N.S. mass shooting report calls lack of mental-health care a 'public health emergency'

The final report into the Nova Scotia mass shooting has validated what friends, neighbours and family members of those killed in April 2020 have been saying for years: they were failed by the province and are still dealing with a "public health emergency" because of unmet mental-health needs.

The Mass Casualty Commission's lengthy report was released last week, and has strong words about the situation in Nova Scotia's Colchester, Cumberland and Hants counties.

"Given the long-term implications of unfulfilled support needs following mass violence, we call for recognition of this situation as a public health emergency," the commissioners wrote.

They set a deadline of May 1, 2023, for the provincial and federal governments to jointly create and fund a plan to address the issue. It's the first benchmark of all 130 recommendations in the report.

"There is that gap. You have to wait months to get into a psychiatrist, any mental-health programs that don't cost you money at the hospital, anything like that," said Erin MacKinnon, who is a resident of Portapique, N.S.

"It's really not easy when you go for help, it's not available to you — and I do think that that is a major problem right now."

The rampage on April 18 and 19, 2020, began in Portapique when the gunman attacked his partner before killing 13 people in the small Colchester County community. He killed nine others the next day as he drove south across the province, posing as an RCMP officer.

Although support centres to connect people with help were set up right away in areas like Portapique, Shubenacadie, Masstown and Wentworth, residents and victims' families told the inquiry that they were only handed lists of psychiatrists or other professionals. They would then discover that some therapists weren't taking patients, or would have to drive more than an hour to Halifax to get help.

The commissioners wrote that the "extent of unmet need cannot be measured" because a needs assessment hasn't been carried out and there has been no evaluation of the services that were provided.

Two of the centres in Portapique and Wentworth stayed open until January 2021, much longer than originally planned. But, MacKinnon said the "denial process" was long because of the horror that had taken place, and the realities of COVID-19 kept people isolated.

"Once we started talking to our friends face-to-face, and talking to our neighbours and seeing things for our own eyes, is when it really started to set in and hit," MacKinnon said.

That's when a neighbour named Andrew MacDonald came to her door with the idea of doing something to help the community move forward, MacKinnon said, and their local "build-up" project began.

As a result, Portapique now has a new playground, and a new community hall is going up. MacKinnon said the project has been "healing" for her to have something positive to focus on, and their group recently got a grant to offer mental-health programming locally.

"That gives us an opportunity to provide services right here to people that need this," MacKinnon said.

Still, she said one initiative alone won't solve the problem.

'We need more'

"It's sad to say that we need more. We're grateful for what we are getting, but it does have to go deeper," MacKinnon said. "It's a battle that we're going to have to always fight."

The report shared many anonymous responses from the Share Your Experience online survey, in which people wrote to the commission to describe how the mass shooting affected them. 

One person wrote they were disappointed that no new funds had been invested to hire more guidance counsellors or school psychologists, who are often responsible for multiple schools.

"I know from my son's first-hand experience that there are more children in our community who need mental healthcare than there are staff to treat them. This is despicable," they wrote.

"If the deadliest mass shooting in Canadian history is not enough to trigger an investment in mental healthcare in a region – what has to happen before extra funding is committed to assist the youth of a community?" 

Laureen Rushton, who lives 30 kilometres east of Portapique in Belmont, N.S., has been echoing the call for better resources. Her 18-year-old son, Lucas, died in May 2021 from what she believes was an accidental overdose, after struggling with mental illness. She has said her son tried accessing mental-health services at least 50 times in the five years before his death.

Like many in the area, Rushton's family was connected to various victims of the April 2020 rampage. She had taught alongside Lisa McCully at Debert Elementary School, she knew Joy and Peter Bond, and Lucas had been a classmate of Emily Tuck's.

"After the shooting, we searched because he was affected, because he knew Emily … and he also knew Lisa as well. They were pretty good buddies, and we struggled to find a therapist," Rushton said.

There still isn't enough permanent mental-health support in the community three years later, Rushton said, calling the province's recent offer of a free, one-hour counselling session "a Band-Aid being put on a surgical cut."

Instead, she has been pushing for the province to open walk-in mental health clinics, separate from emergency departments.

