Psychiatrist pressures vulnerable patient to sell her his house

During the investigation, the man said he felt manipulated and pressured into selling his house. Photo / 123RF

A New Zealand psychiatrist has been found in breach for convincing her mentally unwell patient to sell his house to her.

Mental Health Commissioner Kevin Allan today released a report which found a psychiatrist and a nurse failed to maintain professional boundaries with their patient.

A man - who cannot be named for privacy reasons - was admitted to a public hospital for a five-day medical detoxification programme in June 2017.

His clinical notes showed he was facing challenges including a marriage breakdown and the possible sale of his home. Records also showed he was also "vulnerability of suicide risk".

The man self-discharged a couple of days later and a safety plan was put in place. However later that day, the nurse tried calling him six times but got no response so she and the psychiatrist went to visit the man at his house.

During this risk assessment visit they discussed the man needing to sell his house due to a relationship break up.

The man and his ex-wife later sold their house to the psychiatrist, with the nurse in frequent contact with the man to progress the sale and purchase of the property.

During the investigation, the man said he felt manipulated and pressured into selling his house and believed staff acted unprofessionally when he was in a vulnerable situation.

Allan was critical of the psychiatrist and the nurse saying they crossed professional boundaries.

"This case has reinforced the importance of professional boundaries in a clinician-patient relationship and demonstrated how engaging in financial transactions with a patient can compromise the therapeutic relationship," Allan said.

The commissioner found that the psychiatrist and nurse did not provide the man with services that complied with legal, professional, ethical, and other relevant standards and, accordingly, that they breached the Code of Health and Disability Services Consumers' Rights.

As a result of the investigation, Allan recommended that both the psychiatrist and nurse apologise to the man and complete relevant training.

He also advised that the Medical Council consider whether a review of the psychiatrist's competence was appropriate and that the Nursing Council do the same in regards to the nurse.

The Medical and Nursing Councils, and the New Zealand Medical Association, were told to consider reviewing their standards and guidelines, in light of this case, to give clearer guidance on the ethics of financial transactions between patients and providers.

The District Health Board, which was not named in the report, was also criticised for not providing relevant refresher training to staff but was not in breach.

Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Samaritans 0800 726 666
• If it is an emergency and you feel like you or someone else is at risk, call 111.