‘Reprehensible’: hospital slammed after discharging homeless, mentally ill patient three times

Albert McKnight 1 April 2021 43
Canberra Hospital

Canberra Hospital. Photo: File.

A damning report has slammed ACT Health’s decision to remove a homeless, mentally ill patient from hospital care several times.

The 33-year-old, who has a diagnosis of schizophrenia, was discharged from psychiatric care on three occasions in February and April 2020 and went on to light seven fires around Canberra.

In an ACT Supreme Court judgement, forensic psychiatrist Dr Richard Furst blasted ACT Health over its handling of the case.

He said discharging the patient three times while he was in a psychotic state, without stable accommodation and without a feasible discharge plan, was “reprehensible and negligent in the extreme”.

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“Furthermore, it is only through good luck, rather than good management, that neither [the man] nor any member of the community were seriously injured or killed as a consequence of those grossly deficient episodes of ‘care’ and poorly thought-out discharge plans,” Dr Furst said.

He said the Canberra Hospital’s “failure” to adequately treat and detain the patient – which it should have done due to its duty of care and the provisions in the Mental Health Act – was the “indirect but substantive cause” of the fires the man started.

The agreed statement of facts showed, over the course of an hour, the man lit seven fires in Woden early in the morning of 12 May 2020, starting with a fire at the Woden Hotel which damaged the building’s interior as well as its outside walls before it was extinguished.

He then set six public rubbish bins on fire at Woden’s Westfield Shopping Centre, including near the Australian Red Cross store, McDonald’s restaurant and Hoyts Cinema. He was arrested four hours later.

READ ALSO: Coroner says Canberra Hospital ‘failed’ four patients who took their own lives

When the matter came before the ACT Supreme Court, Justice Chrissa Loukas-Karlsson accepted his pleas of not guilty by reason of mental impairment to a charge of arson as well as six counts of damaging property and ordered him to submit to the jurisdiction of the ACT Civil and Administrative Tribunal.

Justice Loukas-Karlsson said the man’s schizophrenia meant he “could not control the conduct when carrying out the offences”.

Dr Furst called for an independent review of systems at the Canberra Hospital and community mental health services focusing on the discharge planning process for chronically psychotic and dangerous patients who are mentally ill, homeless and pose an unacceptable risk when discharged.

Emma Davidson

Minister for Mental Health Emma Davidson. Photo: Michelle Kroll.

In response, Minister for Mental Health Emma Davidson said the ACT Government was constantly reviewing and improving processes and procedures but did not directly answer questions about what the government would do to ensure the situation was never repeated.

“Recently we’ve implemented a number of initiatives including the refurbishment of a 10-bed sub-acute extended care unit on the site of Brian Hennessy House,” she said.

“The unit, which opened this week, is for transitional and rehabilitation accommodation for people with enduring mental illness.

“Another 10-bed unit will be developed over this term of government.”

Ms Davidson also said the Adult Community Mental Health Team was operating a pilot program to improve how to meet the needs of people experiencing mental illness and homelessness in the city catchment area.

“The pilot aims to provide people with an assertive response from a designated sub-team to meet their short-term needs and then step them down to standard clinical management for ongoing and more longitudinal care,” she said.

If you or anyone you know is struggling and needs help, contact Lifeline on 13 11 14 at any time or visit www.lifeline.org.au.

If you are concerned about someone’s immediate safety or wellbeing, call 000.

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43 Responses to ‘Reprehensible’: hospital slammed after discharging homeless, mentally ill patient three times
Weskal Deskal Weskal Deskal 4:25 pm 04 Apr 21

This is ultimately the failure of our politicians. They’ve had many, many decades to implement legislation to protect mental health patients from this kind of health system incompetence from happening; and it should be nation wide and not up to the whims of local governments. This and the embarrassing criminal lack of funding to ensure these sick people are properly cared for and not homeless. The pretense of these highly over paid and under productive public servants is evident when they allow this gross lack of duty of care to happen, but won’t allow terminally ill people the dignity to end their suffering in a medically assisted environment. Shame on them!

Brianna Brianna 6:57 pm 03 Apr 21

Quite frankly, there is just not enough funding for mental health. You know there’s a massive problem when a person can be released from AMC and into a housing property but someone with mental health problems just end up on the street.

