For more than two weeks an inquest into the death of a Palmerston North mental health ward patient has examined events leading to his suspected suicide.
Shaun Gray. Photo: Supplied
On Thursday, the hearing was told about a different side of 30-year-old Shaun Gray, a father of one who loved animals.
"As you have heard in this inquiry, he was a prescribed drug addict," Gray's mother Christine said.
"We as a family don't dispute this."
Gray died on 16 April 2014 at the mental health ward's high-needs unit.
He was admitted to the ward after being taken to the hospital's emergency department the day before, following an overdose.
Christine Gray said her family wanted the inquest to hear about the rest of his life and personality.
"He had a rainbow lorikeet named Ratbag. Ratbag was never in a cage, but was on Shaun's shoulder most of the time."
Gray was also a loving father.
"Shaun was never judgemental of anyone. In fact, Shaun was known to sit and talk to homeless people, even sharing his smokes with them."
Christine Gray said her son was like an orange: "You needed to peel the skin back to get to his heart".
"We as a family have found it very hard reliving the last part of his life. Our wish is for this inquiry to make a lot of changes for the better, so that people stop dying unnecessarily, and to get the care vulnerable people need and deserve."
Gray's death and the suspected suicide of another ward patient, Erica Hume, a month later triggered reviews that found the ward not fit for purpose.
A new one is under construction, but since 2014 there have been more deaths.
Between 2018 and 2021, Dr Vanessa Caldwell was in charge of the MidCentral District Health Board's mental health and addiction services.
Dr Vanessa Caldwell. Photo: RNZ / Jimmy Ellingham
She told the inquest about improvements introduced over that time, and getting the business case for the new ward over the line.
Dr Caldwell was asked about comments a former ward nurse and union rep made last week, saying nothing had changed at the ward, which lacked leadership.
"Whilst there would be no disagreement that the facility itself is not fit for practice and makes a hard job even harder, I would have to respectfully disagree with the suggestion that there have been no changes," she said.
Those changes covered everything from information sharing to training.
"Following this tragic event I consider that significant improvements have been made to practices on the ward.
"These improvements have been focused on patient safety as well as wellness and recovery, and family involvement in care planning.
"Staff numbers have also increased and dedicated roles for education and patient safety have been created."
Under the watch of MidCentral, Gray was prescribed high amounts of medication in 2013, before these were scaled back in 2014.
David Chaplow. Photo: RNZ / Jimmy Ellingham
Expert witness Dr David Chaplow suspects many factors played a role in Shaun Gray's suicidal intent.
"It's difficult to know what set him off. I suspect it was the long road he had travelled with addiction, with his irritation of having his medication changed, with his irritation of coming to the pharmacy and expecting one thing and getting another, then his exasperation of taking his overdoses."
The inquest is expected to finish on Thursday evening.
Coroner Matthew Bates is expected to reserve his decision.
