Mrs B

52y · Female·Hanging due to depression

Mrs B, a 52-year-old woman with a 17-year history of recurrent depression, suicidal ideation, and borderline personality traits, was admitted to Cairns Base Hospital Mental Health Unit on 11 March 2008 with escalating suicidal ideation and plans to hang herself. On 14 March, after Dr L. assessed her as not being at acute high risk of suicide and placed her on category B observations (15-minute checks), she absconded within minutes and purchased rope and a stepladder from a nearby hardware store. She was found hanging at the Cairns Showgrounds on 15 March. While the coroner found Dr L.'s clinical assessment and observation level were reasonable given the need to balance therapeutic care with safety, the case highlights the critical importance of physical monitoring of mental health unit exits. Her selective disclosure of symptoms to clinicians, her history of impulsive absconding when hospitalised, and recent acute suicidal ideation documented by nursing staff suggested higher risk than her presentation to the psychiatrist indicated.