CBC Saskatoon Link:

https://www.cbc.ca/news/canada/saskatoon/sask-health-saskatoon-mental-shooting-police-steven-rigby-1.5420097

The last time Carey Rigby-Wilcox spoke to her son Steven, she was standing by his driver's seat window as he pointed a gun to his head.

"'I'm done, Mom, I'm done. I can't take this anymore,'" Rigby-Wilcox remembers the 27-year-old saying between tears.

It was Dec. 22, 2018. Within the next two and a half hours, Steven was dead. Saskatoon police later said there had been an officer-involved shooting.

The exact circumstances of his shooting remain unclear to the public, but medical records legally obtained by Rigby-Wilcox show that, two days before his death, Steven was discharged from a Saskatoon mental health centre despite documented warning signs, including a recent suicide attempt.

A doctor who committed Steven noted he had recently talked of "provoking police to shoot him."

"He absolutely was failed," Rigby-Wilcox said of how the Saskatchewan health system dealt with Steven.

Man in southwest Saskatoon dead after officer-involved shooting

The Saskatchewan Health Authority has declined to discuss Steven's case "due to the patient privacy legislation," even though Rigby-Wilcox has consented to their doing so.

Rigby-Wilcox said she's sharing her son's story because she wants systemic changes — including more mental health beds, more caregivers and more guidance for the parents of out-of-hospital adults struggling with suicidal tendencies — to prevent deaths like Steven's.

"All the issues that we faced as a patient, as a family, really should be dissected," she said.

"Something positive has to come out of this."

'He's my sidekick,' Rigby-Wilcox said of her firstborn. (Supplied by Carey Rigby-Wilcox)

'The first person I would call'

Steven was the eldest of four siblings. He managed a telecommunications store in North Battleford and had a second home in Saskatoon.

"He was smooth. When he sold phones, he could sell anyone anything," said longtime friend Tyler Robin.

Steven loved to play soccer and Xbox and was "the first person I would call or hang out with whenever I needed support," Robin said.

'If I ever was upset about a girl, he would be the first to cheer me up,' says longtime friend Tyler Robin (right). (Supplied by Tyler Robin)

"Each morning when he came to work he stopped at my desk and we would chat for at least a half hour," said colleague Shelly Martin. "He needed to know how [my family] was. My granddaughter occasionally would video call me and ask 'Where's that guy, that Steve guy?'"

Co-worker Shelly Martin (second from right), seen next to Steven at the wedding of another colleague. 'Steven was always smiling and laughing, always happy and having fun,' she said. (Supplied by Shelly Martin)

Rigby-Wilcox said the family became aware of Steven's mental health issues six months before his death. She said he was an alcoholic who suffered from anxiety and depression.

"He was on some anxiety/depression pills which amplified his suicidal thoughts," she said. "He then added more alcohol to his life to suppress those voices of suicide."

Catching the warning signs: N.W.T. workshops promote suicide prevention

Robin said he also knew about Steven's mental health struggles, including two suicide attempts.

In one August 2018 incident, "[Steven] attempted suicide by helium asphyxiation with a kit he had ordered a year previously," according to one document obtained by Rigby-Wilcox. "It was aborted when he fell forward and the [bag] came off his head."

Police took Steven to Battlefords Union Hospital, where he underwent a suicide risk assessment.

"There's a big difference between having a thought and acting on a thought. Do you think you might actually make an attempt to hurt yourself in the near future?" he was asked.

"Yes," the assessment form recorded as his response. He stayed in hospital for several days.

Steven was seen at Battlefords Union Hospital in North Battleford after a reported August 2018 suicide attempt. (CBC)

'No guidance from anyone'

Once out of hospital, Steven spiralled, Rigby-Wilcox said.

She said he was taken to Saskatoon's Royal University Hospital (RUH) several times, once after being picked up with a gun to his head. Run-ins with police became regular, she said.

Martin, Steven's co-worker, accompanied him during one North Battleford hospital visit.

"The doctor said, and I was there when he said it, 'This is not a mental health issue, this is an addiction problem.' No one in the health care system would listen no matter how many times he cried out for help."

During a Sept. 27 visit to RUH, a triage nurse noted he had a known history of suicidal ideation, "with multiple attempts in the past."

Rigby-Wilcox and her husband, Rich, want more information on what happened during Steven's shooting. They're hoping for a coroner's inquest. (Guy Quenneville/CBC)

By November, Steven was living on and off his parent's acreage southwest of Saskatoon. One day, Steven threatened to commit suicide by cop if his family called the police again, Rigby-Wilcox said.

"We had no guidance from anyone [on] the outside," she said. "No resources, no medical, no guidance from any physician."

Robin said Steven should have been "immediately put on lockdown" after his first suicide attempt.

"He never should have been able to get the drugs the way he did, he never should have been able to walk out of care centres."

'As if they didn't believe us'

During one of Steven's visits to RUH, an E.R. doctor asked Rigby-Wilcox for proof of Steven's suicidal tendencies, she said.

