British Columbia

Haida Gwaii doctor concerned with practice of sedating mental health patients for air transfer

Haida Gwaii is revered by tourists from around the world for its rugged beauty and remote location off of B.C.'s north coast. But living there comes with its own challenges — particularly if you need help with your health.

Health care on the remote island chain in Northwest B.C. is challenging for patients and practioners

Dr. Tracy Morton has concerns about the practice of putting mental health patients into medically-induced comas in order to get them off-island. (George Baker/CBC)

A doctor from Haida Gwaii is concerned about a common practice he says is putting mental health patients at unnecessary risk.

Dr. Tracy Morton is a general practitioner on the remote island chain in northwest British Columbia.

He told CBC's Daybreak North many mental health patients on Haida Gwaii have to be sedated — often against their will — in order to access care in an appropriate facility.

Ethically when somebody is so unwell, that really takes priority over patient autonomy. - Dr. Tracy Morton, general practitioner on Haida Gwaii

The problem is Haida Gwaii's hospitals in Queen Charlotte and Masset lack the designation to hold mental health patients against their will, he said.

So patients with a severe mental illness, he explained, must be transferred immediately to a designated facility.

The problem is the closest hospital is in on the mainland in Terrace, B.C. This means patients have to be transferred by air ambulance.

"An aircraft necessitates reliance on Transport Canada's rules around safety which are really quite rigorous," he said.

"For those who are mentally ill and psychotic, for example, and where there's a risk of violence, they need to be sedated sometimes very deeply."

Transfer causes further medical problems: Morton

Morton said there were 13 such instances in the past year, and he said at least one of the instances of sedation was so extreme the patient ended up needing life support.

"The irony is that they come in physically well — although mentally unwell — and the process of accessing care makes them quite medically unwell," he said.

He said he doesn't take the decision to sedate and transfer a mental health patient lightly and there are stringent guidelines.

"It's heartbreaking sometimes to take somebody who does not believe they're unwell. Sometimes the use of force is required to get them to comply with treatment," he said.

"Ethically, when somebody is so unwell, that really takes priority over patient autonomy."

British Columbia Emergency Health Services (BCEHS) confirmed patients may have to be sedated for transfer. In a statement, the group said a risk assessment is conducted by the sending physician, receiving physician and BCEHS emergency transfer physician to determine the level of sedation.

Getting designation

Dr. Morton said he's hoping to get a designated hospital on Haida Gwaii so mental health patients don't have to be transferred by air.

The new hospital at Haida Gwaii has a dedicated mental health observation room. (Eryn Collins/Northern Health)

A newly constructed hospital recently began operations this month, and Ministry of Health spokesperson Lori Cascaden said the facility has a dedicated mental health observation room.

Once staff meet certain criteria like specialized training, Cascaden said Northern Health will apply for a Mental Health Act designation.

She anticipates the designation will be received by early 2017.

Many other health concerns

Mental health care on the island chain isn't the only health concern. Cancer patients, of instance, also face challenges.

Dutes Dutheil is tired of having to make the trip from Tlell, on Haida Gwaii, over to Prince Rupert in order to receive cancer treatment. (George Baker/CBC)

With no chemotherapy nurse on Haida Gwaii, cancer patient Dutes Dutheil has to take a trip to Prince Rupert for treatment.

Cancer screening technologies are also limited on the islands.

Retired cigarette salesman Ron Lockhart lost his wife to cancer in Nov. 2015. Now he wants his former employer to fund cancer-screening technology for families on Haida Gwaii.

The population of Haida Gwaii is around 5,000 people.

With files from Andrew Kurjata, George Baker, Carolina de Ryk, and Ash Kelly

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