‘Everything is wrong’: how a trip to the hospital led this mentally ill man to fight to stay in Canada

A man suffering from a serious mental illness faces expulsion from Canada in a case that advocates say sends the worst message about seeking medical and mental help to those in this country in a precarious way.

Mehdi Oussama Belhadj Hassine is now fighting to avoid his removal, which was ordered after the Canadian Border Services Agency stated that the severity of his schizophrenia would likely place an “excessive demand” on Canada’s health and social services.

The 27-year-old from Saudi Arabia has been in Canada since 2012 as an international student. He graduated last year with a degree in business administration from the University of Prince Edward Island.

However, during the pandemic, Belhadj struggled with his mental health, his friends say.

Earlier this summer, he was with a friend when he began to hallucinate about hopping on a private jet to visit his family in Saudi Arabia.

It turned out that Belhadj was experiencing an acute psychotic attack. That July episode landed him in a mental hospital. He was later turned over to the Canada Border Services Agency and detained in a provincial jail. The border agency determined that Belhadj is destitute, in poor health and must be removed from the country.

After spending a month at the Provincial Correctional Center in Miltonvale, PEI, he was released this week with the help of his friends and supporters.

Among several issues surrounding the Belhadj case is what prompted Hillsborough Hospital to contact border officials.

Halifax attorney Lee Cohen, representing Mehdi Oussama Belhadj Hassine, says his client does not recall consenting to the hospital having his medical records released to the Canada Border Services Agency, nor was he mentally capable of doing so without legal representation.

“Mehdi was taken to the hospital for mental health care. He was admitted involuntarily. And while he was there, under the protection of the people who were supposed to treat and care for him, they facilitated the arrival of the Canada Border Services Agency, ”said Lee Cohen, a Halifax attorney representing Belhadj.

“Everything is wrong and he has failed Mehdi. It is a warning to other people, particularly foreigners in Canada with temporary status, that if you need mental health care, you better think carefully before accessing it. That is the history “.

Citing patient privacy, the provincial health authority overseeing the 69-bed psychiatric hospital declined to comment on the details of Belhadj’s case, but said it would not contact the border agency in such circumstances without a patient telling them. I requested.

Governed by privacy legislation, healthcare professionals are prohibited from revealing a patient’s health and medical information without the person’s consent.

“Sanitary facilities are safe spaces for people. We never want people to hesitate to go for emergency care, such as urgent mental health care, out of fear of immigration issues arising, ”said Dr. Michael Gardam, Acting Executive Director of Health PEI in a written statement.

Belhadj was making his own decisions and there is no protocol that requires staff to report this to border officials, Gardam noted.

“Situations in which border services are contacted are rare and are done at the request of the individual.”

His lawyer maintains that Belhadj does not recall giving his consent, nor was he mentally capable of doing so without legal representation.

“There’s no reason to think that the Canada Border Services Agency would have been involved in this guy’s life. They wouldn’t have heard from him, ”Cohen said.

Under Canadian immigration law, an alien who has already been authorized to enter the country may be deemed inadmissible after the fact for medical reasons if his or her health condition can reasonably be expected to cause an “excessive demand” on social services or of health.

However, border officials generally do not enforce the rule proactively, unless a health condition is identified during a medical examination of a foreign national before they visit, work, or study in Canada or when they apply for permanent residence from Canada.

Documents presented in Belhadj’s detention reviews show that he had had five pre-hospital admissions since mid-2020 for acute psychotic episodes and 14 unpaid medical bills.

Belhadj, born and raised in Saudi Arabia to Tunisian parents, came to Canada in 2012 as an international student.

He started having mental health problems during the pandemic, says Sobia Ali-Faisal, from an advocacy group based in PEI, who has known him for two years.

Sobia Ali-Faisal, who met Mehdi Oussama Belhadj Hassine two years ago when she was working as her research assistant at the University of Prince Edward Island, says the 27-year-old is' sweet, genuine, educated, honest, straightforward. and smart 'but began to have episodes in May of last year at the beginning of the COVID-19 pandemic.

It took him longer to finish his education because his studies had been interrupted by the loss of family members and some financial problems, but Ali-Faisal said that Belhadj had always maintained his legal status in Canada.

His study permit expired in March 2020, but due to his mental health issues, he did not immediately apply for his graduate work permit within the stipulated 90 days after graduation.

