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Canberra Hospital Fails Duty of Care – Again

By 27 July 2011 47

As much as I hate trial by media once again I have to report an appalling case of Canberra Hospital dropping the ball when it comes to providing mental health services.

A young family member recently overdosed on illicit drugs in a Canberra nightclub and was taken to hospital by ambulance. The next morning he attempted to discharge himself in spite of clearly being quite ill and having a documented long history of mental illness. So of course the inevitable happens and he ends up getting only as far as Civic before having a psychotic episode putting himself and the public in danger. Thank goodness no one was hurt but I wonder if ACT Health would accept liability had you or your family been involved in this, which could have easily been the case.

I also would like to report how well the ACT Police handled this situation. It really shows how much they have stepped up to the challenge of dealing with these types of situations and I am very grateful to them for keeping my relative and the public safe in very challenging circumstances. I do think it’s a shame that they have to do ACT Health’s job for them and it’s obvious that even they are not happy about this.

The last straw in this incident was my conversation with the now infamous Crisis Assessment and Treatment Team. Remember them? The team that services suicidal people who then walk out and kill themselves?

I wish that I had recorded the conversation to play back here and highly recommend that people start doing this. Before attending the Police station to see my relative I called them to ask why he had been released and if I could return him to the hospital given his history and that he clearly was quite ill. I was trying to be proactive and prevent further incidences.

The response was that an evaluation had been done months earlier on this individual, and that if I returned to the hospital it would be a minimum of eight hours sitting in the emergency room before we would be seen. This was followed by the standard lecture on how triage works. Thankfully the ACT Government has spent hundreds of thousands of dollars on television ads to explain why they can’t provide services at the hospital unless you’ve had an arm ripped off or someone as stupid as me wouldn’t understand that.

I would like to explain to the Government that providing emergency services DOES NOT preclude also providing quick professional services to those in great pain or need who haven’t had their arm ripped off. If they would stop spending so much time and money telling us why they can’t do this they might actually be able to hire more staff and some people who know how to provide services. I for one, am very tired of being treated in a condescending manner by people who simply can’t rise to the challenge.

My relative is now recovering and dealing with the consequences of his actions. Thanks to the Police and family, this is one time where you won’t read about it on the front page of the Canberra Times.

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47 Responses to
Canberra Hospital Fails Duty of Care – Again
rescuedg 12:41 pm
27 Jul 11
#1

That sounds like a pretty terrible experience. However, I’d be clear to separate Canberra Hospital from Mental Health ACT, 2 different entities. Mental Health is dramatically understaffed in the ACT and across Australia. With Mental Health Nurses overloaded and put in unsafe situations almost daily due to the lack of staff (e.g. having to do home visits to psychotic patients alone) they often have no capacity to take on additional patients.

What I found really disgusting was when you look at the budget for ACT Health, during all of the talk of improving Mental Health services, Mental Health significantly underspent its budget.

colourful sydney rac 1:51 pm
27 Jul 11
#2

That sounds like a terrible experience, however, I am not sure what the hospital could have done, are you suggesting that they could have/should have detained him against his will?

I imagine this would be quite difficult given he presented to hospital on the basis of a drug overdose rather than for a mental health issue.

timeeh 2:25 pm
27 Jul 11
#3

Mental health (at least in the ACT) is absolutly appauling… close family member has “issues” and i have spent many hours in emergency after certain things happened… every time we left she was given the once over from a mental health “counseller” and informed that they would now be doing follow/check ups on her. But that was the last she would ever hear from them, I realise it is not all their responsiblity but really, why tell people that you are there to help them and will do so, then turn around and do absolutey nothing… Seems like a complete waste of tax payers money on a completely useless dept. Very similar to DOCS…

EvanJames 2:31 pm
27 Jul 11
#4

It’s so frustrating when they try to push mental health into the general health model. It’s not. And you can’t pretend it is. A person with their arm ripped off and a person going ballistic due to paranoia are not the same animal.

The national nonsense with their making it so much harder for mental health nurses to train as such and be credentialled hasn’t helped either. Here are people who want to deal with people suffering from mental health illness, and they’re putting obstacles in their way.

dazzab 3:03 pm
27 Jul 11
#5

colourful sydney racing identity said :

That sounds like a terrible experience, however, I am not sure what the hospital could have done, are you suggesting that they could have/should have detained him against his will?

