The Royal Inland Hospital in Kamloops is 387 kilometres from Stone Indian Reserve No. 1, located on the south bank of the Chilcotin River. It’s about a 4.5-hour drive between the two, considerably longer if you have to hitchhike or find a way to Williams Lake to take the bus. Two years ago, it was the distance between 18-year-old Jacob Setah and his home community at the time of this death.
Jacob died in June 2014. He had been involuntarily committed to Royal Inland Hospital less than a week before his death, but escaped from a secure ward by breaking a window before leaping to his death off of a parkade.
Last month I had the honour of representing the Yunesit’in Government, located on Stone First Nation, in the Coroner’s inquest into Jacob’s death. Along with Jacob’s family and other members of the Yunesit’in band, we sought answers to the circumstances that led to his death: Why was Jacob, who attended to Williams Lake hospital in need of mental health care, taken so far from his home? And why did police, after Jacob had fled the hospital and threatened to jump from a four-story parkade, decide that a Taser would more effective than words in bringing him down from the ledge?
Lack of mental health services for rural youth
Jacob’s story is, sadly, not a unique one. In communities across Canada, First Nations youth face grave danger. At the same time a five-person jury presided over the coroner’s inquest into the death of Jacob Setah, community leaders in Attawapiskat, Ontario called out for help in the midst of a mental health crisis which had seen 11 First Nations youth attempt suicide in 24 hours. Both Stone Reserve and Attawapiskat have facilities available for a mental health clinician to provide assistance and guidance to youth directly, in their community, but have failed to secure either the funding or adequate housing for the position to be properly filled.
Youth like Jacob, who begin experiencing symptoms of depression or psychosis and are in need of immediate mental health care, often need to travel significant distances to receive care. Six months before his death, Jacob had visited Cariboo Memorial Hospital in Williams Lake seeking help after his family became concerned about his mental state. He was prescribed medication but returned to his home community without any follow-up care or medical assistance of any kind, an all-too-common scenario for First Nations youth.
This is not where the failings end. It is not surprising that Jacob’s situation continued to worsen. After attending Cariboo Memorial Hospital for the second time, Jacob was moved—against his will and without the consent of his family—to the Royal Inland Hospital in Kamloops because it was the closest place with a designated psychiatric facility. After five days in the psychiatric unit without visitors, he made his escape.
Questioning police involvement in mental health crises
It is incomprehensible how it could be RCMP officers, not hospital staff or members of his family, who would have the last contact with Jacob, and how that contact could be so inexplicably violent. As two officers engaged with him, attempting to communicate with him and bring him down from the ledge of the parkade, calls were made to a trained crisis negotiator and members of the family in an attempt to identify someone who might be able to convince him to come down. After 40 minutes at the top of the parkade and with resources en route, Jacob moved away from the ledge to receive a cigarette from one of the officers. Suddenly, and without planning or instruction from his superiors, one of the officers decided to taser Jacob in an attempt to incapacitate him. The Taser failed, and Jacob immediately turned and jumped off the parkade, taking his own life.
Despite extensive regulations on the use of Tasers in British Columbia, and the hard lessons learned from tragedies like the death of Robert Dziekanski, it still feels like we have not figured out how to train our police to properly respond to a mental health crisis. On the stand at the inquest, and in front of the jury and Jacob’s family, the officer who deployed the Taser against Jacob referred to it as a form of “de-escalation”, implying that its use was consistent with training given to officers who carry conducted energy weapons.
If officers are being taught that violence against an individual in mental health crisis is a form of de-escalation, and quick solutions to uncomfortable standoffs are being prioritized over the presence of a skilled crisis negotiator, it is no wonder why we continue to see a significant amount of police-involved deaths and shootings in British Columbia.
Ideally police should be provided the necessary training to feel like they can overcome barriers in communication that often arise in the midst of a mental health crisis. And on a grander scale we must invest in the resources needed to treat mental illness before crisis ensues. The amount of police-involved deaths can only go down when police become less involved in mental health care.
An urgent need for better care
One thing that was clear from hearing the evidence at the Coroner’s inquest is that Jacob should never have been in Kamloops in the first place.
If Jacob had been provided mental health care as a youth living on reserve, or if Williams Lake had adequate facilities to treat youth in mental health crisis, his death could likely have been prevented.
Of the 15 recommendations made by the jury at the conclusion of the inquest, 13 were directed at health care providers and health authorities, urgently calling for immediate improvements to the way we deliver mental health care in our communities and at designated psychiatric facilities.
There is reason to be hopeful. The last two years have seen the creation of the First Nations Health Authority and the laying of a foundation for significant changes to the way health care is provided to First Nations communities.
Now we owe it to Jacob, and current and future generations of First Nations youth growing up on reserve, to make these recommendations a reality.