Questions linger after killer bolts for second time
• A man who went missing from the psychiatric hospital where he is being treated after beheading his mother in 2010 has been apprehended, but questions remain about how he was able to bolt for the second time in a year.
The Centre for Addiction & Mental Health (CAMH) is reassessing its protocols after Thomas Brailsford escaped during a supervised medical appointment in Bloor West Village on Thursday. He was not accompanied by an armed guard, but by clinical staff who could only tell him absconding was a bad idea.
Mike McCormack, president of the Toronto Police Association, said using hospital staff as escorts when the patient has a violent history or has killed someone is insufficient.
“Our concern is that escorted passes don’t involve security escorts,” said McCormack. “I would say it’s more of a chaperone.”
Brailsford went missing in the Jane/Bloor Street West area. A member of the public recognized him near Lake Shore Boulevard and Windermere Avenue at about 11 a.m. Friday and called police.
In a statement, CAMH said it ‘‘is reviewing the specifics of what happened in this case to look for potential areas for improving our protocols.”
Dr. Sandy Simpson, the centre’s chief of forensic psychiatry, said beyond telling patients that absconding from escort is a bad idea, staff have little power to stop them.
“One person can’t restrain one person,” he said. “The escort is there to manage any risks up to a certain point.”
Clinical staff or members of the hospital’s interdisciplinary team usually escort patients, with police support in rare cases for high-risk patients.
In 2010, Brailsford, 55, was found not criminally responsible for killing his mother. He called police to her apartment after she died of “sharp force injuries with a knife,” according to police. He was initially charged with first-degree murder.
This is not the first time he has been the subject of a police search. Last September, he did not return to CAMH from an unsupervised day-pass.
“He failed to return to when he should have (in 2014). We have reviewed his security level with care in terms of looking at the risks he posed, and that resulted in him having a higher level of supervision with that last day (in 2015),” said Simpson.
Not only does absconding from an escort result in a patient’s day-pass privileges being withheld, “It undermines their progress and reduces public confidence in the program,” he added.
A review board decides whether CAMH patients qualify for day-passes and escorted outings, or can live unaccompanied in the community. It can gradually increase the leave time and loosen supervising conditions, depending on the patient’s progress.
Simpson says patients begin with two staff members escorting them and progress to being on their own in the hospital grounds and outside.
If a patient decides to leave, clinical staffers immediately report the case to supervisors and the police, but do not restrain or pursue.
Health lawyer Lisa Feldstein said in addition to liability concerns, physically restraining a patient bears many safety risks. “Hospitals have a genuine concern for the welfare of their staff, and need to mitigate the risk of their staff getting into physical altercation with their patients,” she said.
Toronto police do not track statistics on the number of mental health patients who have hurt members of the public after absconding from escort, but Simpson maintains that number is zero.
In the last five years, changes to day-pass protocols at CAMH have reduced the rates of absconding from escort by 40 to 50 per cent at a time when the hospital has higher numbers of forensic patients, he said.