That would have been the exact correct procedure given his mental health record and there are legal procedures used all the time to do just this. They didn’t do it because beds are tight or not available. That’s simply unacceptable.

colourful sydney rac 3:08 pm
27 Jul 11
#6

dazzab said :

colourful sydney racing identity said :

That sounds like a terrible experience, however, I am not sure what the hospital could have done, are you suggesting that they could have/should have detained him against his will?

That would have been the exact correct procedure given his mental health record and there are legal procedures used all the time to do just this. They didn’t do it because beds are tight or not available. That’s simply unacceptable.

I find it hard to believe that a hospital can forcibly detain someone who has presented for a non mental health matter on the basis that they have a past history of mental illness.

Eppo 3:21 pm
27 Jul 11
#7

I don’t think there should be any finger pointing at The Canberra Hospital here. I feel for you, but it seems you’re looking for someone to blame.

This person presented as a drug overdose, was treated and then decided to check himself out the next morning. On what basis does the hospital force him to stay? He has a history of mental illness, yes, but my grandfather has a history of heart problems. The hospital doesn’t force him to stay if he turns up with a broken arm. Unless this person had an episode of some sort whilst at the hospital, they are not to blame.

I can’t imagine these drugs are doing much good for a mental health issue either. Should maybe try and get off those…

dvaey 3:23 pm
27 Jul 11
#8

dazzab said :

That would have been the exact correct procedure given his mental health record and there are legal procedures used all the time to do just this. They didn’t do it because beds are tight or not available. That’s simply unacceptable.

Okay, so they should have detained him, and put him where? In a broom cupboard? Should they have detained him and arranged for his transport to AMC? Should they have kicked another patient out of a bed, to ensure that this individual was provided for, at the expense of another?

dazzab 3:47 pm
27 Jul 11
#9

colourful sydney racing identity said :

I find it hard to believe that a hospital can forcibly detain someone who has presented for a non mental health matter on the basis that they have a past history of mental illness.

Happens all the time. It’s not difficult at all to get a 24hr order to detain a person with a history of mental illness just for this very purpose. And believe me, you should be thankful for this.

Chop71 3:56 pm
27 Jul 11
#10

He made a choice and he overdosed.

Stop there (and think for a minute) before you put the blame on the hospital.

colourful sydney rac 3:57 pm
27 Jul 11
#11

dazzab said :

colourful sydney racing identity said :

I find it hard to believe that a hospital can forcibly detain someone who has presented for a non mental health matter on the basis that they have a past history of mental illness.

Happens all the time. It’s not difficult at all to get a 24hr order to detain a person with a history of mental illness just for this very purpose. And believe me, you should be thankful for this.

I can understand that this may be the case *if* the person presented with a mental health problem, but, I believe it would be out of line to section someone, on the basis of a past history of mental illness.

dazzab 3:59 pm
27 Jul 11
#12

Eppo said :

I don’t think there should be any finger pointing at The Canberra Hospital here. I feel for you, but it seems you’re looking for someone to blame.

Not blame. No point in that. Accountability would be nice though. If you do a crappy job at work does your boss just let it slide? These people work for us and should be accountable to us. Again, if my relative had driven a car head on in to you and you suffered a lifetime of consequences, would you feel the same?

Eppo said :

This person presented as a drug overdose, was treated and then decided to check himself out the next morning. On what basis does the hospital force him to stay?

A clear danger to himself and the public seems like a reasonable basis to me. I didn’t say this in the article but this same person was on the front page of the Canberra Times about 18 months ago after a siege in Civic which caused quite a bit of problems for innocent people. Again, I think once you are one of them you will have a much different opinion.

colourful sydney rac 4:08 pm
27 Jul 11
#13

dazzab said :

Eppo said :

I don’t think there should be any finger pointing at The Canberra Hospital here. I feel for you, but it seems you’re looking for someone to blame.

Not blame. No point in that. Accountability would be nice though. If you do a crappy job at work does your boss just let it slide? These people work for us and should be accountable to us. Again, if my relative had driven a car head on in to you and you suffered a lifetime of consequences, would you feel the same?

Eppo said :

This person presented as a drug overdose, was treated and then decided to check himself out the next morning. On what basis does the hospital force him to stay?

A clear danger to himself and the public seems like a reasonable basis to me. I didn’t say this in the article but this same person was on the front page of the Canberra Times about 18 months ago after a siege in Civic which caused quite a bit of problems for innocent people. Again, I think once you are one of them you will have a much different opinion.

