Questions are being raised yet again about a psychiatric hospital in Dartmouth, Nova Scotia, and its ongoing problem of patients going missing without leave.

The East Coast Forensic Psychiatric Hospital says it has tightened up its protocols since a patient overdue on a day pass murdered a prominent gay rights activist five years ago. But CTV Atlantic has learned of dozens of patients who have violated their leave times since -- some by hours, others by days.

In one incident this past June, one patient who failed to return to the Halifax-area hospital from a day pass was picked up by police in Prince Edward Island, after he exposed himself to two teen girls in a shopping mall washroom.

The man, who had a history of similar offences, had been under treatment at East Coast Forensic , after being found not criminally responsible for his offences. He was on a day pass from the hospital and had been due to return three days before he was picked up in P.E.I.

This was not the only incident involving patients from East Coast Forensic. In one case in 2013, a patient didn't return from a day pass for over a month and made it to the U.S. border. In early 2014, another patient was absent without leave for four days. In January, 2015, another man left the hospital without permission and could not be located for 24 hours.

The most high-profile case involved Andre Denny, who killed gay rights' activist Raymond Taavel while out on a pass five years ago. He pleaded guilty to manslaughter in November, 2015, received an eight-year sentence and served his time at East Coast Forensic. He was granted early release after serving two-thirds of his sentence and given supervised community access in July, 2017.

After Taavel's murder, the hospital conducted an extensive review of its policies and practices and said it put stricter measures in place. But yet the issue of missing patients continues.

East Coast Forensic Hospital's Clinical Director Dr. Aileen Brunet says there have been major improvements since Denny's case and the vast majority of people return on time and when expected. She says that in order for patients to leave the hospital unescorted, four groups of experts must sign off on a day pass, even if it's for as little as three hours.

“We look at how stable their mental state has been, how their behavior has been in hospital. Have they been taking their medication regularly?” she explained.

Patients must hand over an itinerary, and they are monitored while in the community. She says patients are typically asked to carry a cellphone, which they are required to leave on and answer if they call.

“And we have a new position that was created a few years ago called the community monitor: someone whose role includes going out and checking on where people are during their pass,” she said.

When patients on leave fail to return to East Coast Forensic within the allotted time, they are immediately considered absent without leave, or AWOL. The Nova Scotia Health Authority says that the number of AWOLs in 2013 was 42. The following year, there were 40. In 2015, there were 43, and last year, there were 47.

Dr. Brunet points out though that the majority of those cases involved patients who were late by only a couple of minutes. But several of those AWOLs went missing four hours or more, including:

  • ten in 2013
  • three in 2014
  • seven in 2015
  • four in 2016

Dr. Brunet says hospital officials do their best to balance the rights of the patients to liberty and the need to reintegrate into society, with the risks of allowing them back into the community unescorted. She says it's “a constant balancing act” that isn’t always perfect.

“Ultimately, we're dealing with humans; not everything can be predicted,” she says.

But for the mother of the two girls in P.E.I. who witnessed the patient exposing himself, that’s not enough.

She says her daughters were badly shaken up by what they saw. The patient involved was returned to East Coast Forensic and never charged, leaving the mother, who wants to remain anonymous, wondering why no one was ever held accountable.

The mother says the hospital needs to do more than just review its policies.

“Don't even take the chance of them messing up and ruining other people's lives,” she says.

With a report from CTV Atlantic’s Laura Brown