necessary.
Jamie Livingston, an assistant professor of criminology at Saint Mary’s University in Halifax, said in a telephone interview a conditional discharge indicates that an NCR person can be safely managed in the community under certain conditions, similar to parole.
“If a person is ready for discharge to the community and are being blocked because of lack of resources, then their liberty is being unnecessarily restricted and their recovery may be stifled,” he wrote in an email, adding they could become depressed or frustrated.
However, the professor said people waiting for placement will normally be allowed day passes into the community.
In addition, some of the delays can be due to the necessity to make arrangements to find safe, affordable housing that provides sufficient support, he noted.
Livingston said to his knowledge the practice hasn’t been challenged legally in Nova Scotia, but British Columbia courts have ruled it isn’t legal to hold a conditionally discharged person indefinitely in a forensic hospital in that province.