Incapacity Case Study

The Investigation Committee refers matters to the Fitness to Practise Committee if it believes members are incapacitated to teach or to carry out their professional responsibilities.

Incapacity refers to a situation where a member suffers from a physical or mental condition that makes it necessary to impose terms, conditions or limitations or, in some cases, revoke or suspend the member’s certificate to protect the public interest.

Fitness to Practise hearings differ from disciplinary hearings. They focus on whether a member is incapacitated, for example due to illness, rather than whether the member committed an act of professional misconduct. Disciplinary hearings are open to the public. Fitness to Practise hearings are closed as they may deal with confidential medical matters.

The following account is based on facts from the type of cases the Fitness to Practise Committee deals with, and raises important questions about health, well-being, professionalism and employment. Details have been altered to respect confidentiality.

Parents began calling the school when they heard that a high school teacher swore regularly in class and yelled “shut up you f**ing retards” and “you’re all f**ing useless!”

The news greatly surprised the principal. The teacher had always acted professionally and was well-liked by students and staff. The principal set up a meeting to discuss her behaviour and to issue a disciplinary letter. The member was deeply embarrassed and confessed she had not been feeling herself.

Following the meeting, the teacher missed a number of days at work without notifying the school. She also failed to submit student marks on time for report cards. When the principal subsequently heard students were openly smoking and drinking beer in her class, he notified the board.

During the board’s investigation, a family physician confirmed the member suffered from bouts of depression, had trouble waking up in the morning and felt increasingly unmotivated by her work. The physician said he had prescribed an anti-depressant, but couldn’t confirm the member was taking it. The board placed the member on paid sick leave and reported her change in employment to the College.

Shortly after, the College received a handwritten letter from the member accusing the principal of launching a smear campaign to ruin her reputation. “Everyone is out to get me,” she wrote. “Now the board and the College are trying to frame me too.”

The Investigation Committee carefully reviewed the results of its investigation, including all legally available medical reports and written statements from the principal and students. The Committee was of the view that the member’s illness was affecting her ability to fulfill her professional duties and referred the matter to the Fitness to Practise Committee.

The member appeared before the committee and pleaded no contest to the allegations of incapacity. She confessed that, when she went to the pharmacy to fill her prescription, the pharmacist said the pills would make her feel like a zombie. She was so frightened by this information that she never took any of the medication. She recognized that this decision affected her work and her interactions with students, but still hoped to get better. Since taking sick leave, she had started to see a psychiatrist who testified at the hearing.

The psychiatrist reported that, in addition to depression, the member often saw dark shadows and heard voices. Her handwritten letter suggested early stages of paranoia. The psychiatrist explained that these symptoms were typical of depression and psychosis, a condition requiring counselling and medication. He said that if the member continued to receive treatment, her symptoms would almost certainly improve to the point where she could return to work.

If you were a member of the panel, what would you do?

The Outcome

Based on the medical evidence, the Fitness to Practise Committee agreed the member was incapacitated due to a mental condition or disorder. Given the psychiatrist’s evaluation and the teacher’s willingness to seek treatment, the committee decided to impose terms, conditions and limitations on the member’s teaching certificate.

The member could return to work gradually and on a part-time basis, provided her psychiatrist notified the College, in writing, that she was well enough to do so. The psychiatrist, with the member’s consent, also agreed to file regular medical reports to the College for three years and notify the College immediately if the member’s condition worsened or if they felt students might be at any risk of harm or injury.

The committee noted that these terms, conditions and limitations would support the member’s re-entry into the profession as well as serve and protect the public interest.

The Centre for Addiction and Mental Health (CAMH) reports that, in any given year, one in five Canadians experiences a mental health or addiction problem, and just 50 per cent of Canadians would tell friends or co-workers they have a family member with a mental illness.

If you noticed a dramatic change in a colleague’s behaviour, what would you do?