"It's as if they didn't believe us. I just don't comprehend that. There were so many incidents."

Rigby-Wilcox said her son's appearance may have led people to doubt the extent of his problem. One medical document described him as "pleasant and agreeable," with a "stylish hair and clothing."

"Steven said, 'People think that I don't have mental issues, that I'm not struggling, because I can hold myself and I can look like a man,'" Rigby-Wilcox said.

Steven's mother says he told her, 'I can say what I need to say' to convince people things were OK. (Supplied by Carey Rigby-Wilcox)

Steven was also in denial about his suicidal behaviour, according to the medical records and his friends.

"He was very much the type of person to be too proud to admit his struggles or ask for help," Robin said. "He joked about it, that he would never be admitted again because they're all nuts and he's not."

Martin echoed that sentiment.

"He was really an ace at hiding it," she said. "Up until August of 2018, I don't think there was more than a handful at work who knew."

'Why would they let him out?'

Police brought Steven back to RUH on Dec. 18, following another bender.

The next day, a doctor diagnosed him with alcohol-induced depressive disorder, noted he was at "acute" risk of suicide and committed him to the hospital's Irene and Les Dubé Centre for Mental Health.

"The involuntary process is only used when it is deemed that a patient has the potential to harm themselves or others, or when the patient is likely to suffer serious deterioration," said Amanda Purcell, a spokesperson for the Saskatchewan Health Authority.

The doctor noted Steven's August 2018 suicide attempt in North Battleford and "escalating recent comments expressing suicidal intent, including provoking police to shoot him."

The doctor's note, warning of past talk of suicide by cop, on the form committing Steven to the Dube Centre for mental health in Saskatoon. (Supplied by Carey Rigby-Wilcox)

"We thought this was the be-all-end-all," Rigby-Wilcox said of Steven's admission at the Dube Centre. "'You're the professionals. I'm handing my love of my life to you. Please take care of him.'"

Rigby-Wilcox visited Steven on Dec. 20. Later that day, according to Rigby-Wilcox, Steven recounted what happened after his family left.

"[Staff] said, 'We have people that have no family support like you, that are on meth, that actually are worse off than you that need this bed. Are you willing to give your bed up?'" according to Rigby-Wilcox.

"Steven told me, 'Mom, what was I supposed to say?"

Staff at the Dube Centre checked on Steven every 30 minutes, according to a nursing progress report. (Guy Quenneville/CBC)

Only months before, the Saskatchewan NDP had complained that the 54-bed Dube Centre had been over capacity for years.

Dube Centre overcrowding concerns NDP

Still, given Steven's history, "Why would they let him out?" Rigby-Wilcox asked.

On Steven's summary discharge form, a psychiatrist noted he appeared "calm, coherent and organized" and planned to room with a sponsor for a few days.

"He is aware of the physical risks of alcohol withdrawal [including seizures] and is declining voluntary admission," reads the certificate revoking his committal to the Dube Centre.

Steven spent the night at a hotel.

On the morning of Dec. 21, he went to his parents' home, where he slept all day, according to Rigby-Wilcox.

Dec. 22, 2018

Steven appeared cheerful the next day, but the smartphone he left behind after his death paints a completely different picture, Rigby-Wilcox said.

"At 5:25 p.m., when he's sitting there [at his grandparents' home], joking around, laughing on the floor with the dog, watching a movie, he's Googling how to shoot himself in the head," she said.

At around 7 p.m. CST, Steven left in his car.

"I never thought to take his keys away," Rigby-Wilcox said.

Many of Steven's friends, including Tyler Robin, got a call from him that night.

"He took the time to call every single person he felt he needed to just to say goodbye," Robin said.

Tyler Robin and some of Steven Rigby's other friends got these matching tattoos in Steven's honour on the one-year anniversary of his death. (Marc Wishart/Instagram)

"Just come home," Rigby-Wilcox said to Steven on the phone.

Worried about Steven's drinking and driving, Rigby-Wilcox and her husband Rich set out to find him. They tracked him down on a dead-end grid road near their acreage, armed with a handgun stolen from his grandfather's locked safe, she said.

"He's just yelling, 'Mom I can't do it anymore. I'm gonna f-----g die,'" Rigby-Wilcox said. He stuck the gun outside the window and shot twice in the air, she said.

Rigby-Wilcox said she and Rich followed Steven's car, called 911 and told the operator about Steven's recent talk of suicide by cop. Rigby-Wilcox now regrets that call.

"I think I killed my kid," she said.

Watch a clip of Rigby-Wilcox talking about her last moments with her son:

Watch

Carey Rigby-Wilcox on why she tried to tape her suicidal son

4 days ago 1:26

"Because we couldn't understand why he got out" 1:26

'Officers perceived a threat'

According to a statement released the next day by the Saskatoon Police Service, "an adult male in distress ... was reported to be driving a vehicle heading toward Saskatoon while making threats to harm himself and law enforcement officers, and was in possession of a handgun."

