Coroner Peter Ryan wants the Hawke's Bay DHB to consider whether its current policy around mental health in-patients is enough. Photo / File
Coroner Peter Ryan wants the Hawke's Bay DHB to consider whether its current policy around mental health in-patients is enough. Photo / File
A coroner is recommending policy reviews for the Ministry of Social Development and Hawke's Bay's District Health Board after the suicide of a Hastings man.
Coroner Peter Ryan is asking MSD to look at the way it assesses benefits for people experiencing a mental crisis.
Ryan also wants the DHB to reassess how it deals with people with addictions, and to consider the involvement of family members of at-risk patients.
Graeme Duncan Fothergill died on January 27, 2020, aged 46.
In the recommendations, Ryan noted that Fothergill had an increased alcohol intake and anxiety attacks before his death.
Family and agency support for Fothergill was difficult as he believed he did not have a drinking problem and feared if he reduced his drinking, his anxiety attacks would worsen.
Ryan's findings also recorded the views of Fothergill's ex-partner.
She expressed concern there was no urgent action to help him by the DHB, because of his denial of his addiction, and that he should not have been discharged from the mental health service because of his severe depression score.
She also stated that there was a long delay between Fothergill finishing his employment and the provision of a benefit from Winz.
She stated that she considered his financial difficulties to be a factor in his anxiety, along with the "glacial pace" of obtaining support from MSD.
Ryan recommended the DHB should consider finding ways to treat severely at-risk mental health patients despite the patient's refusal to address their addictions.
He also said the DHB should consider whether its current policy and practice adequately and properly provided for consultation with close family members for mental health in-patients regarding the care and treatment plans for those patients.
And it should consider whether appropriate weight was placed on the involvement and views of close family members with overall patient management.
The Hawke's Bay DHB said it will consider ways of improving its engagement with at-risk mental health patients. Photo / Warren Buckland
HBDHB chief operating officer Chris Ash told Hawke's Bay Today the DHB had only recently received the coroner's final report and needed to take time to fully review it.
"The DHB does, however, accept the coroner's recommendations and will consider finding ways of improving how it engages and treats at-risk mental health patients with addiction issues."
The coroner also recommended that MSD should consider establishing a priority system for clients who were significantly at-risk of self-harm and for whom delays in providing support were likely to exacerbate their distress and increase that risk.
In response to the recommendations, MSD deputy chief executive Viv Rickard said they were "carefully" considering the coroner's report and recommendations.
"We did provide some information in response to the provisional findings of the Coroner where we set out our approach to dealing with persons at risk of self-harm," Rickard said.
"We recognise a model of "recognise, ask, get help" (RAG). This entails recognising those at risk of self-harm, asking the right questions empathetically, and to get help. Getting help can involve contacting other agencies."
The coroner recommended that MSD should consider establishing a priority system for clients who are significantly at-risk of self-harm, following the death of Graeme Fothergill. Photo / Paul Taylor
The DHB made submissions to the coroner pointing out that the Mental Health and Addictions Service had worked in collaboration with the Ministry of Social Development (MSD) in the development of a new "Crisis Hub".
The DHB said it also planned that alongside clinical staff will be a peer support workforce to assist and support individuals through their journey.
"I am encouraged by this initiative," Ryan said.
"It is likely to help reduce the stress on already distressed people who are navigating the process of obtaining the requisite financial assistance."
The coroner noted the DHB had initially misinterpreted the purpose of his recommendation to consider finding ways to treat severely at-risk mental health patients despite the patient's refusal to address their addictions.
"It is not aimed at treating the addiction, but rather treating the underlying mental illness of the patient with the addiction," he said.
"It is unclear to me whether a person with a mental illness and an addiction can be helped with their mental illness without first being helped with their addiction issues."
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