One of New Zealand's leading psychiatrists broke down in tears yesterday as he told a murder-suicide coroner's hearing of his frustrations with an under-resourced mental health system.
The hearing in the Auckland District Court also heard that axe killer Lachlan Jones had attacked a previous flatmate, and mental health staff knew about it.
Dr Wayne Miles' testimony - during which he had to stop to compose himself several times - was heard on day two of an inquest into the deaths of Jones and his landlord, marine engineer Malcolm Beggs.
Jones, an outpatient of Waitemata Health's acute psychiatric unit who discharged himself against medical advice, killed Mr Beggs with an axe then gassed himself at their Universal Drive property last August.
Dr Miles, Waitemata Health's clinical director of mental health, described services provided for young people as "woefully inadequate."
He said it was no wonder Jones did not like dealing with mental health services.
He said that in Jones' first contact with the system in 1998 he was given anti-psychotic medication and suffered a "horrific reaction."
"This is because this country won't fund the proper drugs ... we have to use old ones ... while the rest of the world prescribes new generation drugs."
He said there would have been "no problem" if Jones had received the right medication and good care with family involvement, after first showing signs of problems around age 15.
"But that is not the experience of so many customers in this country ... that's why I got emotional."
He said there was a lack of trained staff at all levels of the system and not enough beds to cope with the rapidly rising number of acute patients.
The other main development to come out of yesterday's testimony before coroner Mate Frankovich was that when health professionals came into contact with Jones shortly before the murder-suicide, they did not consider him to be a risk to himself or others.
This was despite the fact that Jones had attacked a previous flatmate, forcing the man to move out of their shared accommodation in fear.
Jones was assessed in May last year by a community assessment and treatment team after branding the word "murder" on his leg, and it was decided to treat him in the community.
"Many individuals who are successfully treated in the community have 'voices' - even violent," Dr Miles said.
The court also heard from psychiatrist Dr Penny Woods, who assessed Jones in May last year after he had carved "murder" on his leg.
Jones would not let her look at his leg, but denied he had suicidal or murderous intentions.
Jones was "monosyllabic" and difficult to establish a rapport with. He was behaving oddly, with "bizarre" facial grimacing and his eyes flickering around the room.
She said it seemed best to work closely with Jones in the community, ensuring he took his medication and in touch.
Dr Woods said another factor in this decision was the limited number of psychiatric beds available in the city.
Some time later Jones contacted the team saying he was upset because he had been burgled and was considering suicide. He was moved to a motel and visited twice daily by nurses, but quickly began improving.
Inquest told woeful system failed killer
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