By: Natalie Akoorie

Ministry of Health director of mental health Dr John Crawshaw will monitor the implementation of mental health services changes recommended after an inquiry into a patient’s care.

Desperately-needed changes to mental health services prompted by failings in the care of a patient with complex needs, have yet to be implemented.

Instead the recommendations from a damning inquiry that made more than 100 findings highlighted by the patient’s treatment, are still being worked through by various Government agencies across the country.

In mid-June the Weekend Herald revealed details of a leaked report stemming from the six-month inquiry under the Mental Health Act, which was largely critical of the care provided to the patient.

The case is so sensitive this newspaper is not publishing any details that could identify the patient.

But it was known about by high-ranking officials including then Minister of Health Dr Jonathan Coleman.

The report revealed a catalogue of failings and made more than 100 findings that have “significant implications” for other patients.

“There was no long-term care or responsibility taken by any of the specialist child and adolescent psychiatrists, clinical teams or caregivers, beyond their specific facilities,” the report said.

Though some specialists and institutions were praised for their efforts, none treated the patient properly for what was thought to be the root cause of the problems.

The Weekend Herald cannot outline those causes because of legal reasons.

The inquiry found “serious shortcomings” in the services provided to the patient and made findings relating to continuity and consistency of care; clinical decision-making; clinical assessment, diagnosis and formulation; discharge and transfer planning; care and relapse prevention; communication between clinical teams; and Child, Youth and Family placement decisions.

Its recommendations included the need for:

• Changes to inpatient service provision to behaviourally disordered young people with high and complex needs;

• Community placements for these young people;

• Clinicians to use phenomenological criteria [perceptions, emotions and judgements] when assessing a person’s suitability for assessment and treatment under the Mental Health Act;

• Assessments made from a longitudinal perspective for better management strategies;

• Clinicians in DHBs across the country to be able to access patient clinical records including mental health records;

• To assertively treat trauma.

The inquiry was ordered by the Ministry of Health’s director of Mental Health and Addiction Services, Dr John Crawshaw.

In a letter attached to the report he expressed concern over the patient’s treatment, which was brought to his attention by district inspectors of mental health – lawyers advocating for patient rights.

“After careful consideration I have formally accepted the inquiry’s findings and recommendations, some of which have significant implications for mental health services nationally,” he wrote.

This week Crawshaw answered questions on action taken since the report’s release more than a year ago.

“Agencies have responded well to the report, and are working toward implementing the recommendations,” he said.

“I am satisfied with the progress in implementing recommendations and confident agencies are treating them with the seriousness they deserve.”

Crawshaw said the Ministry had an ongoing function to monitor the progress of issues raised in the course of the inquiry, with the long-term actions still ongoing.

“I correspond regularly with agencies on their progress implementing the recommendations.”

It’s understood the report has been released to the district health boards involved in the case.

Crawshaw would not say if the patient was still receiving treatment because of privacy issues and a court order outlining rules around publication of the report.

When asked if the report would be shared with the panel undertaking a national mental health inquiry, Crawshaw said the Ministry would comply with its obligations under the Inquiries Act.


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