Post-trauma stress 'a factor in death'

Many involuntary patients have post-traumatic stress after their discharge from a WA mental health clinic, a consultant psychiatrist told an inquest yesterday.

Kartiky Argarwal said that was one reason he discharged Anthony Edwards, 26, from the Alma Street clinic's secure unit into the community in March 2012.

Six days earlier Mr Edwards, who was diagnosed with schizophrenia, had been detained involuntarily at the clinic for 28 days.

Mr Edwards, one of Australia's best junior golfers, was found dead the day after his discharge.

"Anthony was not happy on the ward. He said he felt quite restricted and traumatised," Dr Argarwal, a registrar at the Fremantle clinic for nine years, said.

"It's a difficult ward with acute patients for a young man. I see a lot of people with post-traumatic stress after discharge from that ward."

Mr Edwards' mother Catherine has told the inquest her son was "very unwell" when she spoke to him the night before his discharge, which had shocked her.

Dr Argarwal estimated he had discharged "60 or 70" form-six patients - those to be detained involuntarily for 28 days - directly into the community. "It's not uncommon," he said. "About one out of 10." He said Mr Edwards appeared to have recovered well from his psychosis and wanted to go home. He did not admit Mr Edwards to the open ward because he believed he would have discharged himself and that drugs and alcohol could be found on the open ward.

But with hindsight, Dr Argarwal said a longer stay would have helped Mr Edwards if drugs and alcohol were not involved in his death. An autopsy revealed no illicit drugs in Mr Edwards' system and a blood alcohol level of 0.05.

It was Mr Edwards' first presentation at the clinic in six years. He was found to have had a relapse into psychosis after taking amphetamines and his antipsychotic medication was changed.

The court was told WA's chief psychiatrist Nathan Gibson, who investigated his death, found there had been "no consistent approach to documenting his risk".

Dr Argarwal said the treating team relied more on direct, verbal communication with colleagues.

Mr Edwards had a follow-up appointment a week later but Dr Gibson concluded this should have been within 24 hours.