Episode Two 8th June 2011

When I wrote my letter to Dr Paton on 7^th June I was unaware that a few days earlier an incident had occurred at Ms H’s home that had caused her great distress. Suffering from severe chest pains she called an ambulance. When the ambulance arrived its officers refused to enter her home until the police arrived. They did so on the basis of a protocol that they claimed had been put in place by a combination of the police, NSW Health and the NSW Ambulance Services. Neither Ms H nor myself were aware of this protocol. No-one had discussed it with us or informed us what would occur if Ms Holmes required care from ambulance officers. Ms H was shackled and taken to Hornsby Hospital against her will. When her chest complaint had been dealt with she was given a taxi docket so that she could go home. In an email to me Ms H wrote, “The whole saga was humiliating and I believe Dr Ladd and Peter Young were the persons along with the Northern Sydney Central Coast area health executives who had this protocol put in place.” Numerous questions arose for me as Ms H’s Primary Carer – questions to which, a yer later, I have still not received answers from NSW Health.

Dr Michael Paton
Clinical Director, Mental Health Drug and Alcohol
Northern Sydney Local Hospital District  &
Central Coast Local Hospital District
NSW Health Service - Health Reform Transitional Office Northern
Cameron Building, Macquarie Hospital
North Ryde NSW 2113                                                                                                 8^th. June 2011

Dear Dr Paton

Further to my letter of 7^th. June.

As there has been no resolution as yet to the question of what happens vis a vis the ambulance services if Mt T has a stroke/medical emergency, I have moved into Ms H’s home until this matter is resolved. In the event that Mr T is in need of the services of an ambulance I will call it and see to it that Ms H is not in the house when the ambulance officers arrive. This is an absurd state of affairs – unless you can provide evidence to justify this aspect of Ms H’s Case Management Plan.

In the meantime, I have some more questions – inspired by my reading of a summary of the Mental Health Act of 2007.

Under “New features of the 2007 Act” is to be found:

“Additional objectives to be applied in the provision of care and treatment (s68),  including: Care and treatment should be designed to assist people with a mental illness or mental disorder, wherever possible, to live, work and participate in the community”

Is Dr Young’s action in calling Ms H’ employer, resulting in her losing her job, a breach of this part of the Act?

“Every effort that is reasonably practicable should be made to involve  patients in the development of treatment plans and plans for ongoing care.”

Has Ms H been involved in any way in the development of treatment plans and plans for ongoing care for her? Has she even been informed as to what these plans are?

“The role of carers for people with mental illness or disorder and their rights to be kept informed should be given effect.”

Why has NSW Health not only failed to keep me informed, as Ms Holmes’ Primary Carer (whom she calls ‘dad’), but has actively refused to give me information that I have requested many times – namely a copy of Ms H’s Case Management Plan. Could you please send this to me immediately at Ms H’s address: xxxx

“An authorised Ambulance Officer who is providing ambulance services to a person may take them to a mental health facility if the officer believes they may be mentally  ill or mentally disturbed.”

Did the ambulance officers who took Ms H to Hornsby Hospital believe her, at the time, to be mentally ill or mentally disturbed? If so, what was the basis of this assessment? If the ambulance officers were merely doing as they had been told, who told them to transfer Ms H to Hornsby Hospital?

“Ambulance officers must be specifically authorised to undertake this role.”

Were the ambulance officers who took Ms H to Hornsby authorized to do so?

I have reason to believe that both the police and ambulance officers involved in this 2^nd. June incident will confirm that Ms H told them, on several occasions, that she did not wish to go to Hornsby Hospital under these conditions (in restraints) or that she should be detained at Hornsby Hospital for three to four hours. That Ms H was sent back to her home in a taxi at approximately midnight is, I believe, clear evidence that there was no mental illness component to the actions taken by the police and ambulance officers on this night.

“Persons nominated as Primary Carers are to be provided a range of information.  Particular note should be taken of the requirement in section 75 to notify the primary carer within 24 hours of a person being involuntarily detained in a mental health facility.” 

Why was I not informed, on the night of 2^nd. June, that Ms H had been involuntarily detained at Hornsby Hospital – albeit for three or fours hours only? Why have I never once been informed by either Manly or Hornsby Hospitals that Ms H has been involuntarily detained? It must be abundantly clear, from your files, that I am Ms H’s Primary Carer. Indeed, she has more than once placed a document on file to this effect.

Under “Notices” is to be found the following:

“Mental health facilities should endeavour to obtain other contact information, eg  telephone and mobile numbers, particularly for primary carers, so that notifications can be supplemented as necessary to ensure timely provision of information.”

Given that Hornsby Hospital is in possession of my phone number and is well aware of the role that I play in Ms Holmes’ life, why have I never once been provided with information? Why, each time I ask for information, (about Ms Holmes’ Case Management Plan, for instance) am I never provided with it. Never!

I trust that I will get answers to my questions soon so that Mr T and Ms H can rest assured that they will not experience a repeat of what occurred on the night of 2^nd. June. I trust also that a copy of Ms H’s Case Management Plan will arrive by post tomorrow.

best wishes

James Ricketson

One year later I still do not have a copy of any Case management Plan provided to me by NSW Health.