'It seems to be she was silenced,' mom says as Ontario inquest examines death of Indigenous inmate
'My daughter was going to tell me something and I'll never hear those words,' Delilah Blair's mom says
Sitting through an inquest into her daughter's death, Selina McIntyre says the hardest part is "knowing my daughter wanted me and I wasn't there."
McIntyre, of Hay River, N.W.T., spoke to CBC News after testifying before a coroner's jury in Windsor, Ont., that's examining the death of Delilah Blair, an Indigenous woman with Cree ancestry. Blair died by suicide after she was found without vital signs in her cell at the South West Detention Centre (SWDC) on May 21, 2017.
Her mom testified at the inquest, which began Monday, that she didn't know her 30-year-old daughter had been in jail since April until she received a call about her death.
"[My] first thought after she told me she passed, 'Can I hang it up and then it's not real?' I was so upset," McIntyre told CBC News.
Since then, McIntyre has learned her daughter made two written requests to speak with her mother. Two weeks before her death, the inquest was told, Blair wrote: "Can I please phone my mother? Cause I need someone to talk to. Please and thank you." It's unclear what jail staff did with those inmate request forms because they weren't filled out correctly.
Seeing those words in writing created waves of emotion for McIntyre.
"My daughter was going to tell me something and I'll never hear those words from her. It seemed to be she was silenced for some reason."
WATCH | Selina McIntyre talks about the 'most hurtful part' of listening to the inquest:
Blair, a mother of four, was in the Northwest Territories and Winnipeg for years before arriving in Windsor. McIntyre flew more than 4,000 kilometres from Hay River to get answers about how her daughter died.
The family's Indigenous roots and Cree culture have been an important piece of this inquest.
Jurors heard none of the jail staff who testified this week even knew Blair was Indigenous. There was no Indigenous programming offered in the women's mental health unit, elders weren't accessible and at the time, there wasn't a Native Inmate Liaison Officer.
"To not recognize the need to understand or acknowledge that Indigenous inmates or women that find themselves in custody have different needs ... just disregards everything we've been talking about, everything we know, everything commissions have told us," said Christa Big Canoe, legal director with Aboriginal Legal Services and counsel representing McIntyre during the inquest.
"It's somewhat disappointing that in 2022, we've heard time and time again, we didn't know at the time she was Indigenous. It's not good enough. We need to do better."
WATCH | McIntyre describes the moment she got a call about daughter Delilah Blair's death:
An inquest is automatically called under the Ontario Coroners Act after someone dies in custody, unless the death is from natural causes. A coroner's jury can't assign blame or fault, but is tasked with determining the circumstances of a death and developing recommendations to prevent similar deaths.
Mom hopes inquest is a 'wake-up call'
Blair became an inmate at the SWDC in April 2017. At the time of her death, she was awaiting sentencing after she pleaded guilty to a robbery charge.
Now, McIntyre said, her "baby's at peace." But in her eyes, she hopes "some kind of wake-up call" comes of this inquest.
"This has to stop. Native girls, men, boys. This has to stop. Stop doing this to our people," said McIntyre. "There has to be training, and understanding and humanity for our people. Not another girl goes out this way, and that's what I want."
When correctional officers found Blair in her locked cell at 8:01 p.m. ET the night she died in hospital, the jury heard she had no vital signs.
No defibrillator brought to Blair's cell, jury hears
Several jail staff who have already testified also said an automated external defibrillator (AED) was not brought to Blair's cell during the emergency response. It wasn't until 8:13 that paramedics arrived with an AED — 12 minutes after they found Blair unresponsive.
Matthew Sulatycki is a registered nurse who was part of the health-care team that responded to Blair's cell on May 21, 2017.
He testified Friday that two emergency response bags were taken to the 30-year-old's cell, but neither had an AED. They are not currently included in those bags, and never were, he said. Sulatycki said that may be due to cost.
"I would have liked if an AED would have showed up … I can't say whether it would have made a difference. It may have, it may not have," Sulatycki testified.
There are 11 AEDs at the SWDC, the jury heard. Although Sulatycki admitted to not knowing policies "super well," he believes the protocol says a correctional officer with the rank of sergeant is responsible for bringing an AED to an emergency.
"I believe that policy was in place [before Blair's death]," Sulatycki testified, saying he remembers doing some research to understand "what went wrong."
During the inquest, the jury also heard from an expert who called conditions Blair experienced "appalling."
The women's mental health unit at the SWDC "is more like segregation to me, in terms of the way it's looking" and not a "therapeutic space," testified Kelly Hannah-Moffat, who's done research and consultant work on justice issues for both the Ontario and federal governments.
She's also specifically researched conditions of confinement and prison reform.
In Blair's case, she also had what's known as an inmate care plan. It contained details about watching for signs of depression, anxiety, withdrawal and psychosis. Hannah-Moffat said those documents are "absolutely critical" for people inside jail mental-health units.
However, two of the correctional officers who were responsible for Blair's care during her time at the SWDC testified they knew nothing about her inmate care plan. In fact, they testified they were unaware how to access any inmate's care plan, even in 2022.
The inquest is scheduled to continue until June 30.
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