Shayne Hay's family looks for answers at Royal Alex suicide inquiry
Hay needed social worker more than psychiatrist at the time, doctor testifies
Shayne Hay, 34, checked into the Royal Alexandra Hospital
in September 2010 saying he was suicidal. He hanged himself at the
hospital 12 hours later. (Supplied)
That missing hour will haunt them all, forever.
Sometime between 11:30 a.m., when Shayne Hay came to the nurse's desk to ask a question, and 12:25 p.m., when he was found hanging from a light fixture over an emergency room bed, something inside a tormented young man changed, and his final act ended his life and altered countless others.
On Thursday, the people who loved Hay and the health-care workers who tried to care for him gathered in Courtroom 449 to come to some agreement about what happened.
But after two days of testimony, the fundamental question remains beyond any answers.
No one will ever know what Hay was thinking in those final moments before he killed himself.
His parents, his sisters and his brother will always remember the little boy who was adopted into their family when he was five. How he overcame a rocky start in life - his birth parents were heroin addicts - and did the best he could, for as long as he could.
The doctors and nurses will always remember the patient they lost.
In early September 2010, Hay spent two weeks as an inpatient at the Royal Alexandra Hospital.
On September 15, he was transferred to the University of Alberta Hospital, to Unit 5-G2, where patients in "transitional" beds await discharge.
Hay was treated there by Dr. Christine Froelich, a psychiatrist for the past 15 years. She testified that Hay was "future oriented," that he had plans to get a subsidized apartment, that he was a chronic, rather than an acute, risk to commit suicide. He had talked, off and on, about killing himself for 15 years.
Hay was taking Reactine for seasonal allergies. She wanted to prescribe Seroquel and Zyprexa. But he wanted Clonazepam and Ativan, and became agitated and angry, and made veiled threats, when she wouldn't prescribe them.
She told court his anger was an intimidation tactic.
On a daily progress report, one U of A nurse noted: "He stated that he's a time bomb when he's upset."
But Froelich said it was her clinical judgement that Hay was angry only because he couldn't get the medications he wanted, in the quantities he wanted.
"This man had a history of past substance abuse and alcohol abuse," she said.
"We don't know anything," she said, "about the risk factors for suicide in the short term."
To be diagnosed as an "acute" risk, a patient must display suicide ideation, have a concrete plan and real intent, and understand the lethality of that plan, Froelich said.
Thousands of people are chronic risks, she said. They think about killing themselves, but the vast majority never progress to actually planning to end their lives.
Emergency rooms turn such people away every day. If they didn't, she said, "all the beds would be filled, not just the psychiatric beds, but all the beds in the city."
Around 5:15 p.m. on Friday, Sept. 17, Hay left the U of A hospital. At some point, he walked across the High Level Bridge, stopped and thought about jumping.
In the end, he changed his mind.
At 1:16 a.m. on Saturday, he showed up at the Royal Alexandra again. It was a busy night in the emergency room. Nurse Pam Cooper testified that she spoke with Hay around 3:30 a.m. Because all the designated ER mental health beds were filled, she took him back and got him settled into an acute care bed, in room A-20.
"He was very clear to me," Stagg testified. He said Hay told him: "I would not, could not, jump off that bridge," and said Hay made it plain that thoughts of hurting his family stopped him.
Stagg said his clinical judgement, based on years of experience as an ER doctor, told him that Hay was experiencing "a social crisis," that his life was coming apart because he had nowhere to live, no job, and problems with his relationships.
"He need a social worker more than he needed a psychiatrist at the time," Stagg testified.
That Saturday morning, Hay was not, he said, an acute risk to harm himself, or anyone else.
Stagg was asked why the stop on the bridge hadn't convinced him that Hay was an acute suicide risk.
"He ended up in our department," Stagg said. "That's where he wanted to be."
The doctor said he and Hay made a plan, that the young patient would wait to be seen by a psychiatrist and perhaps then be re-admitted to hospital.
Stagg said media reports that Hay hanged himself because he couldn't get help are simply not true.
Asked how he feels about Hay's suicide, Stagg said: "I'm as shocked today as I was in 2010."
The last witness called on Thursday was likely the last person to see Hay alive.
ER nurse Anina Yaremchuk briefly broke down in tears when an inquiry lawyer asked if she remembered Shayne Hay.
"I'll never forget," she said.
Yaremchuk said she checked on Hay at 7:15 a.m. and found him sleeping. She checked again at 11:20 a.m. Ten minutes later, Hay came to the nursing desk to ask when the psychiatrist was coming.
He went back to room A-20. Sometime in the next 55 minutes, he changed his mind again. At 12:25 p.m. he was found dangling from a light fixture.
Yaremchuk was asked to describe what she saw, and how Hay hanged himself.
"It was a strap … from his backpack," she said.
After a long day in court, Hay's family emerged into the bright afternoon sunshine to talk about their loss, and their hopes for the future.
Hay's mother, Carol Woolsey, said she wants to remember that happy little boy she adopted more than 30 years ago.
"He obviously cared about us a lot," she said. "He was a loving son. That's how I want him to be remembered."
"Our goal is not to blame anyone," said Hay's sister, Heather Toporowski, a health-care consultant who once worked for Alberta Health Services.
"We have no doubt that Shayne went there (the Royal Alex) because he wanted to live, he wanted to feel safe. Part of our struggle is understanding what changed."