However, due to the COVID-19 pandemic, Ottawa relaxed the rules and gave international graduates trapped in Canada until Dec. 31 to apply for the work permit, Ali-Faisaland said, and Belhadj did and is still waiting. a decision on the application.

“It was just after May of last year that her mental health problems started. We saw him in those states of psychosis. He was talking to himself about everything and a little lost in his own head, hearing voices, ”said Ali-Faisal of BIPOC USHR, which means Black, indigenous peoples of color united by strength, home and relationships.

“We were very concerned about his own safety because he lived alone and we were quite concerned that he might end up hurting himself by accident. That’s when the wellness checks started. “

Temporary residents, such as international students and migrant workers, do not lose their health coverage in Canada while in “implicit status” awaiting an extension of their visas or in transition to become permanent residents.

It is not known when Belhadj lost his health coverage amid all that chaos, potentially causing him to default on his hospital bills.

According to submissions to the government court presiding over reviews of Belhadj’s arrest, a border agent met with a psychiatrist at Hillsborough Hospital on July 21, a week after his admission to the hospital, about the man’s mental state. .

In a letter, Dr. Michael Eleff said that the patient was diagnosed with severe schizophrenia with paranoia and disorganized thinking disorder.

“Despite the use of some illicit drugs in the community, even in the hospital, he is still fraught with mental illness and cannot cope outside the hospital at this time,” Eleff wrote, expressing doubts about the prospect of the patient’s release. in the next four to six weeks.

“He’s just too sick and lacks the insight, judgment and impulse control to live outside of the hospital right now.”

On August 3, the border agency issued an inadmissibility report against Belhadj concluding that his prognosis has been deemed “poor,” his recurring hospital admissions are costly, and the nature and severity of his schizophrenia would be expected to cause “Excessive demand” for health and social services. The annual threshold for that determination is set at $ 21,798.

In a notice issued for Belhadj’s arrest and detention at the hospital on August 13, a border agent said the man violated immigration law and had allowed his status to expire for more than a year.

“Mr. Belhadj is homeless and with nowhere to reside. Friends are no longer able to approach him due to behavioral issues,” the agent wrote, adding that the border agency was making an effort to explore alternatives to detention, including accommodation. in two facilities.

“Belhadj … can’t afford a phone, so phone notifications don’t seem like an option at this time.”

The agency recommended that Belhadj be better held in solitary confinement in the provincial jail than released in the community.

Ali-Faisal, who has called authorities to conduct wellness checks in Belhadj in the past, said he cannot understand why his friend is being treated as a criminal rather than for his mental health.

“We want to know why the Canada Border Services Agency would even consider itself a contact institution for a patient who is involuntarily in a psychiatric hospital,” he said.

Ali-Faisal said that Belhadj would be deported to Tunisia, where he only visited twice in his life, because his residence in Saudi Arabia was based on the employment of his father, who passed away two years ago. As an adult now, you need an employer to sponsor you to stay in Saudi Arabia or to send you back to Tunisia, where you have a sister.

In a review of the detention this week, the man’s lawyer told the court that his client had submitted a refugee claim on Monday, which will essentially derail Belhadj’s admissibility hearing scheduled for next Tuesday because his asylum claim must get treated first.

Despite concerns raised about Belhadj’s flight risk, court judge Cristian Jadue was satisfied with the release plan put forward by his supporters to provide him with fixed accommodation, 24-hour supervision, and a $ 5,000 bail, in addition to ensure that you attend to all necessary medical services. treatment.

During the detention review hearing, Belhadj’s designated representative Julie Chamagne, who was appointed by the court out of concern about her mental capacity to make decisions, said she was concerned about the continued incarceration of the man’s welfare.

“Detention in many cases exacerbates people’s mental health problems,” Chamagne said in advocating for their release. “Keeping Mehdi in custody on the grounds that it is his best interest is really a paradox.”

In light of this case, Gardam of Health PEI said it is important to review what services are provided to non-Canadian residents who do not have health insurance when authorities cannot deny them emergency care or emergency admissions.

“The image of a person of color leaving a health care facility into CBSA custody is alarming to marginalized and racialized communities,” said Gardam, who was chief of staff at Toronto’s Humber River Hospital and an outspoken ally on issues of racism.

“Despite the fact that in this particular case Health PEI did not do anything inappropriate or against the wishes of the patient, the perception shared on social media deters people from seeking care and is detrimental to the relationship between people and the health care system. . “

Nicholas Keung is a Toronto reporter covering immigration for The Star. Follow him on Twitter: @nkeung


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