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Co-ordination of care of man with mental health issues

Co-ordination of care of man with mental health issues 17HDC00632

Mental Health Commissioner Kevin Allan today released a report finding Waitematā DHB in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures relating to the discharge of a man from its Community Mental Health Service.

A man in his fifties with a history of a major depressive episode with psychotic symptoms, post traumatic stress disorder, and chronic obstructive pulmonary disease was under the care of the DHB’s Community Mental Health Service (CMHS). He was receiving services from two support organisations to assist him to live in the community. These services were funded by the DHB’s Needs Assessment and Service Coordination service (NASC).

The man was discharged from the Community Mental Health Service following a visit from his key worker, and a discussion at a multidisciplinary review meeting.

The Mental Health Commissioner was critical that at the time of discharging the man, the DHB failed to appoint a lead organisation to oversee his ongoing care. Mr Allan was also critical that the support organisations were not invited to the multidisciplinary review, that the man was not reviewed by a psychiatrist at the time of the proposed discharge, that the discharge summary was not circulated to the support agencies, that the discharge was not discussed with the man’s family, and that incorrect assumptions were made at the multidisciplinary review meeting about the level of support available to the man from his GP and his family.

Mr Allan was critical that the DHB’s NASC did not escalate or address concerns about the man’s reluctance to receive support services when these were raised by one of the support organisations after he was discharged.

Sometime later, the man’s sister took him to see his GP. He was very short of breath and had lost a significant amount of weight. He was treated in hospital, but sadly died from pneumonia secondary to malnutrition and depression.

Mr Allan said the man’s case highlights the importance of health service providers working together in unison to meet the needs of consumers who are living in the community.

Mr Allan recommended that the DHB apologise to the man’s family, implement processes to improve the discharge process, undertake an audit of compliance with discharge processes and familiarise NASC staff with the Equally Well Consensus Paper to be used in the context of needs assessment and contracting support services.

The full report for case 17HDC00632 is available on the HDC website.


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