Culture of secrecy around mental health must end

A report inspired by the Malcolm Beggs killing says lives come before privacy. JO-MARIE BROWN reports.

Malcolm Beggs, who was bludgeoned to death with an axe in 1999 by Lachlan Jones, had no idea his 19-year-old flatmate was a paranoid schizophrenic.

The fact that Waitemata Health kept such information secret - even from Jones' own family - was harshly criticised after the murder.

Now the Mental Health Commission has recommended that staff dealing with such patients be more open in disclosing information to family, friends, and other mental health agencies that come into contact with them.

Health Minister Annette King ordered the review on information-sharing last year after Auckland coroner Mate Frankovich said failures within the mental health system were to blame for the 1999 murder and Jones' subsequent suicide.

The commission's report, released yesterday, agreed that changes were required.

"Overall, there was insufficient understanding by mental health staff of their obligations to provide necessary information to other parties involved in the ongoing treatment and support of people with serious mental illness."

Staff needed more training on privacy legislation, while a change in "behaviour and culture" was needed to achieve greater openness, the commission found.

Malcolm Beggs' father, Brian, welcomed the findings, saying his 25-year-old son would have been alive today if a more open approach was taken three years ago.

"Malcolm was never given any information, and one of the main causes of his death was that no one ever told him a thing.

"[Meanwhile] Jones was getting inadequate care because no one was talking to anybody," Mr Beggs said yesterday.

The Beggs family hoped the recommendations would save someone's life in future and urged mental health clinicians to support the new proposals.

"There does need to be an attitude change," Mr Beggs said.

"The Privacy Act has been used a lot of the time just to fob people off.

"It's easier to say we can't give out information because of the Privacy Act then actually go to the trouble of putting information together and telling somebody."

The commission found that many clinicians were confused or misunderstood the Privacy Act and Health Information Privacy Code.

The legislation allowed them to pass information on to those likely to be affected, such as family and friends, if people posed a danger to themselves or others.

But changes in practice were needed, and staff should particularly improve their communication with individual patients and their families, the reviewfound.

Acting commission chairman Bob Henare said there were inconsistencies between clinicians because no clear, nationwide policy existed for staff to follow.

"It's not properly coordinated and it's not, above all, consistent," Mr Henare said.

"I think our staff across the board are doing their best and they're doing it according to what they know, but they need to know a lot more."

Mrs King said the Ministry of Health would now work with all District Health Boards and the Privacy Commissioner to form a nationwide policy protocol and implementation plan by June 30.

The commission would also be asked to review all health boards in 18 months to see that the changes had been made and whether they were proving effective.

"The solution is having clear policies on information-sharing as well as professionals who are well-trained, supported and informed about privacy issues."