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Child and Adolescent Mental Health Services
Learning advocacy skills
results in great care
Disorganised community mental
Lack of understanding about Autism
results in poor service
young woman receiving mental health care
Learning advocacy skills results in
A family of three children with medical issues had not
been well supported to access the services they needed. After one
son was diagnosed with ADHD, the providers refused to listen to the
parents' concerns and impeded all they were attempting to do for
him. The parents felt disrespected by the social worker and
paediatricians and felt there had not been a good standard of care
for their son.
There were also issues about care and skill in relation to their
other son who was prescribed adult depressants, who was soon to be
seen by another psychiatrist.
They sought advocacy help to lodge their complaint and voice
their request for a second opinion with another paediatrician who
could take a fresh look, with an unbiased view.
Another son is now under a Child Developmental Service which is
difficult to get into.
The family are delighted with this. As well as having a special
diet for the children, they were finally receiving good support and
improvements to the services provided. The mother said they
even made home visits. Through her experience with the advocacy
process, the mother felt empowered enough to take on injustices by
a different organisation, concerning her children.
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Disorganised community mental health
The mother of a consumer believed her
son received poor care from the community mental health service,
and contacted an advocate to complain that:
her son not receiving his medication
from the community mental health nurse when it was due'
the service did not record their new
address which resulted in the nurse visiting the wrong address on
two occasions and going to the wrong house on the third
she was unable to access medication
for her son from either of the two community mental health services
or the mental health ward at the hospital after hours.
As a result of not receiving his medication, her son became
increasingly unwell and eventually had a violent episode resulting
in his admission to the mental health unit where he is still a
After considering the options, and with the assistance of the
advocate, the consumer's mother wrote to the manager of the mental
health service outlining her concerns and requesting a meeting.
This was attended by the manager and the mental health nurse who
had tried to visit the consumer to administer his injection. She
acknowledged that because they did not record the new address she
visited the wrong address then the wrong house.
The manager said a new 0800 mental health line was in the
process of being set up for all mental health calls. The manager
agreed to remind the inpatient ward of processes for recording
calls from consumers and those acting on their behalf. The manager
also acknowledged the systemic errors that had taken place and said
the community mental health service was already under review with a
report due at the end of the year.
The mother of the consumer felt her concerns had been addressed
and was pleased with the outcome of the meeting.
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Lack of understanding
about Autism results in poor service
DHB ~ Autism ~ Nonverbal ~ Rights 1, 4, 5, & 6 ~ Respect
~ Appropriate standards ~ Effective and full communication
A mother of a nine-year-old girl who is non-verbal and has
severe Autism contacted an advocate about the service her daughter
received from the local hospital.
When her daughter became unwell with severe stomach pains she
took her to the hospital for an assessment. While they were
waiting, the little girl displayed some challenging behaviour due
to her Autism. The doctor said he couldn't examine her because she
was being "badly behaved". The mother tried to explain that
children who have Autism have communication difficulties (even when
they are verbal) and if they are uncomfortable or in pain this will
often manifest in extremely challenging behaviour. The doctor
prescribed some Ibuprofen for her pain and then discharged her
home. The mother felt that the doctor was dismissive of her
concerns and very judgemental about her daughter's
With the support of the local advocate she wrote to the hospital
regarding her concerns. She was upset that neither she nor her
daughter had been treated with respect. She expressed her
disappointment that her daughter had not been examined and went on
to say she felt all staff at the hospital need to be aware of the
specific needs of children with Autism Spectrum Disorder and to be
respectful when they are dealing with parents. Her daughter had
been discharged home without a full investigation into the cause of
her stomach pains.
Although her daughter is non-verbal and was clearly in a lot of
pain the discharge report stated that the primary diagnosis was
"behavioural problems", which the girl's mother felt was
judgemental and disrespectful to her daughter. She said she
would be willing to meet with senior staff at the children's
hospital to discuss this incident in an attempt to prevent it
She received a written response from the hospital with an
apology for what had occurred. The hospital acknowledged that
the communication at the time of the consumer's admission had not
met expectations and that this had been discussed with staff who
were involved in her daughter's care and treatment. The
hospital noted that they did not have a clinical guideline on the
management of patients with Autism Spectrum Disorder and agreed to
follow up with the Developmental Service to ensure that all staff
are made aware of the specific characteristics and needs of this
group of patients. They also modified the electronic
discharge diagnosis list to include Autism Spectrum Disorder,
rather than 'behavioural problems'.
The girl's mother was happy with the outcome of her complaint
and pleased to have had the support of the advocate to raise her
concerns. She was keen to have her complaint used as a case
study to highlight how important it is that health professionals do
not ignore health symptoms in an individual who also has a
disability - particularly when they are non-verbal and can't speak
up for themselves.
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Suicide of young woman receiving
mental health care
Suicide ~ Mental health ~
Youth Residential Care ~ Adult Psychiatric Community Case
Management ~ Root Cause Analysis (RCA) ~ Resolution
The mother of an 18-year-old woman
contacted the local advocate to express concern about the care her
daughter had received in the months prior to her committing
suicide. Her daughter had been living in Youth Residential Care and
had transitioned from Youth to Adult Psychiatric Community Case
Six months prior to her death the
daughter had requested her mother become involved in her care,
lifestyle plans and to support her at appointments.
The advocate met with the mother and
heard her concerns. She wanted to know why she had not been
contacted by the Adult Psychiatric Community Health team or the
psychiatrist for six months before her daughter's death. She also
mentioned a number of other issues about her daughter's care.
When the woman felt able to meet with
the mental health service, two meetings were organised - one with
the Mental Health team and the other with staff from the Youth
Residential Management team. The advocate supported the mother at
both meetings where she was able to voice her concerns and get some
answers to her questions.
Following these very emotional
meetings, a further meeting to discuss the findings from a Root
Cause Analysis (RCA) investigation into the tragedy was organised.
The advocate also supported the woman at this independent meeting
where consulting clinicians from other services had thoroughly
looked at all of the factors surrounding her daughter's death. She
was told that staff training is one of the areas looked at as a
part of the findings, along with policies and procedures.
The woman felt her concerns had been
taken seriously and she was pleased her unanswered questions would
be looked into. She was also very happy that the investigation was
independent with external people looking at what had happened and
she appreciated the advocate providing ongoing support at all the