Kevin's story: Man's lost battle with mental illness leaves friends seeking answers
Kevin Blair, a 35-year-old Fredericton man, died by suicide in August
On Aug. 29, the night before Kevin Blair was found dead by suicide, Darren McCarthy and Michelle Dempsey asked Fredericton police to perform a wellness check on their friend.
A check was made and they were told Kevin would spend the night in hospital.
But he didn't stay the night. Kevin texted Darren and Michelle, his girlfriend, to say he went home just 20 minutes after arriving and he was going to try to kill himself.
Darren said he asked for another wellness check, and an officer found Kevin safe, albeit emotional, at home.
An appointment was arranged with a crisis worker for the morning. Kevin was then left alone for the night.
The next day, Darren and Michelle received an email from Kevin. As they read it, they knew it was too late. Their friend was gone.
The email was sent on a time-delay, ensuring there would be no attempt to intervene. It was his suicide letter — 35 pages of how the mental health system failed the 35-year-old, how it didn't do anything for him, how he could manipulate it.
After a months-long struggle to save him, Kevin's friends are left questioning how he slipped through the cracks. They're now calling for change in what they see as a flawed, under-resourced system unable to help a man who became determined to end his life.
"There's a lot of people that are crying for help and they're not getting the help and there's a problem," said Darren. "We have to find the problem and try to address it to prevent this from happening again."
'Denial is the thing'
Kevin, who lived in Fredericton, was a sensitive guy who loved cooking, gardening and technology, like 3D printing, his friends said.
He had a small social circle that included some family. His mother died when he was a young man.
He struggled through school with a learning disability and was often in pain due to fibromyalgia.
He was close with Darren and Michelle, who lived with him for four years. They saw how he struggled with his mental health, describing vast mood swings.
"Situational depression" is how they described it. He seemed to have trouble working through the ups and downs of life; losing a job or breaking up with a girlfriend could be hard for him.
But he resisted the idea he had mental health issues, they said.
"He understood he had issues. He had fibromyalgia. He always had migraines and headaches. He had a hard time with lights and stuff like that. But he attributed it that was his main thing and that was it," said Darren.
"But there's, and like I said, the situational depression … he just kept saying it's situational. 'So the situation goes away. I'll be fine. But until then life sucks,''' Michelle added.
"Denial is the thing," Darren said.
There's a lot of people that are crying for help and they're not getting the help and there's a problem.- Darren McCarthy , friend of Kevin Blair
Kevin talked about trying to kill himself, they said. He even talked about asking for assisted death at the hospital, but he did not accept that he had a mental health problem.
Kevin eventually got help after he attempted suicide in June 2018. He remained in hospital for two weeks and a treatment plan was developed — visits to a psychiatrist every three months and medication for his pain.
Michelle recalled how frustrated he became. The doctors and counsellors would ask, 'How can we help you?' and he didn't know what to say. She said it's a difficult question to answer yourself when you're confused, in constant pain and feeling hopeless.
Trying to save Kevin
A few months ago, Kevin began talking more intently about suicide again.
Whenever Darren thought Kevin was in serious trouble, he would call the mobile health crisis line or the police to perform a wellness check. The calls became so common, the police would recognize his voice.
"They would call back and say, 'Yeah, we're talking to him and he's OK today.' And you know, 'Yeah, he seems a little off today, but I don't think today's the day,'" Darren said.
In the last week of Kevin's life, Darren made multiple calls to the crisis line and the police. He called the mobile crisis hotline in Fredericton at least six times, but the service runs from 4:30 p.m.to midnight and sometimes nobody would answer the call, or it would be bumped to Tele-Care.
He was told by Tele-Care little could be done because it wasn't Kevin who was making the call. Crisis lines, wellness checks, therapy, medication — nothing seemed to work for Kevin.
Why was Kevin allowed to leave the hospital?
The night Kevin was brought to the emergency room after the first of two wellness checks by police, he remained at the Dr. Everett Chalmers Regional Hospital for just 20 minutes, his friends said.
Horizon Health referred questions from CBC News to Dr. Sanjay Siddhartha, the health network's chief of psychiatry for the Miramichi region. He said he could not speak to the specific case, but, in general, anyone brought into the emergency room would be triaged by a nurse and, if deemed to have urgent needs, they would be referred to a doctor.
If they need a psychiatric assessment, that can be arranged, he said, adding each regional hospital in New Brunswick is covered by a 24/7 on-call psychiatric rotation.
The emergency room physician could also institute a "form one" if the individual requires involuntary treatment, he said. In that case, he said, the doctor has to be convinced the person suffers from a mental illness, may be a risk to themselves or others and examination for the next 72 hours would be merited.
"It's a well thought-out arrangement that usually works very well," Siddhartha said.
"But at the same time, I would point out that accidents do happen."
A form one was not used in Kevin's case that night.
"Suicidal behaviour is alarming and it's upsetting, but it's very difficult always to conclude that all people who have attempted uncompleted suicide are necessarily seriously mentally ill," Siddhartha said. "And that's not very clear to many of us in public that that's the case."
Manipulating the system
But Darren said professionals need to listen to people who know the individual best when they say he's suicidal.
As Kevin's mental health declined, they said they saw what professionals who saw him every so often could not: a man with a problem that was getting worse and worse.
"They have to see it. They have to live it," Darren said. "You can't just go about what he says and that's [it]."
Darren said Kevin often described how he could manage his way through mental health services, how he would "brag" about knowing how to manipulate care providers.
"And I told that to the police," he said. "He's not an idiot. He's smart and he knows he's manipulating and all that."
Darren said the police told them they're trained to spot that kind of behaviour and he was "not that bad."
"'He's not that bad,'" he repeated. "He's gone and that's a sin because we were three weeks into it, begging for help."
Mental health calls on the rise, police say
The Fredericton Police Force said it could not talk about specific cases, but it did explain how a wellness check works.
There are two types of calls, for assistance and for transport. In assistance calls, the office typically assesses the needs of the situation and connects the individual with the proper services, be it mental health or addictions in the community.
If the individual is considered a risk to themselves or others, however, police can transport the person to the hospital to be assessed by a trained professional.
While the year-over-year number of transport calls has dipped slightly, the number of calls for mental health assistance has soared.
From January to June 2018, Fredericton police responded to 149 calls, but that number jumped to 287 over the same six-month span this year.
"I don't know if there's an increase or not of mental health incidences, but I think what's happening is our loved ones are more aware that they can reach out for help and individuals as well," said Monique Harquail, a social worker and the mental health co-ordinator for the force.
"The stigma of mental health is decreasing, so I think it's a good thing."
In Saint John, police responded to 785 calls for assistance in 2018 compared to 624 after nine months into 2019.
Moncton, Codiac RCMP responded to 769 calls last year, and 750 calls to Aug. 1 of this year.
Elsewhere in the province, New Brunswick RCMP say they have seen the number of calls grow each year. There were 3,783 calls in 2016, then 4,067 in 2017 and more than 4,400 last year.
If you or someone you know is suffering from mental health issues or suicidal thoughts, the Crisis Services Canada website is a good resource. You can also call them toll-free at 1-833-456-4566 or text 45645.
With files from Elke Semerad and Myfanwy Davies