The December 2023 death by suicide of a South Surrey teen has prompted a change to how Fraser Health supports vulnerable youth who've had an appointment cancelled due to clinician illness.
Felicity Donovan's experience with the health authority's Short Term Assessment Response Treatment (START) program "led to a review, and from that review, we initiated this protocol," Mike Kenyon, Fraser Health's director of regional mental health and substance use services, confirmed Thursday (Sept. 5), referring to changes implemented last month for how unexpected absences of START employees are handled.
"Moving forward, we want to make sure that there is a clear, on-paper policy that was consistent in practice 鈥� and that it's clear for everybody what the approach is."
Felicity, 16, died after being found unresponsive in her bedroom on Dec. 19. Struggling for some time with depression, she had been participating in the START program, which provides services for children and youth who are experiencing mental health and/or substance-use crises.
Connecting with a START team member weekly since late October 2023, Felicity wasn't offered an alternative when a mid-December appointment was cancelled.
She died days later.
According to Felicity's father, Fraser Health officials acknowledged earlier this year that there had been a "missed step" in the support that was being provided to his daughter, through the absence of a protocol to ensure continuity of care in the event of an unplanned staff absence.
It happened "at the worst time with the worst outcome," David Donovan told Peace Arch News in March.
Kenyon wouldn't discuss specifics of Felicity's journey as a START client, or the process that was in place prior to August. However, Fraser Health officials told PAN earlier this year that typically, when a scheduled appointment is missed or cancelled, the team will connect with the client and their family, and 鈥渨ill emphasize that if the client requires immediate medical attention or if there is a significant threat of serious physical harm to themselves or others, they should call 9-1-1 or visit the nearest emergency department.鈥�
Emails and documents shared with PAN by the Donovans confirm that a specific policy regarding continuity of care in the event a clinician is ill or unexpectedly unavailable did not exist at that time. As well, there was no direct contact with Felicity when her appointment was cancelled.
"We are sorry that this did not occur, and that it left Felicity feeling like she could not access help urgently when she needed it," an Aug. 29 letter from the health authority's Patient Care Quality Office states.
Kenyon said health authority staff report absences through the Employee Absence Reporting Line (EARL) and that the changes implemented last month are specific to how START clients and their families are impacted by such absences.
"We've made an adjustment or change to how START responds to that," Kenyon said.
Elaborating, Kenyon said the new protocol "is there to ensure that there is direct contact with clients in the event of this absence, and clients are offered an appointment the same day with an alternate care provider, or they can reschedule the appointment as early as possible with their usual care provider, or, as clinically indicated, we also connect them to emergency health services."
"This protocol makes sure that we're consistently responding this way, and makes clear what the approach is."
Kenyon said the health authority is "extremely grateful" to Felicity's family for their insights and said Fraser Health will continue to work with the Donovans around the established protocol.
David said his family is appreciative of the latest development and "think we are headed in the right direction."
"If these changes are implemented, they can save lives like Felicity's. It is nice to see changes being made that will increase the likelihood that children needing support get that support and don't fall through the cracks."
He noted his wife, Laura, met with Premier David Eby and Minister of Education and Child Care Rachna Singh on Monday (Sept. 9) regarding Felicity and the family's experience. Details of what transpired at that meeting were not immediately available.
