Whistleblower claims under-reporting in psychological well being is placing sufferers, workers in danger

For two years Jane Thomasson’s job was to oversee security at mental health facilities in the Illawarra area south of Sydney.

Important points:

  • Illawarra mental health workers have accused managers of deliberately misreporting serious incidents on wards
  • A former mental health safety manager said her complaints about the practice have been ignored
  • The local health district of Illawarra Shoalhaven says they are unaware of any false reports

The occupational safety manager had to audit all 17 mental health locations in the Illawarra Shoalhaven Local Health District (ISLHD) between 2017 and 2019 to ensure compliance with health guidelines.

“There have been significant injuries among customers since [were] Assault, there was sexual assault, “said Ms. Thomasson.

However, when she checked the way incidents were recorded internally, she was quickly convinced that the system was broken.

“The reporting systems have not been used properly,” she said.

“Much of the information and data that is up to [the Minister] was actually wrong. “

Ms. Thomasson was in a unique position to watch serious incidents being reported through the Incident Information Management System (IIMS), which ranked incidents according to their severity on a number scale.

The higher the rating, the more likely it is that the department and department health authorities should be notified or involved in the investigation of the incident.

Ms. Thomasson said she noticed a pattern of caregiver ratings being downgraded when reviewing serious incidents.

She told the ABC she believed this was done on purpose to keep her “under the radar” of NSW Health.

When she raised her concern to management, she was reprimanded.

“It got to the point where I was actually told not to open cans of worms,” ​​Ms. Thomasson said.

“They didn’t like what I recommended.”

Jane Thomasson says she watched patients being locked up and detained in psychiatry without documentation. (

ABC Illawarra: Justin Huntsdale

)

“Advised against reporting”

The NSW Nurses and Midwives Association (NSWNMA) is working with the local health district of Illawarra Shoalhaven to improve safety in one of its acute care units at Shellharbour Hospital.

Health and safety officer Veronica Black said the hospital had made positive changes to improve staff safety.

However, she claimed that the review was still inappropriately downgrading major incidents and that the practice was systemic across the state.

“We get a lot of members who tell us they are actively discouraged from reporting,” said Ms. Black.

“Because when they get in touch, it creates work for someone else who has to investigate what happened and investigate the incident.”

The allegations stem from evidence from the New South Wales Regional Health Inquiry that serious patient incidents were inappropriately downgraded in the internal reporting system.

A doctor told Parliament’s committee last month that he was fined for asking a low severity rating for an incident that resulted in the preventable death of a patient.

The limitations of the state incident reporting system were also highlighted in a December 2020 report by the NSW Auditor-General, which found that 40 percent of all physical incidents in the state occur in mental health.

“At high-demand wards where incidents and risks are common, employees report that they cannot log all incidents due to the frequency of events and the time it takes to capture incidents in the system,” says in the report.

White wooden signs point the way to the mental health rehabilitation unit, child and youth programs, and Mental Health Day A former mental health safety manager for the Illawarra Health District claims a major attack on a mental health unit was given the lowest possible risk rating. (

ABC Illawarra: Tim Fernandez

)

Ms. Black said the current system is cumbersome and unsuitable for the frequency and volume of incidents that have occurred in psychiatric wards.

“New South Wales Health needs to develop a system that allows incident reporting to be done very quickly, especially in known high-risk areas,” she said.

“This information needs to be much more transparent than it is now. There needs to be much better oversight, including public reporting of the levels of violence against our health workers. “

‘Accurate dates’ essential

Ian Hickie, professor of psychiatry at Sydney University, said accurate reporting is critical to protecting the integrity of the mental health system.

“There is a problem with relying entirely on a system that reports on itself that cultures can break out into just wanting to be the best of what is happening now,” said Professor Hickie. “It’s a cultural issue for every district.”

Professor Hickie said NSW Health needs to make sure its data is correct to avoid further investigation.

“We have tried to avoid a royal commission by having accurate data on what is really going on. Without accurate reporting, we will not make progress, we will not invest, we will not make these systems safer.”

A low building with palm trees and cars parked in front of it, seen from the street. NSW Nurses and Midwives Association has worked to improve safety in the mental health department at Shellharbour Hospital. (

ABC News Tim Fernandez

)

HCCC complaint

Ms. Thomasson was dismissed from ISLHD in May 2019 after restructuring.

She then formulated her concerns in a complaint to the Health Care Complaints Commission (HCCC).

It detailed specific incidents and called for an external investigation by the administration of the mental health services of the ISLHD.

In her complaint, Ms. Thomasson said that the practices “put staff and patients at risk of (preventable and serious) physical and psychological harm” and that her complaint is a “snapshot” of “many” health problems.

“I am available to discuss problems in more detail if necessary,” wrote Ms. Thomasson.

The HCCC never called, and Ms. Thomasson said she never had the opportunity to report the Wollongong incident or any other examples of misreporting to the commission.

In its response to the complaint, the HCCC stated that it was convinced that the local health district was “not hiding information”.

The commission said it would “make comments to the local health district of Illawarra Shoalhaven to ensure the incidents are being reviewed”.

Ms. Thomasson said she was “stunned” by the HCCC’s response.

“When you have so many mistakes, the consumer, the patient, suffers at the end of the day, and those patients have suffered a lot,” she said.

In a statement, ISLHD alleged that it encouraged employees to report inappropriate use of reporting systems, but that “no such concerns were raised to management at this time”.

However, correspondence viewed by ABC confirmed that both the local health district and state health secretary Brad Hazzard had been made aware of Ms. Thomasson’s complaints about the service in 2019.

ABC’s inquiries to the NSW government were directed to Mental Health Secretary Bronnie Taylor.

In a statement, Ms. Taylor said she was “not notified of specific concerns” but assured that she would look into “any issues … raised”.

Ms Thomasson said that the most vulnerable members of the community would continue to pay the price if the shortcomings in reporting systems were not addressed.

She said the way serious incidents were reported and investigated needed major changes.

“At the moment the managers are investigating an incident and reporting on themselves,” said Ms. Thomasson.

“And it doesn’t work.”

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