Australia has long grappled with a stubbornly high suicide rate and the devastation it causes countless families and carers who have tried to help loved ones struggling with mental ill-health.
Today’s report by health editor Kate Aubusson about Gus Wong, 29, who died by suicide days after he was discharged from a Sydney mental health unit, would represent many families’ worst fears.
Gus died eight days after he was discharged from the unit at Northern Beaches Hospital, where he had been undergoing electroconvulsive therapy (ECT) to help treat schizophrenia, in November.
His parents have detailed a devastating sequence of events and missed opportunities as they push for a coronial inquest into the circumstances that led up to their “wonderful” son’s untimely death.
Gus’ mother, Caroline Yarnell, describes being told by a mental health services staff member not to call the police after she discovered Gus was missing, despite reporting the previous night that he had told her he did not want to live. Police found his body hours later, and later told Gus’ father, Tony Wong, that his son’s death was entirely preventable. Days before his discharge, Gus’ parents had raised concerns with hospital staff that the pair would not be able to monitor their son 24/7.
The number of suicides post-discharge from NSW’s psychiatric hospitals is very small.
But, as Aubusson’s report points out, Gus’ case raises questions about how adequately loved ones are prepared for the “extraordinarily high” rates of suicide immediately after patients are discharged from psychiatric units, compared to rates in the general community.
An internal review of Gus’ care identified no factors of the care provided to Gus that contributed to his death, and that discharge planning, follow-up and collaborative care were comprehensive. His parents say the report contains several inaccuracies.
Yarnell said she was worried staff at the Northern Beaches Hospital, which Healthscope had operated before handing it back to NSW Health in April, “hadn’t really made any effort to investigate what went wrong with their own procedures with a view to saving lives in the future”.
One hundred and fifty people died by suicide in NSW over January and February. The majority (111) were male, and 46 were men aged 25 to 44, the latest NSW Suicide Monitoring System report shows.
Australia’s suicide rate has dropped by about 8.5 per cent in the past decade.
Independent Pittwater MP Jacqui Scruby raised serious concerns about mental health discharge practices and suicide risk escalation in state parliament in May. She has rightly called on the government to strengthen discharge safeguards, family communication and sub-acute services.
The NSW government, which strengthened community mental health supports after the Bondi Junction Westfield stabbing attack, should seize the Northern Beaches Hospital’s transition to public ownership to improve mental health facilities for patients. This should include measures to better equip families and carers.
The Healthcare Complaints Commission acknowledged health services must strike a difficult balance between their duty of care to protect patients at risk of suicide, and clinical judgment, patient rights, and legal requirements.
Psychiatrist and world-leading suicide risk expert Conjoint Professor Matthew Large noted, despite the extremely high suicide rate soon after discharge, hospital staff often avoid frank conversations about these risks. Health services are powerless to know which patients will suicide and when.
However immense the challenge, there is no room for complacency when it comes to mental illness. NSW must find better ways to support families who are trying to keep their loved ones safe.
The ripple effects of suicide – and the silence that often accompanies it – are too great to ignore.
If you are worried about your own or someone else’s mental health, you can contact the Mental Health Line on 1800 011 511.
If someone has attempted, or is at immediate risk of attempting to harm themselves or someone else, call Triple Zero (000) immediately.
Lifeline 13 11 14
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