Patient's 'privacy was put before safety'

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Mental health services have been criticised for putting patient privacy ahead of safety after the death of a 23-year-old man.

A Health and Disability Commission report has found the man's family should have been told of his depression and earlier suicide attempts, despite his being "absolutely adamant" that they be kept in the dark.

"Sometimes individual safety should override his or her privacy, and family or caregivers should be involved to help provide a safe environment for recovery, " commissioner Ron Paterson said.

In mid-2008 the man had ended a two-year relationship with his girlfriend. After aborting a suicide attempt, he sought help from his doctor, who prescribed an anti-depressant and referred him for assessment by community mental health services.

It took a week before he was seen by a nurse, who referred him to a counsellor. He was not seen by a psychiatrist.

Three days later the man was admitted to hospital overnight after harming himself, but was discharged the next day. He died two days later.

Mr Paterson said it was "dubious" the man was a low risk and Northland District Health Board should have told his family about his mental health problems.

"Where there have been several suicide attempts in a short period, and there is no evidence of long-standing family estrangement, there should be a low threshold for notifying family of the risk of self-harm."

The man's mother agreed: "I want the public to know the Privacy Act can be broken in certain circumstances."

The Health Information Privacy Code 1994 allows for disclosure of information to prevent "serious or imminent" risk to life.

In another report, Mr Paterson found that Southland District Health Board breached the right of appropriate standard of care for a 40-year-old itinerant with a long history of mental illness.

Consultation with the man's family, including his sister, who is a psychiatric nurse, did not take place, which meant signs of a relapse were missed.

Privacy commissioner Marie Shroff said patient privacy, trust and confidentially underpinned good medical practice. "The law clearly gives practitioners the discretion to disclose patient information where he or she thinks it necessary for patient safety, but it does not go further and require them to do so.

"That balance is the correct one, I think."

- © Fairfax NZ News