Psychiatrist, mental health team criticised over level of care for longtime patient

5:04 pm on 26 June 2023
generic hospital ward

File image. Photo: befunky.com

This story discusses suicide and may be upsetting for some readers.

Te Whatu Ora Capital, Coast and Hutt Valley and a psychiatrist at its Community Mental Health Team (CMHT) have been found in breach of the Code of Health and Disability Services consumers' rights after a man's death.

The man, in his 60s, had been in the care of two psychiatrists and the crisis contact centre run by the Mental Health, Addiction and Intellectual Disability Service for a number of years.

In 2019, the man's parents became concerned about their son's depressive state, agitation, panic attacks, mood swings, inability to sleep, and talk of suicide. The man harmed himself and died in hospital.

Deputy health and disability commissioner Dr Vanessa Caldwell found Te Whatu Ora Capital, Coast and Hutt Valley in breach of right 4(5) of the code, which gives consumers the right to cooperation among providers to ensure quality and continuity of services.

In particular, inadequate documentation kept by the contact centre and CMHT contributed to inconsistent approaches to the man's care, and culminated in the collective failure by several clinicians at a whānau hui to offer appropriate support to the man.

Dr Caldwell also found the psychiatrist breached right 4(5) of the code for a lack of co-operation with the man's general practitioner to ensure quality and continuity of care.

"I am concerned about the psychiatrist's lack of engagement with the man's GP, particularly regarding changes in the man's treatment and the reduction of antipsychotic medication," she said.

Dr Caldwell recommended Te Whatu Ora Capital Coast and Hutt Valley write an apology to the man's family and update its internal policies to require CMHT psychiatrists to provide regular written updates to other treating clinicians (in particular, primary care providers) within an appropriate time frame.

Te Whatu Ora said it had made a number of changes in response, including ensuring one of its mental health teams has reviewed its whānau/ family participation policy.

This needed "to ensure care, transition planning and exit processes incorporate practices that support collaborative planning and outcomes", Te Whatu Ora said.

Where to get help:

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: free counselling for 5 to 19 years old, online chat 11am-10.30pm 7days/week or free phone 0800 WHATSUP / 0800 9428 787 11am-11pm Asian Family Services: 0800 862 342 Monday to Friday 9am to 8pm or text 832 Monday to Friday 9am - 5pm. Languages spoken: Mandarin, Cantonese, Korean, Vietnamese, Thai, Japanese, Hindi, Gujarati, Marathi and English.

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

OUTLine: 0800 688 5463 (6pm-9pm)

If it is an emergency and you feel like you or someone else is at risk, call 111.