RCMP used a tire deflation device to partially disable Steven's car on Valley Road, near the ramp to Circle Drive West. Saskatoon officers "simultaneously responded to the scene," according to the statement.

Police closed off the shooting scene on Valley Road the next morning. (CBC)

Rigby-Wilcox and Rich were about 100 yards away when Rich heard gunshots. Rich rolled up the window and turned up the car heater to try to block out any further sound, Rigby-Wilcox said.

"[Saskatoon Police] and RCMP members encountered the adult male who refused to comply with officer commands and fired his gun," according to the police statement. "Officers perceived a threat and engaged."

Rigby-Wilcox remembers an ambulance leaving the scene with its lights on, but no siren.

Waiting for answers

Steven was declared dead at RUH.

His friend Robin said he doesn't blame any of the police officers involved. He even had friends on shift that night, he said.

"I feel like it could have been handled differently," Robin said. "It says something about society that 'suicidal individual' meets such force back."

While Steven also spoke to him about suicide by cop, Robin said Steven "would never point a weapon at anyone. He was trained in gun use."

Saskatoon Police Service's major crimes section investigated the shooting. An investigation observer, typically an ex-cop, was also tapped by the province to independently oversee the police investigation.

At a press conference the day after the shooting, Saskatoon Police Chief Troy Cooper said, 'I'd like to express my condolences to the loved ones of the family of the man who was involved in last night's incident.' (CBC)

Saskatoon police say they are waiting on Steven's autopsy and toxicology results before sending the file to Crown prosecutors, who will review it for signs of criminal wrongdoing.

If no such wrongdoing is found, Steven's shooting will likely be the subject of a public coroner's inquest — a fact-finding process that typically focuses on the day of a person's death.

Province taps observer to review internal Saskatoon probe of fatal shooting

Saskatoon police await final autopsy results in 2018 fatal shooting case

Brian Pfefferle, a Saskatoon defence attorney, has agreed to represent Rigby-Wilcox during any inquest.

"This is an important one for the public to be aware of," Pfefferle said.

"There was a very tragic loss of life here that involved someone who had a very supportive and loving family. We have police officers that were put in a very precarious situation. We are repeatedly hearing more and more stories of peace officers going to work every day potentially facing these sorts of situations."

Pfefferle said an inquest could focus on the key question around the incident.

"Why did it happen?"

Rigby-Wilcox has collected Steven's medical documents for the three months leading to his death in a binder. She wants changes, including more guidance for the parents of out-of-hospital adults struggling with suicidal tendencies. 'Something positive has to come out of this,' she said. (Guy Quenneville/CBC)

A legacy of change

Rigby-Wilcox said she wants any review of Steven's death to encompass "all the obstacles and all of the struggles" the family encountered during his care.

She also wants changes to address the discharge policy at Dube, the need for more mental health beds in the province and the role of families when dealing with adult loved ones still struggling with mental health issues out of hospital.

SHA spokesperson Purcell said the authority takes families' health care concerns "very seriously."

"We encourage these individuals or family members to contact our client representative office directly," Purcell said. "From there, we can work together to start the confidential process into finding out what has happened, and see how we may be able to help."

One change is already underway, Purcell added.

"We currently have the ability to admit patients to the soon-to-be-opened Mental Health Short Stay Unit at [RUH], under psychiatry care, for an addition of six beds. This makes a total of 62 beds for specifically for adult patients."

Martin said government-funded, dual-treatment centres capable of treating both mental health and addictions issues are crucial.

Rigby-Wilcox is set to meet with health officials on Wednesday.

"I think that would honour him," she said of the changes she seeks. "I don't want his legacy to be tarnished by Dec. 22, 2018."

If you're experiencing suicidal thoughts or having a mental health crisis, help is available.

For an emergency or crisis situation, call 911.

You can also contact the Saskatchewan suicide prevention line toll-free, 24/7 by calling 1-833-456-4566, texting 45645, or chatting online.

You can contact the Regina mobile crisis services suicide line at 306-525-5333 or Saskatoon mobile crisis line at 306-933-6200.

You can also text CONNECT to 686868 and get immediate support from a crisis responder through the Crisis Text Line, powered by Kids Help Phone.

Kids Help Phone can also be reached at 1-800-668-6868, or you can access live chat counselling at www.kidshelpphone.ca.

ABOUT THE AUTHOR

Guy Quenneville

Reporter and web writer for CBC Saskatoon

Story tips and ideas welcomed at guy.quenneville@cbc.ca

https://www.ckom.com/2020/01/17/grieving-mother-who-lost-son-in-police-involved-shooting-wants-changes-in-sask-health-system/

A Saskatchewan mom has spent the last year grieving her son who died after an exhausting battle with mental health and addiction.

Carey Rigby-Wilcox is now sharing the story of her son, Steven Rigby, and the health care system that she says failed him. She has recently met with health officials and is hopeful changes and improvements will come.

