Adam Kassinen was a modest kid when it came to keeping his clothes on.
Yet, in recent years, the young Comox man developed behaviour that ultimately led to indecent exposure charges, to which he recently pleaded guilty.
“He was one of the kids who didn’t even like to take his shirt off,” says his mom.
While the judge handed down a house arrest in early January, in the hope it will provide better access to treatment, Ruby Kassinen was already exhausted by a lack of mental health support for people with complex needs — a frustration that began well before her son entered the courts.
She wants to make clear she is sympathetic to the victims who witnessed her son’s actions.
“I feel terrible for those girls,” she says.
However, she says the system had long failed Adam through changing diagnoses and prescription on top of prescription over the last four years. At 16, he was diagnosed with schizophrenia. Now 19, he was told by his new adult psychiatrist that he does not have schizophrenia and that the source was a drug-induced psychosis from THC.
“They diagnose him and put him on copious amounts of drugs,” she says.
Of note, Ruby says Adam’s urge to expose himself didn’t start until he was put on a drug called Abilify, used to control depression in adults, or bipolar disorder and schizophrenia in adults and adolescents. Health Canada issued a notice in 2015 that a potential side effect of Abilify (aripiprazole) is a lack of impulse control, such as pathological gambling or uncontrollable sexual behaviours. The warning was echoed by the U.S. Food and Drug Administration.
“In the majority of cases, patients with no prior history of the compulsive behaviours experienced uncontrollable urges only after starting aripiprazole treatment. Within days to weeks of reducing the dose or discontinuing aripiprazole, these uncontrollable urges stopped,” says an FDA safety announcement from 2016.
As a youngster, while Adam needed some supports such as a tutor, he’d never been destructive. Around four years ago, Ruby noticed a change in her son’s behaviour and took a hair sample to a lab in Nanaimo for fear of hard drugs. The test had shown signs of THC from marijuana, though she understood for some, especially young people, this can bring on psychotic reactions.
The odyssey of forensic psychiatry reports and diagnoses that at first had him declared schizophrenic soon began. He was given Risperdal, but he became “flat” when on the drug. His prescription was changed to Abilify, which is when the impulsive behaviour started. It was strange, she says, when her son started to expose himself, he would make no attempts to hide his actions. He also told her being on the drug was like being in a deep trance.
Then came the exposure incidents last June and September. He was arrested shortly after the second one. He did not ask for bail or a preliminary hearing but instead pleaded guilty. While incarcerated, he was put in solitary confinement for 53 days, then taken out at which point he was vulnerable to attacks in the remand centre.
“I don’t understand our system,” she says.
Currently under house arrest, Adam is hauled up at the family home, but Ruby says her son is in no way getting the help he needs. Part of the problem is getting any consistency around a diagnosis. Another question is the potential effect of head-injuries. She wanted a brain scan completed but was told she needed a referral, which the psychiatrist seemed reluctant to give. She has also contacted health officials and various agencies such as the ombudsperson’s office, but she has not been able to make any headway.
She would like to find a facility where Adam can be placed under supervision and taken off all medications to provide a baseline for his behaviour. The ideal place would be something like the Carlile Youth Concurrent Disorder Centre at North Vancouver’s Lions Gate Hospital, but unfortunately, Adam would not qualify as he is not from the Lower Mainland or Sunshine Coast. Vancouver Coastal Health confirms on its website the 10-bed unit is for youth aged 13 to 18 in the VCH service area.
The Record asked the province’s Ministry of Mental Health and Addictions about the availability of services such as Carlile for young people with complex needs like Adam. A spokesperson sent a lengthy response, citing a provincial investment since 2017 of roughly $140 million in youth mental health services. It has added 123 youth substance use treatment and recovery beds. Additionally, in the latest budget, of $500 million for mental health and addictions, $97 million is going to integrated mental health and substance use care for children, youth and young adults in B.C.
Specifically, the ministry points to services like hospital emergency rooms with specialized mental health and addiction services; six urgent and primary care centres on Vancouver Island;, child and youth mental health intake clinics at multiple locations, including Courtenay; two Foundry Centres; 29 community youth substance use beds; and Discovery Youth and Family Substance Use Services centres available throughout Vancouver Island.
None of these options, says Ruby Kassinen, really cover her son’s situation. Since the time of the sentencing, she has had to run Adam to the emergency department at the hospital in the hopes of talking to a crisis nurse. Places like the psychiatric ward, she adds, over-prescribe medication to sedate patients rather than trying to find a baseline to assess the patient, which she feels should be the starting point.
“It’s a complex situation, and anything complex they don’t know how to deal with,” she says. “Nobody wants to be accountable.”
(The story has been edited since posted.)