By Lucy Rickard
As an investigation into the conduct of Fremantle Hospital's Alma Street clinic continues into the suicide of three mental health patients, the widow of a 56-year-old man who took his life prepared to launch legal action against the hospital.
Moira Thomas met for the first time with solicitors yesterday to discuss her expected action against the hospital, determined that someone be held responsible for his death.
On September 2, police discovered the body of her mentally ill husband, 56-year-old Michael Thomas, 13 weeks after he disappeared following his discharge from Fremantle Hospital.
The father-of-two, who had severe depression, was sent home from the hospital in borrowed clothing and a prepaid public transport ticket. He took his life less than a day later.
Widow Moira Thomas said while her husband was alive, she pleaded with hospital staff and doctors to have his condition taken seriously, but her requests fell on deaf ears.
"While he was alive and I was pleading for his life, nobody offered to help me," she said.
She said since his death, the same people offered support but she said it was simply too little too late and "wanted nothing to do with them".
Mr Thomas' case was strikingly similar to two other suicides of patients discharged or refused treatment at the same hospital this year, and all three cases are awaiting a coronial inquest. Some 500 cases are ahead of them - a wait of two or three years.
As part of a renewed effort to raise awareness of the risks of suicide within the mental health community, Geoff Diver has reiterated calls for a change within the health system following the suicide of his 18-year-old daughter Ruby.
Ruby Nicholls-Diver had already attempted suicide as an inpatient at Fremantle Hospital's Alma Street clinic, her first admission as an adult following more than 30 admissions as a juvenile patient.
The day after her attempted suicide on May 2, she was released. Her father Mr Diver, also her primary carer, was on business in the eastern states and pleaded with her over the phone to wait for him to return. Hours later he received the call from police that she was dead.
Eight months on, Mr Diver said he was not bitter, angry nor seeking revenge over his daughter's death. He is pushing for policy change within the Department of Health, and is willing to devote years of his life to see it through.
Mr Diver has since been appointed to the Mental Health Advisory Council, and has at least two years ahead of him before his daughter's case is before the coroner.
In the interim, he is pushing for integral changes to be implemented to save potentially dozens of lives.
The issues, he said, are all interlinked.
He said the process of discharging mentally ill patients from a hospital was too simple, and required more boxes to be ticked off by more doctors before a mentally ill patient can be released.
The lack of funding for mental health, an increase in which he believes would assist in removing the stigma, was one of the primary problems within the department.
Finally, he said the lengthy wait to see the State Coroner could be addressed with two lawyers and two medical inspectors, where the long list could be sorted through in less than two years.
"My worry is that other people might be dying in between this process" he said.
"If we have six people dying this way every year, that's 18 or 20 people dead by the time we get a result here.
He described his anguish as he watched his teenage daughter's six year struggle with a borderline personality disorder.
He said at least once a month, her illness took hold and she would not leave her bedroom.
"I would come back and I sit with her 24/7," he said.
"Probably once a month I would be sleeping on a mattress in the hallway, and I would be scared to open her door."
The renewed plea for changes follows revelations on the weekend that a 27-year-old patient, who was denied treatment at the hospital's Alma Street facility on April 30, committed suicide within minutes at a nearby primary school.
Mr Diver and Mrs Thomas have been supported publicly by Opposition mental health spokeswoman Ljiljanna Ravlich, who is continuing to push for both the investigation and coronial inquests to be made public.
"A full coronial investigation is needed into the admission, treatment and discharge of patients at the hospital's Alma Street clinic, as well as full disclosure of how many other mental health deaths there were at Fremantle Hospital in the past year," she said.
"On behalf of the victims' families, I have raised this issue in Parliament for close to six months with no satisfactory answers from the Mental Health Minister [Helen Morton], who appears to be in a constant state of denial.
"The recent announcement of an internal review into mental health deaths at Fremantle Hospital is too little, too late."
Ms Ravlich said it was "simply not good enough" that Ruby Diver's case may not be heard before the State Coroner for two and a half years.
Ms Ravlich said there were currently 261 cases awaiting decisions before the coroner, and 245 cases currently sitting with the police coronial investigations unit, not yet allocated an investigating officer.
Mental Health Minister Helen Morton told ABC Radio she agreed the suicides needed to be scrutinised, and also that she had known for many months that the admissions and discharge practices needed to be overhauled.
"We have already put in place independent reviews for admissions and discharge practices," Mrs Morton said.
When asked about the alleged systemic problems at the Alma Street clinic following the three suicides this year, Mrs Morton said WA was better resourced and funded than any other state per capita.
She said that "one third of people who died from suicide have had recent contact ...recent as in 12 months at least...with a mental health service".
"We have half the number of community treatment orders for people with mental illness than in other states and what that's telling me is that we are banking our entire effort in trying to keep people safe and secure in hospital beds.
"Whilst we discharge them from hospital we haven't developed the capability of keeping safe and secure in that transition out of hospital or even with moderate risk in the community.
"Consequently our acute or secure hospital beds are becoming clogged with people who don't have an ability - a proper ability to keep them safe and secure within the community and right now that is where our focus is.
"[We are] trying to move to increasing the safety and security and the capability of people in community based care because we can't keep putting them in hospital and putting them there involuntarily, many times against their will."
Support is available for anyone who may be distressed by calling Lifeline 131 114, Mensline 1300 789 978, Kids Helpline 1800 551 800
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