Information on the mental health of a patient involved in a murder-suicide could have been “lost in translation” as he moved between medical professionals, a Hobart psychiatrist has told a coronial inquest.
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On Thursday, the Hobart Coroners Court concluded its last scheduled day of inquiry into the deaths of John Evans and his wife Jillian Evans at their Riverside home in September 2013.
Ms Evans died as a result of blunt force injuries to the head, and Mr Evans was found to have taken his own life.
Psychiatrist Ian Sale told Coroner Olivia McTaggart on Thursday that Mr Evans was in the Launceston General Hospital earlier that year, shortly before being transferred to St Luke’s Hospital.
Dr Sale told the hearing that with information passed on from the hospital’s emergency department to the mental health unit and then to a psychiatrist, key pieces of information on Mr Evans could have been missed.
He said that as this information was passed along, medical professionals may not have had a “full appreciation” for Mr Evans’ medical history.
“A transfer would ideally not only have a letter, but a telephone call and ideally that would be consultant to consultant,” Dr Sale said.
“There may have been important information lost in translation.”
He said if more information was known, a more cautious approach to Mr Evans’ diagnosis may have been taken.
“This man was in a very severe state when he arrived at the emergency department,” Dr Sale said.
He told the inquiry he thought it would have been reasonable to keep Mr Evans in the hospital for longer to gain a better understanding of his mental state.
Dr Sale said there also could have been greater concern raised by Mr Evans’ general practitioner.
He told the coroner that a home visit could have been helpful in the situation, but acknowledged this could be difficult to factor into a doctor’s schedule.
Dr Sale added that for those with mental health issues, medical professionals would often collaborate with family to determine whether a person was minimising their symptoms.
New South Wales psychiatrist John Kasinathan also told the inquiry via videolink that getting collateral information from family was critical to getting as much information as possible.
Dr Kasinathan said a person’s mental state could change in a matter of minutes or hours.
“To go from a [mental health] order to off an order, something must have changed,” he said.
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