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Lorraine Johnson, foreground, holds a photo of her son, Brian David Geisheimer, 30, as Deb Nolet, with a photo of her daughter, Sarah Louise Charles, talks toKim Young outside the B.C. Coroner’s Service in Burnaby, B.C., on Wednesday.John Lehmann/The Globe and Mail

The parents of a man who died by suicide after walking away from Abbotsford Regional Hospital say the facility failed to care for him properly and did not involve family even when requested, a coroner's inquest has heard.

Brian David Geisheimer, 30, was involuntarily admitted to the hospital in mid-December, 2014, after attempting to harm himself. But two weeks later, he left the facility and was found dead in Mission, B.C.

The inquest, which began on Wednesday in Burnaby and is scheduled to run through next week, aims to ascertain the facts relating to the deaths of Mr. Geisheimer and two others in similar circumstances. It is expected to explore the intersection of mental health, safety and privacy rights – an issue recently highlighted by The Globe and Mail – with the aim of preventing similar deaths in the future.

Sebastien Pavit Abdi, 19, and Sarah Louise Charles, 41, both of Abbotsford, also died by suicide shortly after leaving Abbotsford Regional Hospital, where they were admitted separately for mental-health reasons. The three deaths occurred between December, 2014, and April, 2015.

On Wednesday, Mr. Geisheimer's parents told a coroner's inquest they made repeated attempts to get involved in his treatment plan after the initial hospitalization, but were denied meetings with physicians. As well, the parents told the judge and five-person jury that even though hospital staff told them their son was high-risk and would be closely monitored, he was able to walk away from the facility.

"If I heard it once, I must have heard it 15 times: 'He's high-risk and we're keeping a very close eye on him,'" his mother, Lorraine Johnson, testified.

"He was not safe."

Daryl Geisheimer, who brought with him to the witness stand a framed photo of his sharply dressed son, added: "I was trying desperately to get involved [in his treatment]."

Mental health advocates have noted that the recommendations produced from similar inquests have not been enacted. For example: A 2009 inquest into the death by suicide of Ross Alexander Allan at the old Matsqui-Sumas Abbotsford General Hospital after being admitted for mental-health reasons, produced 43 recommendations. They included that B.C.'s Mental Health Act be revised to allow family members to be involved in treatment plans, and that health-care workers recognize their responsibility to ensure that patients delivered to hospital under the act cannot leave without permission or wander freely about the hospital.

"If they had implemented the recommendations, changed their policies … Brian might well be alive today," Ms. Johnson said in an interview. "The jury and the coroners service can make as many recommendations as they want, but if they're not going to be implemented and followed through and regulated, then I don't know."

Ms. Johnson expressed frustration at the feeling that physicians, hospital administrators and staff from the health authority were "passing the buck" in determining what led up to her son's death.

Brian Geisheimer's parents also spoke of feeling unsupported by the hospital and the Fraser Health Authority throughout their son's hospitalization and after his suicide. Ms. Johnson said she received no advice or counselling on how to support her son; Mr. Geisheimer struggled with his own mental health during and after the ordeal.

In an earlier interview with The Globe, Nigel Fisher, program medical director and regional department head of mental health and substance use at Fraser Health, said that if adult patients do not consent to family involvement, policy dictates staff can disclose patient information to them only "when there is an immediate and significant risk to the patient's health."

Most of Wednesday's proceedings were taken up with testimony from Brian Geisheimer's parents. Witnesses scheduled for coming days include the mothers of Mr. Abdi and Ms. Charles, physicians, psychiatrists and police representatives involved in their cases.

Deb Nolet, mother of Ms. Charles, said on Wednesday she hopes for accountability.

"Without accountability, the recommendations do not have to be followed."

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