Steven died on Dec. 22, 2018 in Saskatoon. Hours after his death, Saskatoon police confirmed there had been an officer-involved shooting, details of which are still being kept under wraps.

Rigby-Wilcox said her son had told her several times that he was planning suicide-by-cop.

She says she told this to his doctors and the information is written throughout his medical files.

“At this particular moment I don’t know if he did suicide-by-cop,” she said. “We won’t know until the inquest comes, but the whole thing with Dec. 22, I still don’t know anything that happened that evening. I’ll find out with the public. When the public finds out, I’ll find out what happened to my son.”

Rigby-Wilcox wants to know why her son was even let out of the hospital. Just like multiple times before, Steven had attempted suicide and was taken to the hospital for help. He was admitted to the Irene and Leslie Dube Centre for Mental Health, and within just 24 hours he was released.

She says she and her husband, along with her mother, pleaded on their hands and knees not to let Steven out of the hospital as they knew he needed professional care.

“All the other times he has had a gun, all these things, hanging himself, all these different attempts, it’s all in his files,” she said. “Why is he released the very next morning? It does not make sense.”

She struggles to figure out certain processes doctors took when her son was in their care.

She says Steven was an alcoholic and was prescribed medication that shouldn’t be taken with alcohol. Steven told her he was using alcohol to stop the suicidal thoughts.

“The suicidal thoughts from the anti-depressants and the anxiety medication made his thoughts louder, so he drank to take them away, but then he drank to find the courage to kill himself,” she said. “That’s addiction with mental illness.”

Steven was high-risk, according to his mom. He had been taken to hospital by the police, family, friends and even co-workers, after several suicide attempts.

“There’s so much proof that I have in my medical files, it’s very, if I can say, horrible or sickening,” she said. “The proof is there; he shouldn’t have been let out.”

She says doctors wouldn’t give her any information due to patient confidentiality. He was released from hospital and she and her husband weren’t even aware.

She is almost positive there will be an inquest into his death after the toxicology report is finalized.

She’s hopeful for the inquest, but says it only deals with the night of Dec. 22, 2018 and doesn’t take into account everything that happened leading up to his death.

While looking for answers, Rigby-Wilcox has blamed herself at times for things she said during her desperate 911 call the night Steven died.

“I totally feel that I messed up on my call and I should have said more appropriate things,” she explained through tears. “And I honestly feel like I killed my kid, I do. That’s my guilt.”

After a meeting with health officials Wednesday, she is feeling optimistic.

“I actually felt that our meeting was excellent. I felt that I was heard and validated. They felt compassion for my story and for what we went through as parents,” she said. “Honestly, in my whole heart of hearts, I feel like something positive is going to come out of this.”

She is hoping to change the health system because there are too many people and families suffering now who need the same help her family and Steven did.

“We need more access, we need more accountability, more information, more beds, more awareness, more empathy, more resources, endless amounts of more is what we need right now,” she said.

She believes her son left her with a mission and she plans to do him proud.

“Well, that was Steven’s — I hate to say dying wish, but that’s what he wanted,” she said. “He just struggled so much and he said, ‘Mom, I need you to help change Saskatchewan health care. You need to help it. If I’m going through this, what are other people going through?’ ”

Rigby-Wilcox has been tracking her journey through the website she created, Steven Rigby’s Mental Health Revolution.

The Saskatchewan Health Authority has not yet returned a request for comment about the recent meeting with Steven’s parents.

Case highlights need for more mental health beds, says Opposition Leader Ryan Meili

Posted: Jan 15, 2020 1:26 PM CT | Last Updated: January 15

Saskatchewan NDP Leader Ryan Meili says the case of Steven Rigby, pictured here, highlights the need for more mental health and addictions beds in the province. (Carey Rigby-Wilcox)

Saskatchewan NDP Leader Ryan Meili says the provincial government should review the case of a suicidal man who was discharged from a Saskatoon mental health hospital and then died two days later in an altercation with police.

"It's a really heartbreaking story," Meili said.

On Dec. 19, 2018, Steven Rigby was committed to Saskatoon's Irene and Leslie Dubé Centre for Mental Health because his family was concerned about a previous suicide attempt and a recent threat to commit suicide by cop.

He reportedly appeared calm when he was discharged the next day after declining a further voluntary stay.

Two days after that, on Dec. 22, Rigby died after a police involved shooting on the outskirts of Saskatoon.

His mother, Carey Rigby-Wilcox, says he should not have been discharged, given his history of suidical behaviour. On Tuesday, she publicly named her son for the first time as the man who died in the shooting.

Mother of mentally ill man who died after police-involved shooting says Sask. health system failed her son

"We should not be letting someone who, less than a couple of days before, had been committed because of high suicide risk, out on the street," Meili said Wednesday. "Clearly, that is below the standard of care that he should have been receiving."

Meili said a government review of Rigby's treatment path should come with public recommendations. This would come on top of a public coroner's inquest. An inquest has not yet been announced, but Rigby's family has said they are hoping to see one.

