PSYCH PATIENTS GOT DRUNK, SMOKED DRUGS WHILE AWOL

Patients in Hawke's Bay's psychiatric unit got drunk, smoked cannabis and
committed crimes while on leave or absent without permission, says a
confidential report.

The damning internal report to the Hawke's Bay District Health Board (on
the mental health and addiction services from 2001-2003,) was released to
Hawke's Bay Today, and revealed yesterday.

The report said that if a patient committed a crime while officially or
unofficially on leave from the ward, staff had been reluctant to contact
police and have the patient charged.

"They have been essentially forgiven the offence and ignored, thus being
free to commit an offence again."

If patients assaulted staff and/or brought in illegal substances
"apparently little or nothing was done".

A health board spokeswoman said if hospital staff suspected patients of
breaking hospital rules they would be dealt with on an individual basis. If
staff concluded that a patient flagrantly breached hospital rules, police
would be called, she said.

Police would also be called if visitors tried to supply illegal substances
to patients.

The board's chief executive, Chris Clarke, said systems and policies had
been changed since the period the report applied to, improving staff and
patient safety.

The report was a "warts and all" assessment (of mental health services) and
was largely out of date, Mr Clarke said.

During the period 2001-03, psychiatric patients had the "run of the
hospital" in many instances, the report said.

Several patients went out on leave with substance abuse as an "active
problem" and came back intoxicated, but although substance abuse was
common, it was not listed as a diagnosis in the medical records.

No urine drug screens, or measures were taken to restrict access to drugs
(or other substances), and there was no assessment of patients after they
returned from leave. Neither were they searched for "contraband".

A high number of assaults was a concern, and a symptom of problems such as
substance abuse and the shortage of psychiatrists.

Mr Clarke said a "no-blame culture" was now in place to encourage staff to
report incidents such as assaults. Four permanent psychiatrists would be
appointed by August, as well as locum psychiatrists and registrars.

Staff recruitment was now on track, he said.

There had been a review of patients' medical files and the method of
storage. Yesterday's edition of Hawke's Bay Today revealed a catalogue of
failures at the mental health in-patient unit over a two-year period.

The most serious incidents were a murder and three suicides committed by
patients.