Jenny Rath Jenny Rath 6:48 pm 03 Apr 21

There is a nsw health policy that you can’t discharge someone into homeless ! Sadly must not be for AcT

Linda Stapleton Linda Stapleton 4:51 pm 03 Apr 21

Services in this area are obviously lacking. Follow up is obviously lacking. It is a shame.

Ray Polglaze Ray Polglaze 10:18 pm 02 Apr 21

A further problem is that people with severe mental health and drug problems are being housed in public housing where they are predictably causing great damage to the public housing properties and placing at risk the safety of themselves, the surrounding tenants and the broader community.

Canberra desperately needs long term mental and drug treatment hospital where people with severe long term mental health and drug issues can receive humane treatment and live reasonable lives. I say mental health and drug issues because these often go together.

This is a problem that must be pulled out of the too hard basket and addressed with real funding and action. There needs to be enough beds to meet the need.

It might take years to do the full planning and design work for a long term mental hospital in the ACT. But that work should at least be started.

The ACT Government managed to get built a temporary COVID hospital in a matter of months. If the ACT Government was really concerned about the needs of people with severe long term mental health and drug issues, and the effects on the people around them, it could have a temporary mental health hospital up and functioning in months. That needs to happen.

    Brianna Brianna 7:02 pm 03 Apr 21

    Yes, if the government could get a covid hospital built, why can they not get a mental health hospital?

Kerstin Mahoney Kerstin Mahoney 9:16 pm 02 Apr 21

how the hell did the hospital know they would go and light fires? there’s not enough service to support and house mentally ill people

    Esther Nightingale Esther Nightingale 8:01 pm 14 Apr 21

    Kerstin Mahoney he was in a state of psychosis at the time of discharge!

    The hospital outright failed in their duty of care to him and the greater community

Tiffany Roy Tiffany Roy 6:02 pm 02 Apr 21

The psych facility at Canberra hospital is terrible. The ACT government should do an inquiry into the state of mental health in the ACT.

    Kerstin Mahoney Kerstin Mahoney 9:16 pm 02 Apr 21

    Tiffany Roy the act government is to blame

Natalie Brown Natalie Brown 5:33 pm 02 Apr 21

Just the tip of the iceberg - the things that have happened at this place 🙄

Frank Trapani Frank Trapani 5:17 pm 02 Apr 21

It’s not just the mental health care that is a disgrace in the ACT ... The whole operational process is a national disgrace and very poor quality service... People have been waiting for more than a year to get a consultation with a specialist and even if there’s an urgent referral from a doctor... The hospital administrator keep asking for more details from the doctors??? Is this a joke or is it hellooo USA... System of Care??

Shannah Sykes Shannah Sykes 4:23 pm 02 Apr 21

My sons father was stabbed 8 times and went cardiac arrest from a homeless man in McDonalds dickson on Saturday night for trying to help the guy pay for his food because the girl wouldn’t except his $10 note.

The man got aggressive and starting stabbing him. Mind you, there was no security guard on and multiple people, familys, and younger kids that had to witness this traumatic disgusting behaviour.

Now police say his got mental health but yet his out in the streets. The government system is ridiculous, they need to be locked up and kept medicated.

I don’t care what anyone says until u experience something so close to death and traumatic like this than u can have an opinion, so don’t even bother trying to comment justifying anything for them.

But it’s funny how nothing was on the news about it or social media, they should be keeping people aware of this stuff, not hiding it. 😡

    Lisa Cribbin Lisa Cribbin 6:46 pm 02 Apr 21

    Shannah Sykes it’s sad babe, people aren’t being warned about it

Linda Norris Linda Norris 3:45 pm 02 Apr 21

And the reality is the homelessness services probably wouldn't have accepted him due to his complex issues and care needed.

    Kelly Ann Kelly Ann 4:36 pm 02 Apr 21

    Linda Norris yes they cant provide nursing care

    Frank Trapani Frank Trapani 5:22 pm 02 Apr 21

    Linda Norris it’s a catch 22, for almost all the other services. In saying that, it’s the whole world that is in a mess and not just the ACT.

    Alison Jones Alison Jones 12:08 pm 03 Apr 21

    Linda Norris well said.

