Hospital, DFFH criticism heard in Bendigo XY coronial inquest

A Bendigo girl living in out of home care who passed away by suicide in 2021 had presented to the Emergency Department at Bendigo Hospital "weekly, and at times, daily in the months prior to her death".

Expert panelists Dr BJ Newton and Dr Jacynta Krakouer presented their responses to the life of the girl XY (a pseudonym), and how her care could have been improved as the coronial inquest continued this week.

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The pair agreed that the care XY received - particularly at the hands of the Bendigo Hospital - was "unacceptable".

She was described as "desperately" wanting help, and the court heard she attended the ED so often that a doctor commented that one day, sadly, she would die by suicide.

For Dr Krakouer, a Mineng Noongar woman with a PhD in social work from the University of Melbourne, this comment struck her as a doctor who had "given up on hope and (XY)'s human right to life".

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Dr Newton, a Wiradjuri woman with a PhD in social work and policy from UNSW, presented a report to the court which said, "there was no consideration or regard for (her) cultural needs in all her many interactions with Bendigo Hospital staff".

The panel said XY was "continuously discharged" despite her serious needs.

XY was quoted as saying, "it's like I have to kill myself to show them I'm sick".

She was described as "extremely frustrated that when she repeatedly presented asking for help at the emergency department following a self-harm incident or suicide attempt, only to be medically cleared and discharged".

This was despite the girl consistently saying she was "not well, wanted help and had a plan" to fatally harm herself.

The panel said there were incidents in the emergency department which XY found "extremely distressing", where staff "minimised" her fears and concerns and "did not take her seriously".

The court has also heard that XY had complained that she was "made to undress" in front of a male staff member at the Austin Hospital in Melbourne with no female worker present.

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Dr Newton said this was highly inappropriate "given at the time (XY) was a 16-year-old girl with a history of sexual abuse and exploitation from males".

Dr Newton said there were "a number of very basic strategies" that could have helped XY in her dealings with all health services, such as having an Aboriginal liaison worker present at hospital, as well as when dealing with police.

She also said the Bendigo District Aboriginal Co-operation (BDAC), child protection, Bendigo Health, other hospitals and an Aboriginal child specialist advice and support service case workers (ACSASS) needed to collaborate more effectively.

The importance of co-design and Aboriginal run programs, in addition to "deep respectful listening", were also highlighted.

The court had previously heard XY had sent a letter to the department, BDAC and other service providers in December 2020 to express her concerns about the care she had received.

"Her truth is her truth," Dr Newton told the court, in relation to this letter.

Dr Newton said if XY why was "not feeling a part of making decisions", which was communicated in that letter, then the care team should have asked her how she would like to approach her care.

Dr Krakouer told the court "a parent would pay" and "you would do everything as a parent" to prevent a child passing away.

The court heard the secretary of the DFFH had assumed the role of parent with the implication that exceptional steps of care had not been made.

The panel also commented on the work of services including Anglicare, Victoria Police and the DFFH.

For Anglicare, there was an identified need for "cultural humility training" and closer collaboration with BDAC.

The experts also said culture needed to be considered a protective factor and Indigenous children needed access to cultural items such as flags, totems, artwork, music, songs and TV in placements.

For police, the panelists said XY needed to have access to a liaison worker, with more Indigenous and female staff available for her disclosures of sexual abuse. The court heard Victoria Police had issues with systemic racism and discrimination of Indigenous people.

The DFFH's response and care of XY was criticised for its lack of engagement with her family, a lack of timeliness and urgency, as well as issues of systemic racism which also affected Victoria Police.

The court also heard there were potential areas for more holistic medical care such as through the use of traditional healers, animal - "she loved dogs" - or art therapy, and family therapy, to aid other services.

The court heard as XY's health deteriorated further there was a trigger point after which involuntary admission should have been considered.

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