Suicide after advice not to take medication

A young man committed suicide after his counsellor told him by text message not to take his medication, provided he was undergoing regular counselling.

Acting Health and Disability Commissioner Rae Lamb, in a finding issued today, said the case highlighted the importance of consulting other health professionals working with a person, the dangers of providing advice by text message, and the risks associated with "no suicide" contracts.

The mother of the 18-year-old man complained to the commissioner that a counsellor had told her son not to take medication, and requested through her son that she also undergo counselling.

Her son had seen a psychotherapist who had diagnosed him as schizophrenic/psychotic and urgently referred him to a youth mental health team.

But before his appointment with the team, the man's mother took him to a counsellor who had been recommended by a friend.

The counsellor took a brief history, which did not include the man's drug use, and wrote out a brief "no suicide" contract. She diagnosed him with depression/grief and identity issues.

She also asked him to tell his mother that she should also undergo counselling as part of his treatment.

The man's mother subsequently contacted the counsellor and told her that her son was under the care of the youth mental health team.

The team prescribed an anti-psychotic medication and referred him to an early psychosis intervention team.

However the man remained in contact with the counsellor by text message and asked her whether he should take his medication.

She responded by text that he should not take his medication provided he was undergoing regular counselling.

The man became increasingly depressed and committed suicide.

Ms Lamb found that the counsellor had breached patient rights by using text messages to give advice concerning medication, without seeing the man and or consulting with other providers.

The woman had apologised to the dead man's family.

Ms Lamb recommended the counsellor report back to her on details of how she would approach the use of "no suicide" contracts and text messages, and how she had changed her practice in line with expert advice.

- NZPA