B.C. mom didn't want mentally ill son discharged, 9 days later he died

James Pazder was a regular Vancouver Island kid.

When he was in elementary school, he liked to play soccer and swim. In middle school, he started playing trumpet and took sailing lessons.

As a teenager he won the Parkland Secondary School "Survivorman Award," after breaking his finger in physical education class. He was an avid downhill skier. By Grade 10 he was on the honour roll.

But when he was 17, Pazder was diagnosed with schizophrenia. This began a period of several hospitalizations and a decade-long scramble for his family as they tried to get him proper care. That effort ended abruptly on Feb. 16 when Pazder took his own life.

It was just nine days after he was discharged from the Archie Courtnall Centre at Royal Jubilee Hospital. His mother says both his family and case management team had advocated for him to stay in inpatient care.

Archie Courtnall is the regional emergency psychiatric unit, and is supposed to provide short-term stabilization for patients, and move them on to longer-term care when needed.

Pazder's story reached the B.C. legislature on Tuesday (April 9), when B.C. United MLA Elenore Sturko introduced a private members bill to try to change the Mental Health Act to make it easier for family members to be informed about and involved in their loved one's care.

This expands on a bill Sturko introduced last year, the aim of which is to prevent suicide deaths by requiring doctors to consider people's psychological history when they involuntarily admit a patient. The hope is that if physicians proactively reach out to family members and first responders they will gain background information that may otherwise be overlooked.

Sturko spoke to the press flanked by two of Pazder's brothers, as well as the sisters of James Zimmer, who died in similar circumstances after being discharged from Royal Jubilee a little over a year ago.

For Pazder, one of the major roadblocks to care was that his mental health issues had become intertwined with substance use problems.

This added complexity to his case. He could have easily gotten inpatient treatment for each of those issues individually, but once combined it was difficult to find a place that could deal with both.

But these are problems that often go hand-in-hand.

"There historically has been a silo approach to treating mental-health concerns and addiction concerns," said Erica Woodin, a University of Victoria psychology professor who has studied these interacting issues. "And having services that are available for individuals experiencing both of those conditions is not always available, despite the fact that those are incredibly common co-occurring problems."

A decade of trying

In an interview at the family's home in Sidney, Sue Pazder gave a detailed description of the 10 years her family struggled to get her son proper care.

After James Pazder had his first psychotic break and suicide attempt in the spring of 2014 at the age of 17, he spent two months in the hospital and was diagnosed as schizophrenic.

Over the next two years he was in and out of the hospital as his family tried to figure out a care plan that would work for him.

Finally, after another suicide attempt in February of 2016, he was placed in the B.C. Psychosis Program at the University of British Columbia Hospital. With proper treatment and medication, he was stabilized.

His inpatient care lasted for about 13 months, and included a stint at Cowichan Lodge Tertiary Mental Health Facility in Duncan.

In the years that followed, his treatment came in spurts and starts, with his family trying to keep an eye on his changes and get him help when necessary.

"It goes in cycles," Sue said "He gets down and we catch him and then we take him to the hospital."

During those years, he tried living on his own in downtown Victoria, but while there he was not able to stay away from using drugs.

On the plus side, he began to have his case managed by an Assertive Community Treatment (ACT) team, which brings together several services, including addiction specialists, mental health workers and psychiatrists.

His family continued to support him as well.

"He would be out for a year and then he'd run out of money and he'd come home for a year, and then he'd be out for a year," his mother said.

In 2022, he moved back home and was seeking treatment for cocaine addiction.

He was informed the only place that would be able to treat him is the Red Fish Healing Centre in Coquitlam, but there was a waiting list. He would also have to leave the Island to go there, which meant leaving his support system. Pazder didn't want to do this.

In April of 2023, his mother said he attempted suicide again, this time by overdosing on fentanyl. With help from his brother, she gave him naloxone while they waited for an ambulance. He ended up in the intensive care unit for five days.

For the next 10 months the family continually sought to get Pazder the help he needed for both addiction and schizophrenia. They tried to get him in to several facilities on the Island, including the Edgewood Treatment Centre in Nanaimo, but were continually denied because of his mental-health issues.

In January of this year, he got into detox, but that facility didn't have the resources to treat the mental-health issues either, and the staff let him walk out the door. He ended up back in Victoria, staying at a downtown hostel.

Eventually, in early February, his parents got a call from the hostel saying he was unwell and that someone should come get him. The staff thought it was an extreme hangover. But when he got to his parents house he was pale, very thirsty and acting strange.

The family laid him down in bed to rest. Half an hour later they went to check on him and he had lost consciousness. This started another episode with naloxone and paramedics, but before they could get the naloxone in, his breathing dropped. The 911 operator was about to walk the family through CPR when the ambulance arrived. Just as they got there, Pazder woke up.

His mother rode in the ambulance to Saanich Peninsula Hospital with him, and said his talk was "highly psychotic" the entire way. Because of his condition, two guards were posted outside his room.

He was admitted involuntarily under the Mental Health Act, and transferred to the Archie Courtnall Centre at Royal Jubilee. His mother again accompanied him in the transfer ambulance and said his talk was delusional and psychotic the entire way.

That type of talk continued when the family visited Pazder, but when they tried to communicate this along with other information about his history to his care team at the hospital, they weren't given access to his doctors.

After just five days, and despite the fact that the family and his ACT team had advocated for him to be put into longer-term care at the centre, he was suddenly released.

When he was discharged, he was put into a cab and sent to his parents' house, but they weren't even home at the time. And there was no plan to get him the medications he needed.

"He was not recovered from his psychotic episode, because usually it takes two or three months in the hospital for that to happen," Sue said.

On the morning of Feb. 16, the day Pazder died, a mental health worker from the ACT team came to the family's home to see how he was doing. But it was too late.

The family was left wondering what would have happened if they had been listened to at Archie Courtnall.

The need for change

A spokesperson for Island Health would not comment specifically on Pazder's care, except to say that a review has been conducted.

"In general, patients are discharged when deemed medically safe and appropriate based on the clinical assessment of the care team involved in the patient's care," a statement from the spokesperson reads. "Discharge plans are tailored to each patient and each clinical situation.

The Ministry of Mental Health and Addictions also provided a statement assuring that Minister Jennifer Whiteside's office has been in contact with the family and is supporting them in their fact-finding efforts.

"Their experience is exactly why we are working hard to build a better system of care," says a written statement attributed to the minister.

Part of this work, the statement says, is to expand the model of the Red Fish Healing Centre.

In her remarks to the press after introducing her Mental Health Act bill, Sturko — who is B.C. United's mental health and addictions critic — said expanding this centre and building similar ones in other health authorities so people can get care close to home is crucial.

And if the amendments to the Mental Health Act that Sturko proposes pass — an unlikely proposition with her party not in government — family members could be consulted at critical junctures in a patient's care.

Pazder's brother Alex said at the Sturko press conference that perhaps if the hospital staff had listened to the family, and realized Pazder wasn't a reliable source of information about himself, that he might still be alive.

"If they had been able to converse with us, if they have been able to listen to our side of things, then maybe things would be different," Alex said.

The sisters of James Zimmer echoed this. Zimmer took his own life just hours after being released from Royal Jubilee Hospital last February. His sisters were his primary supports, but they weren't even informed of his discharge.

"We started to advocate so others don't have the same outcome as our brother did," Cindy Zimmer said in a telephone interview the day prior to the press conference. "Yet, here we are, one year later, hearing about James Pazder."