Luke Reeves Luke Reeves 3:31 pm 02 Apr 21

I've seen the ED send home a woman after she had been assaulted as a result of DV. Sent her straight back to the very place and person who put her in hospital in the first place. This woman was livid and frightened the poor thing, he'd beaten her around the ankles too, and she was crawling down the hall in order to avoid being sent back.

That's not the Canberra I know, sending a person back into harms way, she should have been helped far better.

    Kimberley Wilson Kimberley Wilson 11:40 pm 03 Apr 21

    Luke Reeves this is actually horrific

    Luke Reeves Luke Reeves 11:47 pm 03 Apr 21

    Kimberley Wilson I tried speaking in support, saying they can't possibly send her back in harms way. I got mansplained to about how they couldn't do anything for her..... Says enough.

    Kimberley Wilson Kimberley Wilson 11:51 pm 03 Apr 21

    Luke Reeves good on you for trying, I’m sure she was grateful for the support. Absolutely shameful that the hospital can just wash their hands of such an issue; surely a report of abuse has to be referred to authorities, unless she said she didn’t want that / was too scared. I hear about facilities open to women/people escaping DV but how can they help if the victims aren’t being told about them.

    Luke Reeves Luke Reeves 11:16 am 04 Apr 21

    Kimberley Wilson the main thing was they couldn’t understand the fear. 😞

Melissa Hobbs Melissa Hobbs 3:02 pm 02 Apr 21

Not the first time a homeless person has been discharged from hospital back to the street

Alison Jones Alison Jones 2:55 pm 02 Apr 21

Glad to hear Hennessey House is reopening. Very much needed and glad it will again fill a real gap in the mental health system.

I'm sorry to hear that people are still being discharged from mental health services in a state where they are highly likely to come to the attention of the police and justice system. Once they're in the justice system, they're no longer the responsibility of mental health. Which, for way too long, has suited mental health very well, particularly in the case of complex (expensive) patients.

Susie Deards Susie Deards 2:53 pm 02 Apr 21

I’m not sure where the responsibility lies here? I don’t understand... is the hospital required to retain people against their will if in a state?

Is that not a separate body/facility?

    Alison Jones Alison Jones 3:03 pm 02 Apr 21

    Susie Deards the problem in this case, and in many other cases, is that the hospital discharges people who are very unwell and who have nowhere to go. The reason this happens is rarely clear to families of those patients. These patients are then highly likely to end up in the justice system. With proper health care, they would be much less likely to end up in the justice system.

    There is a forensic mental health facility that is part of the prison system but it is preferable that people get treatment before they get to that point. There are very limited facilities to help such people, though I am glad to hear that Hennessey House is reopening.

    Jarrod Male Jarrod Male 3:38 pm 02 Apr 21

    Alison Jones...yes completely agree and has also been my experience with both ACT Mental Health and the youth justice system.

    Susie Deards Susie Deards 4:15 pm 02 Apr 21

    Alison thank you for explaining.

    However I still do not understand why is it the hospital’s responsibility when this young man clearly needed long/er-term care when there seems to not be enough beds and staff? Why is this not a system-wide responsibility??

    Why is the hospital being singled out?

    I think I feel like it’s a blame game rather than finding a solution.

    Kelly Ann Kelly Ann 4:34 pm 02 Apr 21

    Susie Deards would you support early discharge of a person who was still sick with a physical illness?

    Fran Gray Fran Gray 4:46 pm 02 Apr 21

    Kelly Ann I think the problem is that the hospital is only equipped to deal with short term mental health and aren't adequately resourced for long term care.

    Fran Gray Fran Gray 4:53 pm 02 Apr 21

    Alison Jones I understand that this is not the best way to deal with these patients, but it's a hospital not a long term care facility. Old people go to a nursing home when they need long term care, they don't stay in hospital. We need a place these patients can access long term care.

    And the fact that these patients are homeless is not an issue for the hospital to rectify. They can't keep them until they find a home.

    Alison Jones Alison Jones 5:15 pm 02 Apr 21

    Fran Gray if it is not the hospital's responsibility and not the responsibility of anyone in ACT Health, then who is responsible for such patients and their obvious ongoing health and support needs?

    The reality for many years is that when such a patient is discharged, it becomes the responsibility of the police and the justice system. Because some poor souls with complex mental health needs are "treated" by being discharged to exactly nowhere, with no support. Which means they're very likely to end up being dealt with by the police for what ought to be a health issue, not a justice issue.

