HALIFAX -- The Nova Scotia government is promising to act on a review that found "significant gaps" in controls placed on patients who are given temporary release from a Halifax psychiatric hospital following the beating death of a local gay activist.
In the future, decisions to give patients releases into the community would consider the risks based on a set of explicit criteria, the provincial government said on Tuesday.
And it said temporary releases would be suspended for patients who don't return to the hospital until a review of the incident is conducted.
"A tragic death led to this review and many of the facts are not yet confirmed," deputy health minister Kevin McNamara told a news conference in Halifax.
"We will work hard collectively over the next several months to address the gaps identified in this review."
The review also calls for daily assessments of a patient's mental health before they are granted leave.
It says the public should be informed of potential risks when a patient is reported missing and it suggests officials explore the possibility of using cellphones and pagers to monitor patients when they are outside the hospital.
Justice Minister Ross Landry said the province rejected the possibility of using ankle bracelets to help track certain patients with violent histories.
"I'm not aware of information that shows a direct benefit with the GPS while balancing the individual's right to free movement and association," he said.
The Capital District Health Authority also set up a quality review committee to look at policies and procedures at the hospital, which heard that "a culture of AWOL" has developed at the hospital where people going absent without leave has come to be accepted.
"This would suggest that patients and staff have become less concerned about incidents where patients fail to return from community passes," says an appendix to the review from the committee.
The review makes 18 recommendations and was ordered by the government after the release of Andre Noel Denny, who has been charged with second-degree murder in the death of Raymond Taavel.
Denny was on a one-hour unescorted leave from the East Cost Forensic Hospital on the night Taavel was killed in April.
He is scheduled to appear in court on Thursday after the Crown and defence agreed in June to extend a psychiatric assessment of Denny, who was diagnosed with schizophrenia as a teenager.
The report says Denny did not return to the hospital on time on April 16 and his absence was reported to the police.
The review was done by the deputy ministers of Health and Wellness and Justice, and the CEO of the Capital District Health Authority. It also includes reports from two independent experts in forensic psychiatry from Ontario and British Columbia.
It says the justice system and forensic psychiatry recognize patients have a right to liberty that is protected in the Charter of Rights and Freedoms.
"Balancing the right of the public to feel and be safe and the rights of individual forensic psychiatric patients who have been found not criminally responsible on account of mental disorder to get better and reintegrate with the community is challenging," the report says.
"It is made more difficult by a lack of research and development in this area."
The report says existing policies and practices at the hospital are in line with Canadian standards, but improvements can be made.
The government says it accepts all 18 recommendations and will release a report on its progress in implementing them within six months.
"We listened to the independent experts and agree there are improvements to Nova Scotia's forensic health-care system that can, and will, be made," Health Minister David Wilson said in a statement. "We must set the bar higher."
Liberal Diana Whalen said the recommendations in the report mainly concerned policies, procedures and paperwork.
"It's just that I think there is an issue for the public that goes beyond that and it's the issue of whether or not the policies are tight enough to ensure our safety as a society."
Progressive Conservative Chris d'Entremont said the issue of public safety isn't addressed by the report, citing a current policy of notifying the public within three working days when a patient fails to return to hospital.
"If something is to happen on a Friday, it could be until the next Wednesday until the public is actually notified," said d'Entremont. "If they say business days they are making it far too long."
