Lack of family input into decisions made about a consumer’s care under the Mental Health Act

Deputy Health and Disability Commissioner Dr Vanessa Caldwell today released a summary of a case, finding a district health board (DHB) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to provide services with reasonable care and skill when making the decision to discharge a consumer from a Community Treatment Order (CTO) under the Mental Health Act 1992.

The consumer was under a CTO for their anti-psychotic medication and had given permission for the DHB to liaise with family around their care. The family were not consulted about the decision to discharge the consumer from the CTO (which occurred shortly after a difficult time for the consumer and his family) and were not informed about this decision until later. Following removal of the CTO, the consumer stopped taking medication and, just under two months later, harmed themselves and was admitted to hospital.

This case highlights the importance of family inclusion and consultation when providers are making decisions for patients under the Mental Health Act.

Dr Caldwell found the DHB had not adequately communicated nor consulted with the consumer’s family and that no formal review process was put in place to assess whether transition to voluntary treatment had been successful. She also considered that there was a lack of follow-up care provided as a result of a change in frequency of review contrary to the consumer’s care plan, when such change should have been a multi-disciplinary decision.

Dr Caldwell made multiple recommendations to the DHB in order to improve its family and/or whānau consultation in relation to section 7A of the Mental Health Act, including developing relevant protocols/guidelines, and providing training to its Mental Health staff.