Bedford boy hospitalized after falling through cracks in health system

A Bedford family is with their young son at the psychiatric unit of the IWK Health Centre after failed attempts to have him admitted to hospital for violent mood swingsled toa crisis.

The family's life spiralled downward after the boy began experiencing uncontrollable rages in June. The13-year-old wasdiagnosed withAsperger'ssyndrome when he was six, but the condition isn't typically linked to violent thoughts and outbursts.

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The episodes escalated until Steve, the boy's father, was forced to stay home from work to prevent his son from hurting himself or harming his mother and younger brother. CBC News is not identifying the boy because of his age and medical issues.

On Nov. 9, Steve took his son to the emergency department and theIWK Health Centre.

He wanted his son to be admitted to ahospitalinpatient unitknown as theGarronCentre, which has14 intensive care beds reserved for "psychiatric emergencies."

Steve was told his son's violent behaviour did not meet the hospital's criteria for admission to the unitand the family returned home.

Boy rushed to emergency room

On Thursdaynight, the father rushed his child back to theIWK'semergency room. EarlyFridaymorning, the boywas admitted to the hospital'sGarronCentre.

"It is unfortunatethat it took a suicide attempt to get him into the program.What I mean by that is that they did not admit himon Mondayand byThursdaynight, I'm back again," Steve said.

"Nothing really changed except an attempt on his life. So obviously the bar should be looked at and the criteria critiqued ... it's very unfortunate something like this has to happen before your son gets help."

Fortunately, the team at the IWK was able to save and stabilize the boy. He spent the weekend in hospital being assessed.

The family is optimisticthis hospitaladmission the boy had one previous staywill result in a diagnosis of what'scausing thisaggressive behaviour.

The hospital's criteria for admission to the acute care psychiatricunit requires more than a display of violent behaviour or being in a crisis, the hospital says.

The youth must be at immediaterisk of harming themselves or another person, as Steve's family learned this week.

Social crisis not always psychiatric disorder

"Peoplecome to the emergency departmentin a crisis and its not necessarily always related to a psychiatric disorder," said Dr. Ruth Carter, the IWK'sdirector of mental health and addictions.

"In the teenage years, it often can be because of some kind of a social crisis goingon in their lives. They haveintense relationships with their peers and they can get in a crisis mode," she said.

"That crisis may not result in an admission. If there is anythingthatwould suggest a risk of harm to themselves or another then they will be admitted."

About 470 patientswere admitted last year. That is nearly 100 morethan justa couple of years ago.

The hospital says more than half the children it sees benefit from treatment though outpatient services or programs in thecommunity.

Meanwhile, the troubled teen cannot attend school because of his uncontrolled rages.

Police presence is not uncommon at the family's home in a quiet Bedford neighbourhood.

'A switch goes off'

Officers were called twice two weekends ago because of the boy's violent behaviour.

"It's as if a switch goes off.He doesn't know how to control his temper," said the dad.

"On Sunday, he chased a seven-year old kid in the neighbourhood with a leg from a chair and we had to call police again. It's probably the 10th time since he started to get violent last June."

CBC News spoke to thepudgy, curly-haired boy, who wassmiling, tinkering happily with electronics in the garage.

But in the next moment, the young teen's face clouds over.

Swearing, pushing his mother and threatening to kill himself with a rough knife he's fashioned are some of the things that can follow.

He's on medication, but he doesn't think it is helping.

When asked why he hits other people, he shifts uneasily and says: "Sometimes I just get it without any triggers. It just happens."

Refusal to consent to treatment

The family hopes for a diagnosiswere raised whenthe boy was referred to theIWK's Adolescent Intensive Services treatment program on Joseph HoweDrive in Halifax.

The combination dayandinpatient program for 13-to-19 year olds with severe disruptive behaviour, mental health issues or substance abuseisoffered in a recreation-type setting not far fromhome.

But the boy refused to go. According to the province'sInvoluntary Psychiatric Treatment Act,his parents can't force him.

That's because the Act gives patients regardless of agethe right to consent to, or reject, treatment.

"The young person needs to be able to understand the illness or the condition for which they are being seen or recommended for treatment," saysDr. SabinaAbidi, associate chief of psychiatry at the IWK.

"They need to understand what the treatment might be and what the sideeffects are. Theyneed to understand the benefits and risks of accepting treatment, and thebenefits and risks of refusing treatment."

That's a position the boy's dadfinds impossible to accept.

No option but to speak out

"If you have a mentally challenged individual who is 13years old who cannot make rational decisions, the legal guardian should be able to have theauthority to help him get the help that he needs," said Steve.

"A medical professional told me that my son could possibly report me to thepolice if I manhandle him ordo anything forcibly to make him go. That's just nonsense!"

He said the boy and the family are caughtin a loop that includes police, mental health services, the IWK Health Centre, and Community Services.

"We are a family in crisis," said Steve.

Community Services has assessed the boyfor future placement in a group home, but that's a last resort for the family.

"Once he goes into a small options home orWaterville[the detention centre for criminal youth], we've lost him," said Steve. "And we won't be able to pull him back."

The business executivesaid the frustration of trying to navigatethe health system and other agencies to find help for his son pushed him to share the family's experience with the public.

"I've had enough," he said. "I'm a very private person. Even my colleagues at work don't know what's happening.

"But this story has to be told, not just for my son, but the many families out there who are going through the same thing. There is a problem in thesystem, it has to be rectified and I have no option except to speak out."