Schizophrenic man refused treatment

The Southland District Health Board (SDHB) will apologise to the family of a schizophrenic man after he was refused treatment in 2007.

The man, who was 40 years old at the time, began to experience psychotic symptoms from age 15 and has a primary diagnosis of paranoid schizophrenia and polydrug use, the Health and Disability Commissioner said in a report released today.

The report, which omitted the names of the people involved, said the man had generally been treated under the compulsory treatment order sections of the Mental Health Act and had been treated by several district health boards (DHBs).

On June 26, 2007, he demanded medication at Southland Hospital, saying he had not taken any for six months. He then demanded to be admitted to the acute mental health unit.

The consultant psychiatrist said the man was aggressive and abusive, threatening to "smash" the doctor and other staff if he was not admitted.

The psychiatrist contacted police and the man was arrested.

In a statement to police, the psychiatrist said he could not elicit any symptoms or signs in the category of a schizophrenic disorder during their interaction.

"On review of his notes I am not convinced that this is his main diagnosis, but there is plenty of evidence of an antisocial personality," the psychiatrist's statement read.

A month later, the man was taken into custody in Dunedin due to police concerns about his mental state. In a medical examination, an Otago psychiatrist determined the man had a "chronic and relapsing mental illness. . . best described as paranoid schizophrenia".

The Otago doctor contacted the man's sister who described her frustration at being unable to get treatment for her brother.

The sister laid a complaint with the Health and Disability Commissioner, expressing her concern about the care provided by the SDHB.

In his report, Commissioner Ron Paterson ruled the man's care from the SDHB fell below an acceptable standard, saying the clinicians had ignored the primary illness of schizophrenia and failed to use follow-up meetings to determine whether that was the correct decision.

In regard to the Southland psychiatrist, Mr Paterson said he could not pass judgment as the doctor had had limited access to information about the man and was faced with a frightening situation.

Mr Paterson recommended the SDHB apologise in writing to the man's family and offer to meet them to discuss any other concerns.

The SDHB said it acknowledged that various events relating to the man's care could have been handled better and that it was willing to meet the family and apologise.

- NZPA