Coroner's inquest jury suggests 4 improvements to mental health care in P.E.I. hospitals

Warning: This story deals with suicide. If you or someone you knowis struggling with mental health, you can find resources for help at the bottom of this story.

The jury at a coroner's inquest in Summerside has issued several recommendations aimed at preventing any more suicide deaths in P.E.I. hospitals.

The inquest was called as a result of the death of 67-year-old Angela Arsenault, who died after being admitted to the mental health unit at Prince County Hospital in February 2023.

Arsenault's son and daughter participated in the inquest alongside Crown attorney John Diamond, and were able to ask questions of experts and hospital staff who testified.

In her closing remarks for the jury Friday, Lisa Arsenault spoke about a health-care system with many gaps that failed her mother.

"I feel guilty for leaving her [at] PCH. It was supposed to be the safest space for her to be stabilized," she said, in part. "We cannot bring my mother back but we can attempt to save others in similar situations.

"As difficult as it is supporting someone experiencing acute mental-health symptoms, we would have moved the moon and the stars to bring her back to the loving and caring mother, grandmother, sisterand friend that she was."

The circumstances surrounding Arsenault's death were never disputed during theinquest.The Tignish woman had long struggled with her mental health, and had attempted suicide and sought help multiple times before.

In February 2023, she was involuntarily admitted to Prince County Hospital's mental health unit after overdosing on her medication.

Staff members were directed to check on her every 15 minutes.

A few days in, during a routine check, an employee found Arsenault unconscious in the bathroom of her room. She had used the shower curtain rod to hang herself, and later died of a brain injury.

Jury recommendations aim to prevent future suicides at Prince Edward Island hospitals

16 days ago

Duration 2:19

The jury at a coroners inquest in Summerside has issued several recommendations aimed at preventing any more deaths like Angela Arsenault's. She took her own life while in the mental health unit at Prince County Hospital in February 2023.

4 recommendations

On Friday, after hearing four days of testimony this fall about what happened in the months and days leading up to Arsenault's death, a jury issued four recommendations on what should be done to help prevent similar tragedies in the future:

• Moveto a central depository for patient information.
• Consultwith other mental health facilities on improvements for patient safety.
• Evaluatethe process of how room checks are conducted.
• Moveto more timely implementation of facility recommendations and improvements.

A similar death took place in 2016 at Charlottetown's Hillsborough Hospital, which led to an inquest and arecommendation that shower curtain rods, coat hooks and door knobs in hospital units should be adjusted so thatthey could not support a person's weight.

Changes have been made at Prince County Hospital, but only since Arsenault's death.

Diamond said Friday that it can be difficult to predict when someone will attempt suicide in a hospital setting, and ensure every safeguard is in place.

"That's one of the positives to come out of this inquest, is that steps have been taken to remedy some of the issues at the hospital so these type of things can't happen in the future," he said.

"Hindsight's a wonderful thing, and maybe steps should've been taken earlier. Unfortunately, they weren't. I don't think anybody can be held responsible for what took place here."

The jury's recommendations will be sent to the provincial coroner's office and to the P.E.I. government, though they are just that recommendations.

It's not clear if or when they'll lead to actual changes.

If you or someone you know is struggling, here's where to get help:

• Canada Suicide Prevention Service: Call or text 988.
• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling onthe website.
• Canadian Association for Suicide Prevention:Find a 24-hour crisis centre.
• This guide from theCentre for Addiction and Mental Healthoutlines how to talk about suicide with someone you're worried about.