A woman whose father committed suicide last year says the mental health system for seniors in Thunder Bay failed him.
Cindy Salo said 76-year-old Tauno Salo was struggling with the onset of mild dementia.
He was seeing a physician at a Thunder Bay walk-in clinic as well as a geriatrician at St. Joseph's Health Care.
The doctors had prescribed him anti-depressants, but Salo said her father just became increasingly distressed and angry.
In October 2012, she returned from a business trip to Toronto and received a call from her brother.
"He said, 'I can't get a hold of Dad'."
After trying again to reach her father, she called the property manager, who found him dead in his home.
"He left a note," Salo recalled tearfully. "[It said] 'Sorry, sorry, sorry. Dad's sick and tired of being sick and tired'."
Salo said her father was frustrated and felt that his health-care providers weren't listening to him. She added she accompanied him to appointments with his geriatrician and felt "terribly, terribly rushed."
Last January, Salo filed a complaint with the College of Physicians and Surgeons of Ontario naming the geriatrician, Dr. Trevor Bon.
In it, Salo said she had asked for her father to be referred to a psychiatrist, but had been told it wasn't necessary.
Bon responded to the complaint, saying he was trained in psychiatry and was comfortable treating depression.
The College did not find any concerns that would warrant disciplinary action.
According to the College's report, sent to Salo in November, Bon also "advised about changes he has implemented in assessing and treating depressed patients to ensure suicidal ideation and plans are discussed at each visit and to adequately chart a discussion of medication benefits and side effects."
The College supported that change.
Daughter wishes she had been 'more outspoken'
St. Joseph's Health Care management told CBC News that Dr. Bon wanted to comment on this case, but couldn't because of patient confidentiality.
But a hospital spokesperson said the issue of suicide among seniors was important to bring to the public's attention.
Psychiatrist Dr. Lois Hutchinson, who oversees mental health programs at both St. Joseph's Health Care and Thunder Bay Regional Health Sciences Centre, said she wasn't familiar with the details of Salo's case.
She said it's important for health-care providers to have open discussions with patients about suicide risk.
"It is recommended that hospitals and mental health care settings and even other health care settings start looking at assessing suicide risk using ... standardized tools," Hutchinson said.
"Certainly a geriatrician would routinely screen for ... depression as well as suicide risk in their practice," she added.
"There needs to be the ability to refer to a specialized service when things aren't going well. [For example] either the person isn't responding to medication or the case is particularly complicated, like a relatively treatment-resistant depression, or if there [are] psychotic features."
Hutchinson said St. Joseph's Health Care offers specialized mental health care services for seniors.
Cindy Salo said she believes her father could have been helped by more access to those services, including seeing a geriatric psychiatrist.
"I wish that I was more outspoken on my dad's behalf," she said. "It's just not right. It shouldn't have to be that you have to go banging on doors and clawing for help. It shouldn't be like that."