Case Number CSU-2010-AuK-001077 2012 NZCorC 88 CIRCUMSTANCES: The deceased committed suicide. He had a history of recurrent endogenous depression and suicidal ideation. in the period immediately before his death the deceased had become very depressed. Four days prior, the deceased threatened to take his own life but was stopped by his wife. Neither he nor his wife told anyone of these events. On the day of his death the deceased’s wife became sufficiently concerned about her husband to phone the WDHB (Waitemata District Health Board) mental health services. she spoke to a member of the intake and Assessment Team and said that she was fearful that her husband might harm himself and explained what had occurred four days earlier. The staff member told her that another staff member would phone her husband after he got home that evening. she was told to call the police if he threatened to self harm and if she thought there was imminent risk. When the deceased came home he was still upset and later told his wife that he had had enough. Later that evening the deceased took his own life. WDHB clinical records state that a member of the intake and Assessment Team tried to contact the deceased on both the home phone and his mobile phone that evening around 9.30pm, without success. The deceased’s wife said she did not hear the phone ringing and expressed concerns that the mental health services were not more proactive and did not visit her husband. WDHB mental health services reviewed the care and decision making on the day of the call to them and were of the view that while more ‘assertive’ intervention to assess the deceased was an option, the circumstances did not clearly indicate that a more urgent response was required. COMMENTS AND RECOMMENDATIONS: The coroner accepted that the clinical judgment made not to make an immediate urgent visit to the deceased was not unreasonable and that a member of the intake and Assessment Team did try and contact the deceased that evening. However, the coroner commented that looking at the issue from the wife’s perspective, it is easy to understand her feelings that the response to her call to the mental health services for help did not seem sufficiently proactive. She was living with a man she knew was distressed and unhappy and who had threatened to kill himself four days previously. She did not seek help at that stage, but the deceased’s palpable distress on the day of his death was the catalyst for her to do so. When she called the intake and Assessment Team she was given sensible and practical advice to call the police if her husband threatened to kill himself and she felt there was imminent risk and was told to wait for a phone call from a member of the intake and Assessment Team to her husband. This meant that unless she made a 111 call she did not have any other positive plan of action for how to seek assistance or support if she felt concerned about her husband while she waited for the call from mental health services. The coroner recommended that WDHB Mental Health services reflect on the response to the wife’s call of 18 August 2010 and consider whether, in similar circumstances in future, the intake and Assessment Team should routinely give more proactive, practical advice to ensure the person making the referral knows how or where to seek further help or support in the period before the mental health service responds.
Posted on: Thu, 11 Jul 2013 04:21:16 +0000
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