Coronial

15 results for personality vulnerabilities

VIChome2022-03-31

Finding into death of Tessa Michelle Ballam

31y · Female·neck compression in the circumstances of hanging

…Ballam, a 31-year-old accountant with longstanding depression, anxiety, bulimia nervosa, and borderline personality disorder (BPD), died by hanging in August 2015. She had experienced workplace difficulties with her man…

psychiatrypsychologycommunicationsystemalcohol
QLD2025-10-08

Inquest into the death of Peter Owen Pilkington

48y · Male·gunshot wound to chest

…se findings against police, but identified Peter's untreated mental health conditions (PTSD, borderline personality disorder, chronic suicidality), substance use, and easy access to a realistic gel blaster as contributi…

emergency medicinetrauma surgerysystemmethamphetamine
WA2024-11-15

Inquest into the death of Kingsley Dean Garlett

32y · Male·ligature compression of the neck (hanging) in a man with methadone and methylamp…

…led through prison phone calls. Critical clinical lessons emerge: the deceased had emotionally unstable personality disorder and polysubstance use disorder but did not warrant psychiatric hospitalization. However, he wa…

psychiatrypsychologysystemdelaymethadone
VIC2020-04-06

Finding into death of Robert James Lawerence

29y · Male·Shotgun wound to the head

…th complex mental health needs including ADHD, depression, anxiety, Tourette's syndrome, and borderline personality traits, died from a self-inflicted shotgun wound. He held a Category A & B firearms licence obtained in…

psychiatrypsychologycommunicationsystem
QLDhome2017-07-26

Richards, Karen Louise

41y · Female·mixed drug and alcohol toxicity

Karen Louise Richards, 41 years old, died from mixed drug and alcohol toxicity on 11 January 2014. She had consumed heroin (evidenced by 6-MAM metabolite), alcohol, benzodiazepines, and other prescription medications. He…

psychiatryemergency medicinedelaysystemheroin
QLDhome2026-04-21

Inquest into the deaths of F and M

33y · Male·Extensive burns sustained when former partner deliberately splashed petrol on hi…

…care by interim consent order the previous day after psychiatric assessment diagnosed M with borderline personality disorder and chronic PTSD, identifying her as posing significant risk of lethal violence to herself and…

psychiatrypaediatricsdiagnosticsystem
QLDcommunity, community, community2019-08-30

Nebauer, Talieha; Fowell, William and Whiticker, Caitlin Wilkinson

18y · Female, female, male·Caitlin: suicide by hanging; Talieha: suicide by hanging; William: suicide by tr…

…stability, and recent relationship breakdown. Talieha had post-traumatic stress disorder and borderline personality disorder from childhood sexual abuse; she transitioned to an adult facility (PRCCU) with reduced superv…

psychiatrypsychologycommunicationsystem
VICmental health2012-03-13

Finding into death of Matthew Spalding

28y · Male·neck compression subsequent upon hanging

Matthew Spalding, a 28-year-old psychiatric inpatient with borderline personality disorder and recent psychotic symptoms, died by hanging on 25 April 2009. He had been admitted to the A…

psychiatryemergency medicinecommunicationsystemaripiprazole
QLD2025-10-01

Inquest into the death of Duke Allan Wayne Schafer

36y · Male·Ligature strangulation

…en Bloomfield's deliberate premeditation and choice of time/location, but infrastructure and systemic vulnerabilities were exploited.

psychiatrypsychologysystemcommunicationbuprenorphine
WAcommunity2025-06-09

Inquest into the Death of Joyce Gladis CLARKE

29y · Female·gunshot wound to the abdomen

29-year-old Aboriginal woman (JC) of Ngarlawangga Yamatji Martu descent died from a gunshot wound inflicted by police on 17 September 2019. Four days prior, she was appropriately discharged from Sir Charles Gairdner Hosp…

psychiatryemergency medicinesystemmethamphetamine
QLDhospital2008-12-15

Van Putten, Patricia

49y · Female·Respiratory failure sequential to ingestion of Glyphosate due to depression and …

…serious self-harm attempt (throat laceration). She had complex comorbid Major Depression and Borderline Personality Disorder with chronic suicidality. Discharge planning involved intensive community follow-up with daily…

psychiatrygeneral practicecommunicationsystemdosulepin
WA2019-05-02

Inquest into the Death of Fazel CHEGENI NEJAD

34y · Male·ligature compression of the neck

Fazel Chegeni Nejad, a 34-year-old Iranian asylum seeker, died from ligature compression of the neck in the jungle near Christmas Island immigration detention centre on 8 November 2015. He had spent 1,477 days in detenti…

psychiatrygeneral practicesystemcommunicationmirtazapine
VICmental health2013-06-18

Finding into death of Paul Allan Skinner

29y · Male·hanging

Paul Skinner, a 29-year-old with depression and recent suicide attempt, was admitted to a psychiatric inpatient unit on involuntary status. Despite being prescribed 15-minute observations by his treating psychiatrist, nu…

psychiatrycommunicationsystem
QLD2025-09-08

Inquest into the death of Gina Valera

49y · Female·Hanging

Gina Valera, a 49-year-old woman with a history of depression and three prior suicide attempts, died by hanging in Brisbane Women's Correctional Centre nine days after admission on remand for attempted murder. She had be…

psychiatrycorrectional healthcommunicationsystemmirtazapine
QLDcommunity2023-04-05

Grimes, William George

31y · Male·Burns

31-year-old George Grimes with longstanding schizophrenia was found threatening self-immolation after consuming alcohol and missing antipsychotic medication. Despite police de-escalation attempts, he doused himself with …

psychiatryemergency medicinediagnosticcommunicationquetiapine

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