Coroner's mental health plea

17:44, Jan 30 2014

A coroner has recommended South Canterbury residents have access to a more specialised mental health service, following the death of a Morven man who felt nothing more could be done to help him.

Coroner Richard McElrea released his finding into the self-inflicted death of farmer Graeme Kenneth Middlemiss, who died on November 27, 2010.

His findings noted Mr Middlemiss had a background of significant major depressive disorder which was "severe, recurrent and treatment-resistant". He also had generalised anxiety disorder.

In an unusual move, the coroner has allowed publication of several of his findings as he considered it in the public interest to release information which was normally suppressed in the case of self-inflicted deaths.

Mr McElrea concluded Mr Middlemiss had "engaged well with mental health services, had good insight into his conditions, wanted to get well and had a good support network".

He requested the South Canterbury District Health Board clinical director of mental health services, Dr Cecilia Smith-Hamel, give consideration to the "perception of Mr Middlemiss following the meeting with case workers in the community in November 2010 ‘that there was little more that the mental health team could do to help him and that the onus was upon him to adjust his thinking'."


He also commented on Mr Middlemiss not being able to access specialist mental health services in Christchurch.

"The evidence of Dr Cecilia Smith-Hamel is that the anxiety disorders unit in Christchurch is a specialist team, is only available to Christchurch residents and is not a regional service," Mr McElrea said.

"Canterbury District Health Board understands it is the only standalone public health anxiety service in New Zealand. Other DHBs provide treatment for anxiety disorders within their community teams. Mr Middlemiss, a resident of Waimate, did not have access to a specialist unit of this type.

"I make the following recommendation ... that the Minister of Health (Tony Ryall) considers the question of specialist mental health services, such as those available to Christchurch residents at the anxiety services unit at Hillmorton Hospital, with respect to the needs of people living outside of Christchurch."

Associate Minister of Health Peter Dunne said all DHBs had specialist mental health teams, including South Canterbury, whose day-to-day work includes managing anxiety in clients who may, for example, have depression.

"DHBs are expected to take a collaborative approach to service provision in their regions. When a DHB does consider there is a need to access a dedicated, specialist service in another DHB, this is a matter for discussion between the respective organisations.

"It is worth bearing in mind that Canterbury is currently facing a unique and challenging set of circumstances, which the DHB is proactively addressing. Further pressure on its services may have the potential for a reduction in positive outcomes for all involved.

"Any decisions on service access are best made by those involved with management of the services in question."

The Timaru Herald