"Lack of communication and due diligence"

Recently in the early hours of the morning, my adult younger sibling presented to the Royal Perth Hospital Emergency Department following a suicidal attempt on their life.

After receiving a distressed call in the early morning from my parent, who is my sibling's registered Next of Kin and who resides 2000km, I attended the ED. Shortly after my arrival approximately an hour later, I was taken through to an ED bay where my sibling was being treated. I sat and spoke with them and observed they were still visibly distressed, crying and overwhelmed with intense sadness and agitation. Within half an hour of my arrival, two clinicians attended to them to discuss their condition and care. As I understand, one was a doctor and the other a clinical psych liaison.

Following the discussions, my sibling asked me to speak to their treating doctor so that I could better understand the events surrounding their attempt, admission, treatment, discharge and forward care plan, as they felt too embarrassed and overwhelmed to speak about it directly to me.

My sibling told the clinicians they would be coming home with me. For context, I am a young adult, only a year or two older than my sibling with no psychiatric training or background and I live by myself. I asked to speak to their treating psychiatrist and believe I was spoken to by a psych liaison.

In short, the conversation left me in complete and utter disbelief with zero understanding of the events surrounding my sibling's attempt and no comfort in taking them into my care and immediate supervision. I was provided zero information as to how they presented (via ambulance, police or by themself). Zero information regarding the attempt and their risk profile to consider upon discharge.

I recall I was told that it was all circumstantial and there was no treatable illness. I felt my questions were an impost to the team which was confusing as I saw the ED was busy, but certainly not, as I understand it, at capacity. No one asked me if I felt comfortable taking my sibling home. I expressed to the psych liaison that I was a young adult, unequipped and untrained to deal with suicidal ideology and attempt from a loved one. I asked if there was any clinical expert opinion on what needs to happen next and how I should best care for them. I was advised to take them to see a GP the following day and establish a mental health care plan for them. 

They were discharged from the ED with no medication, no discharge summary. Just a medical certificate and pamphlet containing a number of mental health crisis hotlines. Only a few minutes prior to discharge, my sibling verbally made another threat on their life to me in their ED bay which I raised with the psych liaison in my conversation regarding feeling uncomfortable with the decision to discharge them in their current state. I recall I was told to take them home, give them food and kick them out of the car or call the police if I felt unsafe. 

Having worked in the healthcare sector for several years, with experience in clinical governance, I was truly disgraced by the apparent lack of communication, care, due diligence and failure of the treating team to meet basic duty of care. I feel disappointed as an employee and consumer of the WA Health service following this experience with my vulnerable younger sibling.