Failure to establish suicide attempt was related to discharge advice

Key Points
  • To succeed in any claim for negligence the plaintiff must establish that any breach of duty is causally related to the damage claimed.
  • A failure to establish this will result in the plaintiff’s claim failing.
  • The plaintiff’s mother’s evidence on what she would have done if appropriately advised was not accepted as the trial judge concluded that it was affected by hindsight bias and the Court of Appeal concluded that such a determination was permissible.

The Court of Appeal upheld the trial judge’s decision that the plaintiff ‘s claim failed as he failed to establish that the advice provided on discharge for a period of leave, or the lack thereof, was causally related to his subsequent attempt to commit suicide and consequential hypoxic brain injury.

The Court of Appeal in a unanimous judgment upheld the decision of the trial judge, who concluded that the plaintiff in this matter failed to establish a causal link between a failure to provide advice to his family ahead of a period of leave  from a mental health facility and his subsequent suicide attempt. The plaintiff suffered severe and permanent injuries as a result of a hypoxic brain injury following a failed suicide attempt during his leave from a mental health unit.

The trial judge found that the duty of care owed to the plaintiff was to take reasonable steps to prevent injury by hanging. The trial judge found that the only breach of duty that had been established was the  failure to give clear instructions to the plaintiff’s parents to avoid alcohol and contact with a former partner whilst he was on leave and that if they were concerned about his condition they could contact the mental health unit or return him to the unit. That is, the family were not given a plan of action in the event that they had difficulty whilst the plaintiff was on leave.

The trial judge however, found that the failure to properly advise the plaintiff’s parents did not cause the attempted suicide because there was no connection between the consumption of alcohol or a text message exchange with a friend of the plaintiff’s former partner and his attempted suicide. The primary judge also rejected the plaintiff’s mother’s evidence that if she had been properly advised about the importance of the two stressors (alcohol consumption and contact with a former partner), she would have prevented the plaintiff from going out with his friends or returned him to the unit on his return from the outing.

The plaintiff sought to reformulate the duty of care owed to him at the appeal however, this was rejected on the basis that there were no exceptional circumstances justifying it. The Court of Appeal concluded that the trial judge was entitled to conclude that there was no causal connection between the plaintiff’s consumption of alcohol and the interaction with his partner’s former friend and the subsequent suicide attempt. Therefore, the breach of duty in not providing the plaintiff’s parents with information to avoid these was not causative of the suicide attempt and the plaintiff failed to establish liability. The primary judge was also entitled to conclude that the plaintiff’s mother’s evidence as to what she would have done had she been appropriately advised was affected by hindsight bias and therefore it was permissible to reject the evidence.

This matter is a reminder of two factors being, the importance of providing carers of mental health patients with appropriate advice on discharge or ahead of a period of leave. Such advice should include information as to potential stressors which may adversely affect the person’s mental health status as well as an action plan to implement in the event of deterioration. Further, the decision is a reminder that a defendant will only be liable to a plaintiff in the event that any breach of duty is causative of the alleged damage. In the event that there is no causal connection between the breach of duty and the alleged damage, as was the case here, then the defendant will not be liable to the plaintiff.

Post by Karen Kumar

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