"[He] had asked for help in so many ways and wound up not getting the help he needed and is no longer with us as a result," Meili added. "I feel for the family, I feel for him."

Meeting with the family

Saskatchewan's Ministry of Health offered its condolences to Rigby's family Wednesday, calling his death a "tragic loss."

"We are meeting with [the family] in the coming days to learn more about their experience and we look forward to hearing their ideas for possible improvements," the ministry said in an emailed statement.

Meili has some ideas.

"Something that would make a big difference is having a dedicated mental health emergency stream," he said. "There was a mental health assessment unit that was functioning for a while at Royal University Hospital [in Saskatoon]. It's since been closed down but that was a very welcome effort."

'We've gone backward': Families say urgent psychiatric care not a priority in Sask.

The Saskatchewan Health Authority has said it will soon open a six-bed "Mental Health Short Stay Unit, under psychiatry care," at RUH.

Meili said that will only go so far.

"It'll be full in moments," he said. "And it really doesn't address the necessary dedicated emergency care — having a dedicated stream for folks struggling with mental health and addictions to get appropriate, timely care."

Rigby was committed, then discharged, from Saskatoon's Dubé Centre over a two-day period. (Guy Quenneville/CBC)

The Saskatchewan NDP has raised concerns about the 54-bed Dubé Centre before. In July 2018 — five months before Rigby was committed there — the NDP said the mental health centre had been over capacity for years.

In a tweet referencing Rigby earlier this week, Meili again touched on the need for more mental health beds in the province.

"[Rigby] was forced to make an impossible choice to keep a bed or give it up for somebody else who maybe didn't have the same [family] supports he did," Meili said. "But clearly he still needed it. And it's an impossible choice for him but also an impossible choice for the staff."

Pressure on police

According to a police press release issued the day after Rigby's death, he was armed and threatening both himself and officers during the altercation with officers.

"[Saskatoon police] and RCMP members encountered [Rigby], who refused to comply with officer commands and fired his gun," according to the statement. "Officers perceived a threat and engaged."

Rigby was pronounced dead in hospital.

Dean Pringle, the president of the Saskatoon Police Association, said officers are coming into contact more and more with people with addictions and mental health issues.

"Policing is increasingly taking on responsibilities that traditionally other providers and sectors took care of," he said.

"We deal with people in various types of distress all the time in patrol. This time it was mental health distress, and our members are very capable."

If an inquest is called, he said, "there are certainly some questions that will be addressed at the inquest, regarding the mental health system in Saskatchewan."

If you're experiencing suicidal thoughts or having a mental health crisis, help is available.

For an emergency or crisis situation, call 911.

You can also contact the Saskatchewan suicide prevention line toll-free, 24/7 by calling 1-833-456-4566, texting 45645, or chatting online.

You can contact the Regina mobile crisis services suicide line at 306-525-5333 or Saskatoon mobile crisis line at 306-933-6200.

You can also text CONNECT to 686868 and get immediate support from a crisis responder through the Crisis Text Line, powered by Kids Help Phone.

Kids Help Phone can also be reached at 1-800-668-6868, or you can access live chat counselling at www.kidshelpphone.ca.

ABOUT THE AUTHOR

Guy Quenneville

Reporter and web writer for CBC Saskatoon

Story tips and ideas welcomed at guy.quenneville@cbc.ca

Follow Guy on Twitter

This doesn't mean the goal should be abandoned because it was unachievable. Instead, government should recommit itself to ending ER waits.

MURRAY MANDRYK Updated: January 18, 2020

One very pleasant surprise in former premier Brad Wall’s 2012 “Saskatchewan Plan for Growth: Vision 2020 and Beyond” was its commitment “to eliminate wait times in emergency rooms by 2017 and improve access to primary health care.”

The economic plan of eight years ago also vowed to reduce surgical wait times “so that by 2014, no one waits more than three months for surgery” and “Improve access to primary care” — an admission that it’s meaningless to strive for a healthy economy if we aren’t actually healthy ourselves.

Sadly, these goals haven’t been met, perhaps leaving some to think they should be abandoned because they were unachievable. This would be absolutely wrong. Recent events underscore why it’s more important than ever to recommit to these goals:

— In Saskatoon, we learned critical details in the death of 27-year-old Steven Rigby on Dec. 22, 2018 in a police officer-involved shooting.

Medical records obtained by his mother, Carey Rigby-Wilcox, show he was released from the Dube centre attached to the Royal University Hospital two days earlier.

“He absolutely was failed,” Rigby-Wilcox told the CBC’s Guy Quenneville. She said her son suffered from alcoholism, anxiety and depression. “All the issues that we faced as a patient, as a family, really should be dissected … Something positive has to come out of this.”

— In Regina, CBC legislative journalist Adam Hunter reported concerns from the Saskatchewan Union of Nurses that Regina’s Pasqua Hospital ER is at nearly double capacity.

