Jan Higgins was at home in Halifax when her phone rang about a month ago. It was a nurse at the Dr. Everett Chalmers Hospital in Fredericton.
Higgins's son Joshua Hawkins was in the emergency room. Delirious, he had set his clothes on fire.
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"It was probably my worst nightmare thinking that possibly, he's giving up," said Higgins.
'He was smart, talented, musical, funny, kind, loving — he was just an all around wonderful son and brother.' - Jan Higgins, mother
But it was some relief to know he was in the hospital, safe and getting help.
"They kept him for the weekend, they talked to me, got all his information, his background, and then made me believe that yes, we're finally going to get him some help."
But Joshua was released the following Monday.
Joshua suffers from schizophrenia and psychosis, triggered by recreational drug use.
Because of his illness and addiction, he can't take care of himself. He was recently evicted from his Fredericton apartment and now lives on the street.
"All we know is that he is sometimes very catatonic," Higgins said. "Other times you'll get a word or two in there that make sense. The rest of the time he can just be totally non-communicative — very, very, easily agitated."
Joshua grew up in Fredericton and did not go with his parents when they moved to Halifax.
Most days, Joshua sits near Read's Newsstand & Cafe on King Street. He is tall, and his dark hair is matted in dreadlocks. It's hard to tell by looking at him how old he is — his eyes are bright but his face is worn.
He's 31 and because he's an adult, Higgins doesn't have the legal power to make him get the help or take the medication he needs.
"Because of his age, I can't intervene and he won't allow me to intervene," Higgins said.
There are few options for Higgins to help her adult son, and even those are incredibly difficult to navigate.
For Higgins to obtain the legal power to get Joshua the help and care he needs, she has to petition the court under the Infirm Persons Act.
To do that, she needs medical affidavits from two physicians saying that he cannot make decisions to care for himself. Then a judge could grant her committeeship, allowing her to become his substitute decision-maker.
"Doctors have to convince the court that ... the client no longer has the ability to make the decisions themselves," said Chantal Landry, the public trustee for New Brunswick and the director of family law services with the Legal Aid Commission.
But because Joshua is an adult and unstable, Higgins hasn't been able to get him assessed.
"Right now, we cannot get him admitted to a hospital," Higgins said.
She said she regularly calls Adult Protection, the city police, the Mobile Crisis Team, the outreach program in Fredericton, Addictions and Mental Health, lawyers and lawmakers and others.
"Everybody is saying the same thing — before we can begin to help Joshua he needs a full psychological evaluation and as this point, a physical evaluation."
Without those evaluations, Higgins can't make a case before the courts and she is left helpless.
Getting the order "depends on the accessibility of the individual to co-operate and be present for the assessments that are required in order to build your files for the court," Landry said.
There are few options for someone like Higgins, she said.
"Especially when the individual themselves won't comply with treatment. And even if you're a substitute-decision maker for that person and you're consenting to their treatment, if they're out in the community there has to be a way of being able to either bring the treatment to the community or convince the individual to go to either the hospital or wherever they obtain their treatments."
According to Landry, when individuals are considered to be a danger to themselves or others, they could be picked up by the police.
"But the (police) won't pick up somebody if they're not doing anything illegal," she said.
Still, Higgins said, Joshua could be a danger to himself and others.
"If he is on the street, and if he is suffering from psychosis, that itself is a danger to oneself. You cannot make good decisions, you cannot look after yourself properly and with all those things against him his illness will get worse."
"And as a mom, my hands are tied completely because no one will let me give him the help he needs," she said.
It's an issue Warren Maddox, executive director of the Fredericton Homeless Shelters, said comes up again and again.
"It's kind of age-based, that once you go through that age, you're considered your own person, and to be able to take someone and put them into whatever situation, it's extremely limited," he said.
Care and help for adults who suffer from debilitating mental illness is lacking in New Brunswick, said Maddox.
There's "a bit more than a gap — it's a crevasse."
Maddox said groups like the Fredericton Homeless Shelters have stepped in to fill that void, but shelters are limited in what they can do.
Help, he said, needs to come from the government.
"They need to be the ones that step up and provide some type of housing," he said.
Maddox stressed he isn't suggesting greater use of insitutions, such as the Restigouche psychiatric hospital in Campbellton.
"This is another form of housing that's available and can be built or simply purchased that provides the ability for 24-hour support."
Change is coming under the Mental Health Act in November. Bill 41 would bring the community treatment order into effect in New Brunswick.
Several provinces currently use the order, including Ontario and Quebec. It gives some options for families in Higgins's circumstances.
Under the order, a mentally ill person in hospital for treatment would have to agree to co-operate with treatment in order to be released. A consequence of not complying with treatment would be a return to hospital.
But the order is not a panacea.
"Under a community treatment order, there would be a specific provision there for an individual to be brought back for treatment if they weren't co-operating," Landry said.
"But as it stands now, if someone is out in the community and is refusing treatment but is not breaking the law and the (police) don't feel that they're a danger to themselves or others, it's a very difficult situation for the family members to find themselves in because there's really not much they can do."
The promise of the legislation is of little comfort to Higgins, who said that for years she's watched her son's "slow deterioration".
"He was smart, talented, musical, funny, kind, loving — he was just an all around wonderful son and brother," Higgins said.
"We can advocate on an elderly person's behalf if they have Alzheimer's, if they have dementia. This is not different. When somebody has psychosis, their brain is not functioning the way it should normally, and then you add addiction on top of that, and you add homelessness on top of that. It's a recipe for disaster."
Higgins has no intention of giving up. She recently formed a Facebook group called "The Joshua Project — To Speak For Those Unable To Speak For Themselves."
And she regularly posts about her son's condition. Since she's talked about her story, she said, she's heard from several families going through similar situations.
She said she will continue to call the police, Mobile Crisis, and anyone who will listen to her.
"I hope that it doesn't come to Joshua ending up in the emerge because he was struck by a car or something horrible happens to him from being on the street. Those are all possibilities of how this is going to end, and I have to keep hoping and praying that somebody is going to listen to me.
"I just won't quit because I know that my son has so much potential and he was not always like this person that people see on the street. He was a beautiful young man and intelligent, with hopes and dreams just like anyone else. And I still have all of those for him ... and the Joshua that we know and love is still in there and he just needs our help."