New Zealand Doctor Online - Medical News for GPs

20 APRIL 2009

Communication a factor in mental health events

Lucy Ratcliffe
lratcliffe@nzdoctor.co.nz

Daily news: a report into mental health events was released yesterday

Communication issues among mental health services, family members, police, community alcohol and drug services, and other agencies are a key theme emerging from a report into mental health patient events.

Yesterday, the office of the director of mental health released its third report collating deaths reported in 2007 under the Mental Health Act and any other reportable event involving people under the care of mental health services. These events could include fire, flood, equipment failure, police investigation and death.

In 2007, 216 events were reported to the mental health director’s office, of which 176 were deaths. Of the deaths, 85 were suicides.

Eleven suicides involved inpatients, and 74 involved outpatients who had contact with mental health services during the previous 12 months.

Causes of death, other than suicide, for outpatients included medical or natural causes, falls, motor vehicle accidents or fires.

Other circumstances surrounding the events included handover of care and discharge issues, staff training, cover for staff on leave, access to or lack of health records, and cost and access to housing and counselling services.

Reporting variable

Waitemata DHB’s clinical director and spokesperson on behalf of all DHBs, Murray Patton, says in a media statement the definition of reportable events is broad and is variable between DHBs.

Dr Patton says the process of collecting consistent, accurate data across all DHBs is still being refined.

As part of the Quality Improvement Committee’s work, mental health event reporting will become part of the national incident management system currently being developed.

Barely a mention of primary care

Primary care barely gets a mention in the summary of events with just Northland, Waitemata and Taranaki DHBs mentioning GPs or PHOs as part of recommendations or actions following suicides of outpatients.

The Northland DHB investigated more access to counselling services, noting Work and Income, ACC and PHO-funded counselling services are now more accessible.

In Waitemata, the DHB found mental health services didn’t know who the patient’s GP was or what medications had been prescribed. The DHB recommended primary care should know if a patient becomes enrolled in mental health services and that GPs and PHOs should be educated about this.

While in Taranaki the DHB found no individual clinician or area of service directly contributed or could have prevented the suicide, recommendations were made to ensure the patient’s GP was kept up to date.