“We know that in an area designed to have 32 patients, they have 60,” said SUN President Tracy Zambory. “It’s a problem that’s been happening for some time — one that’s pretty intense in recent weeks because it has become a pretty significant patient safety issue.”

Hunter’s story went on to quote Zambory’s concerns that “sheets have been sort of stuck inside the ceiling tiles trying to give these people just a little bit of privacy” and that there are “no call bells, there’s no oxygen, there’s no safety that you would have in a normal hospital room … particularly emergency room.”

One gets government frustration when bombarded for its failings, but answers won’t be found by abandoning laudable goals; they will be found in assessing why those goals haven’t been met. Health Minister Jim Reiter needs to reassess his government’s ER wait-time strategy.

Government can’t be responsible for every unexpected tragedy that unfolds in city hospital ERs, but even a quick perusal tells us we still aren’t dealing with core issues that go well beyond short-staffing. We still struggle with systemic problems of how ERs should be run, how there needs to be a better flow immediately directing patients to non-ER facilities and how desperately preventative measures are needed throughout the whole health system.

For example, the Saskatchewan Health Authority explained the Pasqua ER problems can be attributed to an influenza outbreak — pretty much an annual occurrence in Saskatchewan. By now, shouldn’t we grasp the value of aggressive immunization and other preventative measures that would stop ER visits?

Similarly, alcohol, drug and mental health crises in this province are hardly an anomaly. Making matters worse, drug and mental health issues are attributable to other issues requiring ER visits — everything from assaults to frostbite to horrible realities like Steven Rigby’s case.

We simply need better triaging of both emergency and non-emergency addiction and mental health patients — second and third door options. This isn’t even thinking outside the box anymore. Health professionals have preached this need for years, yet stigmas still seem to be preventing governments from implementing either proper preventative measures or accepting that the health system must bear the costs of channelling these patients into the correct support streams. Times have to change.

Let’s commend the Sask. Party government for setting fine goals to reduce ER and primary care waits, but let’s get serious about what’s really needed to meet these goals.

The answers — while not necessarily cheap or easy to implement — are still out there.

Mandryk is the political columnist for the Regina Leader-Post.

https://thestarphoenix.com/opinion/columnists/mandryk-time-for-sask-party-to-recommit-to-solving-er-woes/wcm/bbc2404e-cc7e-43b2-a48b-a6b8b0ed6a02

Just days ago, a story was published by the CBC about a young man with mental health and addiction issues who died in a police-involved shooting in Saskatchewan. Steven Rigby was addicted to alcohol and also suffered with an alcohol-induced depressive disorder. He had attempted suicide more than once and remained suicidal; he discussed this with family members, friends, and even the doctor’s charged with his care. Despite this, he was asked to give up his space in the hospital’s psychiatric wing — the Irene and Leslie Dubé Centre for Mental Health — and was, subsequently, discharged. Very shortly after he was killed, in an officer-involved shooting, in what may or may not have been a suicide.

Steven Rigby was failed by the mental health system and, because of this, he lost his life. However, he was very likely failed in more ways than just the one being discussed (i.e., being discharged from the psychiatric facility). Steven’s mother noted that her son was on prescription anxiety and depression medications which worsened his mental health and “amplified his suicidal thoughts.” According to her, “His medication made him worse; his gentle nature turned violent after taking some of his medications.” Notably, this is not a key component of the CBC’s story. However, it should be.

In 2010, a book titled “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America” was published. This important book shocked many. It also changed how many mental health professionals view and conduct their work. The author, Robert Whitaker, provides copious evidence to suggest that, despite a psychopharmacological revolution in medicine and, specifically, psychiatry, psychiatric drug use has not led to long-term, positive health outcomes for those diagnosed with mental illness. In fact, the more that psychotropic drugs are used to treat mental suffering, the more the burden of mental illness and disability appears to rise in our societies. For nearly all mental illnesses — depression, anxiety, schizophrenia, bi-polar disorder, etc. — the long-term health outcomes for patients given psychiatric drugs has actually worsened during the past two decades.

Whitaker, and many other authors like him, outline the enormous health risks associated with psychiatric drug use. Some of these include: increasing and even doubling the risk of suicide attempts; elevating risk of stroke; increasing the risk of psychosis, liver toxicity, and death; brain atrophy in children; contributing to autism spectrum disorders or attention deficit hyperactivity disorder following in utero exposure; increasing the likelihood of additional mental illnesses and health diagnoses, and a plethora of discontinuation syndromes. Consequently, an increasing number of peer-reviewed studies and a growing number of psychiatrists, doctors, and researchers are discussing both the limits and dangers of standard approaches to psychiatric care, namely the use of psychotropic drugs.

