Finding into death of Mitchell James Dowling

Contributing factors

• major depressive disorder with atypical features
• binge drinking and excessive alcohol consumption
• interpersonal conflict with housemates
• emotional distress and mood dysregulation
• high blood alcohol level (0.14g/mL) at time of death
• lack of ongoing psychiatric involvement
• limited family engagement in mental health care
• absence of written diagnostic information provided to patient

Coroner's recommendations

1. The APS, ACPA and AAP should advise members that when treating young adults, unless clear reasons contraindicate, they should provide written information about the diagnosis including future symptoms indicating relapse and need for further therapy, which can be shared with family, friends and supports
2. The APS, ACPA and AAP should advise members that when treating young adults with self-harm and suicide issues, management should include exploring the option for patient approval/consent for the psychologist to directly consult with parents or partners about the patient's condition and needed supports
3. The APS, ACPA and AAP should advise members that when treating young adults, management should include establishing whether the patient has discussed treatment and diagnosis with family, friends and supports, and if not, encourage and provide strategies for such discussion
4. The APS, ACPA and AAP should advise members that when psychiatric care is considered appropriate for young adults, clear advice should be provided on how to access such care and the general practitioner should be promptly notified to facilitate access
5. The APS, ACPA and AAP should remind members of the exemption in Health Privacy Principle 2.4 of the Health Records Act 2001 (Vic) permitting disclosure of health information to immediate family members on compassionate grounds