Okay, nowhere in your original post did you indicate that he was exhibiting any signs of mental illness – was he?

timeeh 4:08 pm
27 Jul 11
#14

Eppo said :

I can’t imagine these drugs are doing much good for a mental health issue either. Should maybe try and get off those…

I bet there doing alot better for him than mental health services….

dazzab 4:10 pm
27 Jul 11
#15

Chop71 said :

Stop there (and think for a minute) before you put the blame on the hospital.

I hope you are capable of taking your own advice and indeed have a think about it. The issue of making bad choices and how society deals with mental heath issues are quite separate. I know plenty of people with mental health issues who have had similar experiences that didn’t overdose if that makes a difference to you. Have a friend explain it to you if it’s too complex.

colourful sydney rac 4:11 pm
27 Jul 11
#16

Have you contacted the Ombudsman about this?

alaninoz 6:03 pm
27 Jul 11
#17

dazzab said :

A clear danger to himself and the public seems like a reasonable basis to me.

How do you tell beforehand that someone is going to have a “psychotic episode”? If his previous history makes him likely to have a psychotic episode and so be “a clear danger to himself and the public”, then wouldn’t permanent restraint be appropriate?

No opinion, just trying to follow the logic.

MERC600 6:04 pm
27 Jul 11
#18

Do us all a favour, buy him a one way bus ticket to Brisbane. If he wishes to continue to do self harm, he won’t get frost bite. Sorry but know a couple of people with ‘difficulties’, but they don’t go to nightclubs to hop onto illicit drugs.

Special G 7:00 pm
27 Jul 11
#19

You’re not going to find any sympathy here.

From your original post you mentioned he went to TCH from a drug OD. He was still sick
(medically) and checked himself out – if he’s an adult he can do that against medical advice. If he was displaying suicidal tendencies or stated he was going to hurt other people then sure he could have been detained – but you missed that part.

You could have checked him into a private mental health clinic if you were unhappy with the publc system.

Can’t detain someone on previous history either mental health or criminal – it’s called against their human rights. If you could there would be far fewer psychotic episodes and crime.

NoAddedMSG 7:13 pm
27 Jul 11
#20

I have the CAT team on speed dial (man I hate their on-hold music), and I have dealt with them enough now to know that they need some evidence that the mental health problem is current and urgent (because let’s face it, not all mental health problems are urgent or going to lead to suicide, and some can be dealt with through a GP the next day). So, even if someone has a history of alcohol-related suicide attempts, the fact that someone is exceptionally drunk is not enough to trigger a response – they have to be drunk and talking suicide. It’s just how it works unfortuantely, they just aren’t resourced to deal with the “maybes” – they can only deal with the “definitelys”. So, unless there was any suggestion the drug overdose was deliberate, or he was talking about being the reincarnation of Jesus who was going to purge the world as he checked out, I can see how they would have discharged him.

I have a lot of sympathy for you though, I have had times as well when I have felt very strongly that someone with a mental health problem needs to be sitting in hospital for at least a day or two, and they are out in a few hours. It’s tough.

LSWCHP 7:17 pm
27 Jul 11
#21

MERC600 said :

Do us all a favour, buy him a one way bus ticket to Brisbane. If he wishes to continue to do self harm, he won’t get frost bite. Sorry but know a couple of people with ‘difficulties’, but they don’t go to nightclubs to hop onto illicit drugs.

What MERC600 said.

Knowing he had mental problems, this guy chose to go and take illegal drugs in a nightclub. This is stupid thing to do under any circumstances, but especially so if one has “issues”. Instead of blaming the hospitals, the mental health system, used car salesmen or anybody else, how about pointing the finger at the individual who caused the whole shambles as a result of his choices and his actions.

If he hadn’t made the choice to go out clubbing and eat some ecstasy (or whatever it was) then this would not have happened, and that’s the truth of it.

Chop71 8:40 pm
27 Jul 11
#22

I also hear Vancouver is a wonderful city this time of year

steveu 8:44 pm
27 Jul 11
#23

Sorry to hear you had such an experience – and I dont think you are alone in this. Ignoring the fact that the relative committed a criminal act, and there was contributory negligence to the escalation of their condition as a result of this….There were big promises made in the Health Budget for Mental Health and I think the ACT Government should be brought to account as to why this money hasnt started to be funnelled through. They are chronically short staffed, and are forced to take great risks and will just about always handball patients who are in dire need of care to family or friends. It is very difficult for family to get orders in place to protect the patient – which unfortunately often ends in tragedy, or at least a lack of sufficient treatment for the patient.
Again, sorry to hear about the repeated failure of our mental health system.

dazzab 9:22 pm
27 Jul 11
#24

LSWCHP said :

If he hadn’t made the choice to go out clubbing and eat some ecstasy (or whatever it was) then this would not have happened, and that’s the truth of it.