Sometime between 11:30 a.m., when Shayne Hay came to the nurse's desk to ask a question, and 12:25 p.m., when he was found hanging from a light fixture over an emergency room bed, something inside a tormented young man changed, and his final act ended his life and altered countless others.
On Thursday, the people who loved Hay and the health-care workers who tried to care for him gathered in Courtroom 449 to come to some agreement about what happened.
Shayne's sister Heather Toporowski and mother Carol Woolsey remember Shayne as a happy little boy and loving son. (CBC)
No one will ever know what Hay was thinking in those final moments before he killed himself.
His parents, his sisters and his brother will always remember the little boy who was adopted into their family when he was five. How he overcame a rocky start in life - his birth parents were heroin addicts - and did the best he could, for as long as he could.
The doctors and nurses will always remember the patient they lost.
Hay battled addictions
What Judge Donna Valgardson heard this week at the fatality inquiry was the story of a smart, musically talented but troubled young man who battled addictions and made repeated trips to hospital for psychiatric problems.In early September 2010, Hay spent two weeks as an inpatient at the Royal Alexandra Hospital.
On September 15, he was transferred to the University of Alberta Hospital, to Unit 5-G2, where patients in "transitional" beds await discharge.
Hay was treated there by Dr. Christine Froelich, a psychiatrist for the past 15 years. She testified that Hay was "future oriented," that he had plans to get a subsidized apartment, that he was a chronic, rather than an acute, risk to commit suicide. He had talked, off and on, about killing himself for 15 years.
Hay was taking Reactine for seasonal allergies. She wanted to prescribe Seroquel and Zyprexa. But he wanted Clonazepam and Ativan, and became agitated and angry, and made veiled threats, when she wouldn't prescribe them.
She told court his anger was an intimidation tactic.
On a daily progress report, one U of A nurse noted: "He stated that he's a time bomb when he's upset."
But Froelich said it was her clinical judgement that Hay was angry only because he couldn't get the medications he wanted, in the quantities he wanted.
"This man had a history of past substance abuse and alcohol abuse," she said.
Lack of data on suicide risk
Froelich said there is a lack of reliable information to help doctors make good decisions about a person's risk of committing suicide."We don't know anything," she said, "about the risk factors for suicide in the short term."
To be diagnosed as an "acute" risk, a patient must display suicide ideation, have a concrete plan and real intent, and understand the lethality of that plan, Froelich said.
Thousands of people are chronic risks, she said. They think about killing themselves, but the vast majority never progress to actually planning to end their lives.
Emergency rooms turn such people away every day. If they didn't, she said, "all the beds would be filled, not just the psychiatric beds, but all the beds in the city."
Around 5:15 p.m. on Friday, Sept. 17, Hay left the U of A hospital. At some point, he walked across the High Level Bridge, stopped and thought about jumping.
In the end, he changed his mind.
At 1:16 a.m. on Saturday, he showed up at the Royal Alexandra again. It was a busy night in the emergency room. Nurse Pam Cooper testified that she spoke with Hay around 3:30 a.m. Because all the designated ER mental health beds were filled, she took him back and got him settled into an acute care bed, in room A-20.
Did not want to hurt family
Dr. Andrew Stagg saw Hay at 3:56 a.m. He spoke to the young man for about 20 minutes."He was very clear to me," Stagg testified. He said Hay told him: "I would not, could not, jump off that bridge," and said Hay made it plain that thoughts of hurting his family stopped him.
Stagg said his clinical judgement, based on years of experience as an ER doctor, told him that Hay was experiencing "a social crisis," that his life was coming apart because he had nowhere to live, no job, and problems with his relationships.
"He need a social worker more than he needed a psychiatrist at the time," Stagg testified.
That Saturday morning, Hay was not, he said, an acute risk to harm himself, or anyone else.
Stagg was asked why the stop on the bridge hadn't convinced him that Hay was an acute suicide risk.
"He ended up in our department," Stagg said. "That's where he wanted to be."
The doctor said he and Hay made a plan, that the young patient would wait to be seen by a psychiatrist and perhaps then be re-admitted to hospital.
Stagg said media reports that Hay hanged himself because he couldn't get help are simply not true.
'We had so much help for him'
"We had so much help for him," he said.Asked how he feels about Hay's suicide, Stagg said: "I'm as shocked today as I was in 2010."
The last witness called on Thursday was likely the last person to see Hay alive.
ER nurse Anina Yaremchuk briefly broke down in tears when an inquiry lawyer asked if she remembered Shayne Hay.
"I'll never forget," she said.
Yaremchuk said she checked on Hay at 7:15 a.m. and found him sleeping. She checked again at 11:20 a.m. Ten minutes later, Hay came to the nursing desk to ask when the psychiatrist was coming.
He went back to room A-20. Sometime in the next 55 minutes, he changed his mind again. At 12:25 p.m. he was found dangling from a light fixture.
Yaremchuk was asked to describe what she saw, and how Hay hanged himself.
"It was a strap … from his backpack," she said.
After a long day in court, Hay's family emerged into the bright afternoon sunshine to talk about their loss, and their hopes for the future.
Hay's mother, Carol Woolsey, said she wants to remember that happy little boy she adopted more than 30 years ago.
"He obviously cared about us a lot," she said. "He was a loving son. That's how I want him to be remembered."
"Our goal is not to blame anyone," said Hay's sister, Heather Toporowski, a health-care consultant who once worked for Alberta Health Services.
"We have no doubt that Shayne went there (the Royal Alex) because he wanted to live, he wanted to feel safe. Part of our struggle is understanding what changed."
No comments:
Post a Comment