Rushton said she completely agrees with the report's emergency assessment.

"I'm living it. My son, he lost his life because he couldn't get the support that he needed. And he's not the only one," Rushton said.

Portapique resident Leon Joudrey, 54, died in November, just weeks after he sat down in a small group session with others affected by the violence and the Mass Casualty Commission. Joudrey was the person whom Lisa Banfield, the gunman's spouse, ran to for help early in the morning on April 19, 2020. 

At the time, Joudrey talked about how hard it was to navigate the mental-health system in the immediate aftermath of the shootings.

"When you're shaking every day and somebody tells you it'll be three weeks [for help], doesn't help you much," Joudrey told the commission. "It's like calling 911 and getting a recording."

Joudrey said he'd spent most of the past two and a half years since the shootings away from his property, which he was struggling to sell, staying in a small cabin in the woods rather than live in the area where so many had been killed.

The Nova Scotia Health Authority (NSHA) said in an email that they are "reviewing and carefully considering" the report's recommendations.

"We recognize the sense of urgency, and want to move forward collectively in a meaningful way that will honour the families, survivors and communities," spokesperson Brendan Elliott said in an email on April 6.

Supports added since 2020

Elliott said there is a new outreach worker supporting Portapique, as well as the surrounding communities in Colchester County and East Hants, who will listen to community needs.

"We see this role being a direct connection to mental health and addictions and community," Elliott said.

After a family doctor retirement, nurse practitioners have taken over the patients of the West Colchester Community Health Centre and are adding new patients from the province's doctor wait list in the Economy/Glenholme area. The new Masstown Collaborative Family Practice Clinic is also expected to open this spring, and primary care providers there will collaborate with the West Colchester Community Health Centre.

A Mental Health Commission of Canada project aimed at reducing the impacts of suicide, called Roots of Hope, is now being launched in Colchester County.  

The NSHA primary care team also held a community engagement session for the West Colchester Community Health Centre in September 2022, in recognizing the grief and trauma cycle "can be delayed and/or require extended supports," and other NSHA staff have been asked to explore "ongoing mental health and wellness supports" required in Bass River.

Nova Scotia's Minister of Addictions and Mental Health Brian Comer said Friday he's "committed to reviewing the recommendations in their entirety" and there would be more to say in the coming days.

"We'll certainly work together with our federal colleagues, you know, to make things better for all Nova Scotians, and certainly I'll work very hard on this file moving forward," Comer said.

When asked about hiring more school psychologists for the three affected counties, Comer said there's a variety of other programs for youth like SchoolsPlus but the ratio of clinicians in the school system is "certainly something we can look at."

The Chignecto-Central Regional Centre for Education (CCRCE) covers 67 schools in central and northern Nova Scotia in most of the affected communities.

Jennifer Rodgers, CCRCE spokesperson, said in an email that they have multiple professionals working together with teachers and principals to support students, including: 19 school psychologists, 25 community outreach workers, 51 school counselors, six adolescent outreach staff, 10 mental health clinicians, and 21 child and youth care practitioners.

"CCRCE will continue to work with all students within schools to build resilience, strengthen coping skills, and focus on well-being each year as we know that these approaches help students when they are heightened now and add to their well-being tools for students to use in the future," Rodgers said.

The commissioners also recommended that federal, provincial and territorial governments develop a national action plan to better integrate preventive and supportive mental-health care into the health-care system to ensure greater access to these services "on an equal level as physical healthcare."

• CBC's full coverage of the inquiry into the Nova Scotia mass casualty

In addition, their report recommends that the Nova Scotia Health Authority consult with community-based health organizations in the affected communities to develop a public-education campaign around grief, bereavement, trauma and resiliency.

These awareness campaigns should include ongoing education in schools, the report said, and should be considered alongside existing programs. For example, they could be a requirement for employers as part of workers' compensation programs.

The commissioners also recommend that Health Canada, in consultation with the provinces and territories as well as experts, should develop a national policy to provide health and social support services to those most affected by mass casualty events — both for individuals and communities as a whole.

That national policy should include a multidisciplinary team that can be mobilized within 24 hours to help local service providers set up a support plan immediately after a mass casualty, the report said.