Despite lack of efficacy and the many health risks associated with these drugs, such medications often remain a first-line treatment in both general medicine and psychiatry. Common medical practice is mostly predicated on quick diagnoses based on lists of symptoms and the subsequent application of a psychotropic drug(s). Often a doctor or psychiatrist adopts what is called a “shot-in-the-dark” approach to their prescribing. Specifically, a doctor will begin at the top of the list of “recommended drugs” for a certain diagnosis, prescribing these medications one after the other to see if they help, playing with dosages, and also adding in new psychiatric medications to deal with side effects and secondary symptoms of the original drug that was prescribed. Notably, the side effects of common psychiatric drugs — fatigue, loss of libido, blurred vision, anxiety, mania, and suicidal tendencies — may intensify a person’s mental suffering and can be a major reason why some patients decide to stop taking them.

I once had a counselling client come to me because he was experiencing insomnia after his car skidded off of the highway. He was not injured in the accident but he could have died as another car nearly hit his vehicle at high speed. Before coming to me he went to his family doctor who, after hearing his story, prescribed him an anti-depressant. When he became more anxious after taking this medication, he was then given a benzodiazepine, a very addictive anti-anxiety medication. A month later, his anxiety worsened and he was prescribed a third medication, a mood stabilizer. Next, he was given an anti-psychotic. By the time he came to me for help he was on four different psychiatric medications, all because he had experienced a traumatic event that had naturally disrupted his nervous system, which is a normal response to trauma. His mental health was far worse than just after the accident and he felt trapped, afraid to stay on his medications (because of how bad he felt) but also afraid to stop taking them. Importantly, nothing other than these medications was recommended by this man’s doctor. Even more difficult to comprehend, an article I recently read discussed a young woman who had been prescribed 31 different psychiatric medications. If my client and this woman did not have problems with their brain chemistry before seeing their doctor or psychiatrist, they definitely did once they had.

Another issue is a lack of monitoring of patients once they have been prescribed psychiatric medications. Patients may be given several weeks or a few month’s supply of their medication(s) but they are, very often, not observed closely by the prescribing doctor or psychiatrist. Thus, no one is present or available to monitor their reactions or any side effects that they might experience. If they do start having adverse reactions to their medications, such as severe anxiety, mania, or suicidal ideation, it can be very difficult to get a timely follow-up meeting with the psychiatrist due to long wait times for such appointments. In the case of Steven Rigby, once his medications started to cause an increase in anxiety and suicidal thoughts, he drank even more to try to numb or cope with these thoughts. According to Steven’s mother, prescribing doctors never monitored his reaction to the medications that he was given.

This element of the current medical model is highly problematic because people with mental illnesses, those in very vulnerable positions, are not receiving appropriate care and support. Too often they are being harmed. Importantly, Canadians have a basic human right to safe and appropriate medical help. Yet, our current social policies tend to ignore the scientific evidence mentioned above, thus marginalizing vulnerable people, violating their human dignity, and, very often, making things worse for them.

Ryan Meili, the leader of the NDP in Saskatchewan, quickly responded to the Steven Rigby-Wilcox story and suggested that we need more mental health beds in the province. Yet, mental health beds in psychiatric wards and hospitals simply means the prescription of more and more harmful psychiatric medications. I can think of few things less healing when in crisis than being placed alone in a bed in a psychiatric ward, cut-off from friends and family and the familiar, and placed on large amounts of brain-chemistry-altering medications that have health risks associated with their use and can often result in horrible side effects.

Groups of researchers, mental health professionals, and even psychiatrists have recently formed both the Critical Psychiatry Network and the Foundation for Excellence in Mental Health Care in response to this approach to mental health. These organizations, like Robert Whitaker, question the assumptions that lie beneath psychiatric knowledge and practice. Moreover, people who experience mental health issues, those who have had a mental health emergency, and those who describe themselves as “psychiatric survivors” have begun to come together in rights-affirmation movements to articulate their frustration with their treatment. I believe it is important to listen to these different understandings. I also believe it is important that we practice humility and open-mindedness so as to gain greater insight into both the body and mind, and the interaction between the two. According to Sandra Steingard — Clinical Associate Professor of Psychiatry at the University of Vermont — our current medical perspective may not be the only, or even best, way to understand mental suffering.

Psychiatric drugs may be necessary — even a godsend — in emergency situations like frank psychosis. However, it may be time to seriously rethink the current drug-based treatment paradigm for those who suffer mentally and emotionally and to consider incorporating non-pharmacological approaches from other medical systems into our models of care. Whereas psychotropic drugs are used to help relieve symptoms and, consequently, do not cure mental illnesses, other medical systems are primarily concerned with treating what is perceived as “root causes” of unregulated bodily experience and mental dysfunction. These approaches may be safer and more effective than psychiatric medications. There is also growing scientific evidence, from the field of nutritional psychiatry, to suggest that micronutrient formulations are effective at treating depression, anxiety, ADHD, PTSD, psychosis, and many other mental health issues. Simply put, psychiatric medications should no longer be our first-line of treatment for people suffering mentally and emotionally. There are other, safer options available.