I love this type of statement. I hope a few of you who made it either smoke or stuff yourself with foor until your weigh 200Kgs, both of which are very common. By your values those who contract cancer from smoking or those who have to deal with the many many health issues associated with obesity deserve their fate because they are to blame.

I don’t know what planet you live on but the one I live on is full of human beings who do all sorts of silly and stupid thing for a wide range of reasons. I’m happy that in spite of this, some of us take care of each other.

For those of you taking the high moral ground, careful what you wish for.

For of those who mentioned he’s an adult and checked himself out, I take your point. However, when I picked him up at the Police, they knew he was still quite ill and possibly dangerous or they wouldn’t have detained him in the first place. I can’t believe you think the legal process is more appropriate for that then the health system.

Great comments here and I appreciate all of them including those I don’t agree with. Thanks.

miz 9:30 pm
27 Jul 11
#25

I am so sorry this has happened. I can only say this kind of thing happened to a family member of mine – they just would not listen to the carers, and kept allowing him to discharge himself (or they discharged without telling any family member and we found him outside the hospital, looking lost and confused).

They have to stop trying to separate drug and mental health problems, particularly when there is a history.

It’s a constant cycle – referred to Emergency by private psych, wait for hours while a hosp psych gets called in, eventual assessment, assessed as not critical nough for PSU (translation – no beds available, or, mentally ill person says what staff want to hear to enable discharge, and ignore carers – after all, the person has been thru the system enough times to know what to say. Often they WANT to go home – but actually NEED treatment), carer is told to take person home and contact Mental Health next day. No help for families whatsoever, no treatment for ill person, and no care or responsibility taken by Health department.

If only they would just keep these ill people in hospital until they are actually well.

Ben_Dover 8:41 am
28 Jul 11
#26

Another one then.

“My son / daughter /relative / friend took drugs and ended up in strife, it’s not their fault. No service in Canberra is good enough, and the hospital /police / mental health / CATT / doctors / nurses / uncle Tom Cobbley and awl are all to blame. Everybody else in the world should listen to me and do what I want, as I’ve obviously done such a good job so far, and of course I can play the “mentally ill card” to excuse all the behaviour of the person who went out and got stoned out of their box to absolve them of all responsibility.”

Eppo 8:51 am
28 Jul 11
#27

dazzab said :

For of those who mentioned he’s an adult and checked himself out, I take your point. However, when I picked him up at the Police, they knew he was still quite ill and possibly dangerous or they wouldn’t have detained him in the first place. I can’t believe you think the legal process is more appropriate for that then the health system.

Great comments here and I appreciate all of them including those I don’t agree with. Thanks.

You stated that ‘the inevitable’ happened when he got to Civic and he had an episode. So was he ‘ill’ at the time he left the hospital or not? According to your initial post, he was not. Therefore the hospital is not to blame. He had an episode when he got to Civic. Do you expect the hospital staff to be clairvoyants? To anticipate what would happen in 30+ mins time? Given he was ill when he got to civic and not when he was at the hospital, the police had to deal with it. Is that the best option? Of course not, but again, unless you expect hospital staff to see the future…..?

I honestly don’t know what you expected to happen.

Your comments regarding smokers and the obese are not surprising. You don’t blame someone for sticking a cigarette in their mouths when they get cancer? You don’t blame someone for getting fat when they eat too much? Who else is to blame then? It shows a tendancy to try and externalise the blame, which it seems this post is all about.

Again, I’m sorry that you have to go through these things, but trying to blame everyone else isn’t going to solve anything.

Classified 9:31 am
28 Jul 11
#28

Sounds like a sad situation, and mental health aren’t as organised and resourced as they could be. But given the person presented with a self-inflicted illness caused by an illegal activity, checked themself out against medical advice, and then it would seem went back to civic, I think some clear direction for the person in question is the most important thing.

colourful sydney rac 9:33 am
28 Jul 11
#29

Again, I have to ask – have you contacted the ombudsman about this?

KaptnKaos 9:36 am
28 Jul 11
#30

Eppo said :

trying to blame everyone else isn’t going to solve anything.

+eleventybillion
There is no helping someone who does not want to be helped.

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