    From the experiences of a close relative some years ago now, I can vouch that once such individuals get the good quality health care they deserve (and which you and I would also deserve if we were unfortunate enough to be so ill), they suddenly have no further dealings with the justice system. In the case of my relative, Hennessey House was key to them beginning on the path of long term mental health care and support, rather than being caught up in the justice system, often because there was nowhere else for them to go.

    I am personally desperately sorry that people in such a terrible state as the person featured in this story still get discharged prematurely from the hospital with no further plan for care in place and nowhere for them to live. That is an absolute travesty against a highly vulnerable member of our community.

    Alison Jones Alison Jones 5:21 pm 02 Apr 21

    Susie Deards I get it is not solely the hospital's responsibility. But this is a health issue and no one should be discharged from hospital with no means of accessing support, nowhere to live and no plan for further treatment. That the hospital did exactly this in the case reported is an issue that the hospital needs to deal with. Yes, that requires engaging other areas of ACT Health, who I acknowledge are often reluctant to help in complex (more expensive) cases. But someone who is a hospital patient should not find themselves the next day in a police watch-house, due to the still being very unwell and now completely unsupported. Yet that is what happened here and had happened for many years in Canberra.

    Cass Proudfoot Cass Proudfoot 5:43 pm 02 Apr 21

    Older people who are unable to go home don’t get discharged from hospital with nowhere to go, yet people who need mental health care do.

    Fran Gray Fran Gray 5:47 pm 02 Apr 21

    Alison Jones I agree with you that they need to be treated and looked after. Like I said in my earlier post, they need to be able to access long term care in a proper facility. Unfortunately we don't have long term mental health facilities. And hospitals are not set up for that kind of long term care.

    This is not just an ACT problem, this is Australia wide and it's been a problem since mental health facilities were all closed. Which brought about a rise in homelessness.

    Everyone getting cranky at the hospital isn't going to help anything. They know what needs to be done, but there just isn't anywhere for them to refer these people to. That's what needs to be addressed.

    Nell Feneck Nell Feneck 5:55 pm 02 Apr 21

    Susie Deards it’s a duty of care thing

    Alison Jones Alison Jones 6:10 pm 02 Apr 21

    Fran Gray one last reply and then I shall butt out. The hospital is not solely to blame. Health officials who would prefer to have difficult cases "cared for" in the justice system are part of the problem. The lack of long term mental health care is certainly a problem, though the ACT is not entirely without that. It's just difficult to find and to access. So I agree that the hospital isn't the only problem. But in discharging such unwell people, and discharging them when they are patently unwell and without care or support, is definitely a significant part of the issue. In the case of my relative, the hospital was not part of the long term solution because all it had been at times for that relative was practically a point of entry into the justice system.

    As you can tell, this is something I am passionate about thanks to this relative's experience. I suspect you are too, possibly from the perspective of a health worker. I should acknowledge the genuine care many people, including people in the health system, gave to that relative and that it is a very difficult field in which to work. Thank goodness, there are some kind people working in that area.

    Kelly Ann Kelly Ann 10:41 pm 02 Apr 21

    Fran the hospital has a legislated duty of care not to discharge any patient into homelessness or discharge a patient who is deemed at risk under the Mental Health Act. Im not cranky with the hospital but I do expect adequate and ethical care from them. There is the Dulwah facility for long term secure care when needed.

    Esther Nightingale Esther Nightingale 7:50 pm 14 Apr 21

    Susie Deards the hospital are being singled out because they chose to discharge somebody that was still in a case of psychosis and at serious risk of harm from injuring himself or others. That right there is exactly the terms that need to met in order to hold someone under a psychiatric order.

    They were outright negligible in their duty of care, not once but 3 times.

    I would have to check current ACT policy but I'm pretty sure that discharging someone into homelessness is also a breach.

    In all honesty though anybody that has experienced ACT mental health services at the canberra hospital would struggle veing suprused by this.

Paul Heinl Paul Heinl 2:44 pm 02 Apr 21

Kara Heinl Good ol mental health does it again

Julia Dunn Julia Dunn 2:24 pm 02 Apr 21

Mental health care in the ACT is a national disgrace!

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