Ryan Ward is a mental health activist and a PhD student in psychology. His background is in social work, community health, and health promotion and his current research focuses on Eastern and Indigenous cultural approaches to trauma and healing.

https://medium.com/@stillflowingwater/psychiatric-medications-part-of-the-problem-in-peoples-worsening-mental-health-9c6b536edc21

​In the week before Steven Rigby died, he had become so frustrated he wasn’t getting the help he needed that he withdrew to a Saskatoon hotel, where he tried to overdose. City police eventually entered Rigby’s hotel room Dec. 18 and he was taken to a hospital. The next day, he was committed to the Irene and Leslie Dube Centre for Mental Health. His stay there would be short. Days later, he expressed similar frustrations on Dec. 22, 2018, before he died during a confrontation with RCMP and city police at the age of 27. “He was just kind of getting pushed through the system from here to there,” said his mother, Carey Rigby-Wilcox. Rigby’s experiences included being moved from one counsellor to another and being put on a waiting list for an in-patient treatment bed at the Dube Centre. His parents want more signatures to be required before a patient is released from a mental health facility, and more opportunities for families to be involved in a person’s mental health care if they wish. They spoke with Health Minister Jim Reiter late last year and last week met with other health ministry officials. On Wednesday, in a prepared statement, the Ministry of Health said officials appreciated the opportunity to meet with them. “We had a very good conversation and learned of the many challenges Steven and his family faced in their healthcare journey,” the ministry said. The statement conceded “there is more to be done” and said the ministry will work with the Saskatchewan Health Authority to “identify improvement opportunities” to ensure integrated care. Rigby-Wilcox launched a website, “Steven Rigby’s Mental Wealth Revolution,” to raise awareness about mental health and addictions issues. When he was learning to read as a child, she was inspired to improve her own literacy, later writing about it in her book, “My Mummy Couldn’t Read.” Inspired again by her son, she developed the website with principles he thought were important in saving the lives of people with mental illness and addiction: awareness, access, empathy and accountability. Friend Charlie Andrews said he wants to remember the good times he had with Rigby, whom he met when they were in Grade 9. Andrews remembers him as caring, funny and open about his experiences. At the same time, he said Rigby spoke of putting on a “good face” and hiding what he was feeling. “None of us really knew the extent of this until, obviously, everything happened,” Andrews said. Rigby rose through the ranks of a telecommunications company to a management position, but had anxiety and went from being a social drinker to a heavier one after an unexpected event in his personal life. He had been prescribed benzodiazepines for anxiety — a type of medication that includes Xanax, Valium and Ativan. “The medication he was given made him turn violent,” Rigby-Wilcox said. “Steven is a gentle soul, never would hurt anyone. And the medication just kept making the voices in his head louder, to kill himself.” His parents have notes outlining the times Rigby attempted self-harm. After one incident in which he lost consciousness and struck his head on Aug. 30, he was admitted to psychiatric care in the hospital, where he stayed for less than a week. At one point that November, he told his mother that if she called police about him again, he’d commit “suicide by cop.” The form committing him to the Dube Centre, which Rigby-Wilcox accessed after her son died, noted he had made a similar threat. Rigby was admitted to the Dube Centre on Dec. 19, but left by the end of the following day. Rigby-Wilcox said she wasn’t notified by staff, despite her son wanting his parents to be involved in his care. She called staff herself and confirmed he had been released. He was staying with his parents on Dec. 22 when they left the house briefly, thinking he was asleep. During that time, he left the house and accessed a gun and sent messages to friends and coworkers, thanking them. His parents tracked his vehicle’s movements when they learned he’d left the house, eventually meeting up with him at a dead-end road, where he sat weeping in his car with the gun. “I can’t take it anymore, I can’t do this anymore. I’m done, mom,” Rigby-Wilcox recalls him yelling. She briefly tried to film what was happening as proof he was suicidal, since the family had been asked for proof in the past. Then she put the phone away and the couple tried to coax him out of the car. He drove away. Rigby-Wilcox called 911. Police disclosed some of the details of the ensuing events in December 2018 media releases: RCMP warned city police about a man in distress who may be armed, heading towards the city. The releases said the man didn’t comply with officers’ demands, and that shots were fired. “Officers perceived a threat and engaged,” Saskatoon police said in a release. City police launched an internal investigation monitored by an outside observer chosen by the province. Earlier this month, police confirmed the investigation would go to the Crown pending the receipt of the final toxicology and autopsy reports. A Saskatoon police spokesperson said this week that updates cannot be provided because the incident remains under investigation and will likely be the subject of a coroner’s inquest. The Ministry of Justice said in an emailed statement that the chief coroner will make a decision regarding an inquest after the investigation is completed. Rigby-Wilcox said she knows an inquest will only establish cause of death, but she wants Justice Minister Don Morgan to review her son’s medical records and look at everything that preceded the 911 call. “If anyone knew who he was, (they know) this simply was a tragedy, that it should never have happened. It should never have gotten to this point,” she said. tjames@postmedia.com