THUNDER BAY — Numerous witnesses in the coroner’s inquest into the deaths of Don Mamakwa and Roland McKay while in police custody have testified to a need for more detox beds in the city.
The manager overseeing day-to-day operations of the only detox centre in Thunder Bay on Thursday testified to the success of the program but acknowledged the lack of spaces.
“The demand and need for our services exceeds the number of beds available,” said Nicole Spivak, manager of the crisis and outreach program at St. Joseph’s Care Group and who also oversees the Balmoral Centre.
Spivak testified on the 11th day of the coroner’s inquest into the deaths of Mamakwa and McKay, who both died at the Thunder Bay Police Service headquarters lockup after being arrested for public intoxication.
Mamakwa, 44, of Kasabonika First Nation died on Aug. 3, 2014. McKay, 50, of Kitchenuhmaykoosib Inninuwug First Nation, died on July 19, 2017.
The Balmoral Detox Centre was first opened in 1989. In 2012, through additional funding, began operating under the model of medically monitored withdrawal management with a capacity of 25 beds.
Services are available to individuals over the age of 16 struggling with intoxication or withdrawal from alcohol or other substances.
All admissions are voluntary and individuals are assessed by a crisis management worker and registered practical nurse before entering the centre.
According to Spivak, between 2017 and 2021, the average number of admissions was over 1,600 per year.
Spivak said the centre has seen many people succeed in addressing addiction issues.
“In my years of working in addiction services, individuals, their capacity for change and for acceptance and resilience, is unlimited. It’s really inspiring that way. Even at Balmoral Centre for a few days, the change from the day they first came to us to the day that they leave can be really significant,” she said.
“People are capable of making a lot of change when they are connected and resources are available when needed.”
Earlier testimony revealed that when McKay was picked up on July 19, 2017 by the Thunder Bay Police Service, the Balmoral Centre was contacted but no beds were available for him.
Officers with the Thunder Bay Police Service and paramedics with Superior North EMS have testified that beds are rarely available for people they come in contact with who are intoxicated.
“With Thunder Bay Police Services, they will call and inquire about a bed. If there is one available generally then they will bring the person directly to our centre and we will facilitate a space,” Spivak said. “It is generally quite quick because we know the officers need to get back on the road. With EMS it is the same.”
The time it takes for a bed to be available varies and can sometimes be as short as a few hours.
“We wouldn’t necessarily phone the first responder back,” Spivak said. “They would call us back if they still needed the bed. A lot of times it is through communications we have that discussion. If there is an indication they are going to bring the person to hospital and our admissions change and a bed becomes available we would definitely reach out to Thunder Bay regional to let them know.”
Spivak said having that kind of communication with police is something she thinks should be considered in the future.
In terms of what recommendations she would like to see come out of the inquest, Spivak said it is important that more services are available when they are needed.
She referred to a 2020 proposal by the Thunder Bay Mental Health and Addictions Network calling for 40 new crisis beds, in addition to the 25 at the Balmoral Centre.
“We need funding to provide more services along the continuum of addiction. More services so it is there timely and when it is needed. And close to home,” she said. “There is no one path to recovery for individuals, which is why it’s so important to have a continuum of services.”
On Thursday, the inquest also heard testimony from Andrew Dillon, deputy chief of professional standards with Superior North EMS and Dr. Richard Verbeek, a physician specializing in emergency medicine, who spoke to the assessment conducted by paramedics on McKay the night of July 19, 2017.
According to Verbeek, the assessment conducted by paramedics indicated McKay had an elevated heart rate and high blood pressure, which he called potentially worrisome findings.
“The expected actions of a paramedics would be to recommend or advise the patient they ought to be transferred to the hospital because of the elevated heart rate,” he said. “It is something that would require further assessment or treatment in a hospital setting.”
The paramedics on the scene asked McKay twice if he wanted to go to the hospital but he declined. Verbeek said they should have gone further by advising him of his condition and recommending he be transported to the emergency department.
Dillon agreed, saying a patient needs to be made aware of the medical findings following an assessment by paramedics.
“In this case the elevated heart rate and explain to them that you don’t diagnose why they have an elevated heart rate and need to be made aware that this could stay the same or get worse, but you can’t treat it here and the suggestion should be you go to the hospital to determine what the underlying cause of the elevated heart rate is,” he said. “They need to make an informed decision of refusal in this case.”
Verbeek could not say if McKay would have survived that night if taken to the hospital, but it would have increased his chances.
“I can tell you I would imagine there would be a higher chance of him having survived given how the case played out,” he said. “But at least he would have been in a place where more tests and monitoring could have been done than opposed to at a police station.”
The inquest will resume on Friday.
