Centre cut staff before man’s suicide

Facing a shrinking budget and an uncertain financial future, the NAHA Centre had no choice but to cut staff in late 2015.

Until then, the centre, which houses 15 to 20 homeless men, had managed to scrape together enough funding from private and public partners to employ two social workers who oversaw residents. Now it had to go down to one.

Around the same time, Mario-Nelson Boucher, 44, arrived at its doors after spending 23 years in federal and provincial prisons. He seemed motivated to turn his life around, but the centre soon found out his mental health issues were more severe than first understood. In June 2016, Boucher was found hanging in his room.

“Perfection is impossible,” the centre’s general director, Sébastien Pageon, said of running a homeless centre on such a tight budget.

“But these men have nowhere else to go. And being with us is still better than nothing.”

Pageon was testifying Wednesday at a public coroner’s inquest into Boucher’s suicide. The Quebec coroner’s office is trying to shed light on the circumstances surrounding his death in an attempt to prevent similar cases in the future.

The inquest has been exploring Boucher’s transition from prison — he was last detained at Montreal’s Bordeaux jail — to the NAHA Centre in November 2015.

Boucher arrived at the centre, in the Mercier-Hochelaga-Maisonneuve borough, with an expiring health insurance card, no family doctor and a prescription for antidepressants left over from prison.

The centre was told Boucher had an attention deficit disorder, but staff suspected his mental state was more dire. He would have severe episodes of paranoia, mood swings, and become threatening during mental health crises, requiring police intervention.

Whatever mental health following Boucher had in prison was never communicated once he was released, Pageon said. He was essentially “dumped” at the centre, he added.

“What legal obligations or moral responsibilities,” Pageon asked, does the prison system have when it comes to someone like Boucher once they’re released? What happens to their medical history? Does anyone help them search for housing ?

Andrée Kronström, the coroner overseeing the public inquest, told Pageon she will be exploring the questions. After three days of testimony at the Montreal courthouse this week, the inquiry will resume in the fall to discuss possible recommendations.

“What interests me is how we ensure that everything is in place to facilitate inmates’ exit and social reintegration,” Kronström said. “That there be a continuation of service, a link, between detention and the necessary followup with the appropriate health services.”

The NAHA Centre’s tight budget has had repercussions before and since Boucher’s death, the inquest heard.

In an environment based on trust built between staff and residents, the slim salary the centre can offer makes retaining full-time employees difficult. Interns often take on broader workloads than they should, facing situations they may not be equipped to handle.

Given how fragile some of the men are, a 24/7 presence is probably required, but currently out of reach after cuts to public funding.

At the time of Boucher’s suicide, the centre was already reeling from another resident’s death from lung cancer earlier in the same month. It was also trying to figure out how to operate with only one social worker for up to 20 at-risk men.

Fearing Boucher’s suicide could have a contagious effect, the centre first tried to shield other residents from it as much as possible, then held an emergency meeting with the men to discuss what happened. A handful confided they had battled suicidal thoughts themselves.

When the centre could afford two social workers on staff, shifts would be divided to allow one to work until 9 p.m. each night. Before leaving, the person would do a tour of the centre, checking in on any residents they feared were showing signs of depression.

The service became impossible with only one employee.

“Did we save lives? I don’t know,” Pageon said after describing the nightly checkups. “But did we help? That’s for sure.”