Parents say daughter's suicidal thoughts were downplayed and dismissed | 7.30

Key Concepts

• Borderline Personality Disorder (BPD): A mental health disorder characterized by instability in mood, self-image, relationships, and behavior. The transcript questions the accuracy of this diagnosis in Amber’s case.
• Presidiz: A proposed spectrum of severe mental illness, potentially encompassing aspects of psychosis and mood disorders, often presenting with complex and treatment-resistant symptoms.
• Acute & Crisis Care: Immediate mental health support provided during a crisis situation, often involving emergency services and hospital admissions.
• Voluntary vs. Involuntary Admission: The difference between a patient agreeing to receive psychiatric care (voluntary) and being admitted against their will due to being a danger to themselves or others (involuntary).
• Risk Assessment: The process of evaluating the likelihood of a patient harming themselves or others.
• Discharge Planning: The process of preparing a patient for release from a hospital, including follow-up care and support.
• White Light Foundation: A foundation established by Amber’s parents to advocate for improved mental health care and protocols.

The Tragic Case of Amber Wraith: A System Under Strain

This account details the tragic suicide of 16-year-old Amber Wraith and highlights systemic failures within the Australian mental healthcare system. The narrative underscores the challenges of diagnosing and treating complex mental health conditions, particularly in crisis situations.

I. Amber’s Descent and Repeated Attempts to Seek Help

Amber Wraith, described as a vibrant and engaged teenager, experienced a rapid decline in her mental health starting in 2019. This manifested as severe anxiety, school refusal, and ultimately, depression and suicidal ideation. Over two years, Amber repeatedly sought help, contacting emergency services multiple times and being admitted to four hospitals. Despite recognizing her distress and actively requesting assistance, she frequently encountered dismissal or inadequate follow-up care. She was seen by eight psychiatrists and psychologists, yet a definitive diagnosis remained elusive, initially leaning towards a presumptive diagnosis of Borderline Personality Disorder (BPD).

II. Diagnostic Concerns and the Potential for Misdiagnosis

The Coronial Inquiry into Amber’s suicide raised serious questions about the initial diagnosis of BPD. Leading psychiatrist Professor Jayashri Kolkarnney, after reviewing Amber’s medical records, suggested she was likely experiencing “presidiz” – a complex and often treatment-resistant form of severe mental illness. Professor Kolkarnney stated, “The sad sad sad part about this is that had the diagnosis been made accurately then appropriate care and appropriate treatment could have been provided and I’m still left with oh you know this this could have been prevented and she could have been alive today.” This highlights the critical importance of accurate diagnosis in determining effective treatment pathways.

III. The Final Crisis and Systemic Deficiencies

Amber’s final presentation was at St. Vincent’s Hospital in Melbourne in April 2022. While awaiting her parents’ arrival, she sent them deeply disturbing text messages expressing suicidal intent: “So suicidal. Death is a nice option. I’m excited to die, to be with God, to be at peace, to be out of pain.” Despite these clear indicators of crisis, and her parents’ plea to keep her safe, Amber, being an adult, refused voluntary admission. She was discharged with a plan for follow-up assessment. Tragically, two days after a review noting she was “guarded and likely experiencing depression,” Amber took her own life following a final text message to her father.

IV. Accountability and Hospital Response

The coroner concluded that the decision not to involuntarily admit Amber was appropriate, but identified deficiencies in the care and communication provided by St. Vincent’s Hospital. The hospital CEO issued a letter of apology to Amber’s family, acknowledging that their concerns were not adequately considered, stating, “We acknowledge that had you and your family been listened to more genuinely and in isolation from Amber, your concerns may have influenced the weight placed on the decision to admit Amber to our inpatient unit. We are deeply sorry and accept responsibility.” St. Vincent’s has since implemented changes, including a new process for consulting psychiatrists to review mental health discharges and improved risk assessment protocols.

V. Systemic Challenges and Resource Constraints

The case underscores broader systemic issues within the mental healthcare system. A report from Mental Health Victoria highlighted the struggles to meet growing demand, particularly in a “resource constrained environment.” The report emphasized that effective care requires “time, connection, and care,” which are difficult to provide when resources are limited. Philip Thomas, CEO of Peakbody mental health Victoria, noted the unique challenges of mental health emergencies: “It's not like another kind of illness that you might see in an emergency department. You can't detect or confirm your diagnosis through an X-ray or a blood test.”

VI. Tom Boyd’s Story: A Parallel Struggle and the Power of Advocacy

The narrative also features the story of Tom Boyd, a former AFL player who battled severe anxiety, depression, and insomnia. Boyd’s experience highlights the hidden struggles of high-achievers and the importance of seeking help. He emphasized the ease with which his situation could have escalated to a tragic outcome like Amber’s, stating, “It was so easy to go down that path… It was so easy for every day to be worse than the one before.” Boyd now advocates for mental health awareness and support.

VII. The White Light Foundation: A Legacy of Change

In the wake of Amber’s death, her parents established the White Light Foundation. Their goal is to improve protocols in hospitals for diagnosing mental illness and assessing the risk of self-harm, ensuring that others do not suffer the same fate. They express a desire to honor Amber’s compassionate nature by advocating for better mental healthcare for all. As Tamara Wraith stated, “We were so in shock that somebody in a country like Australia, in a city like Melbourne, could not get support in a moment of crisis that we just didn't want anyone else to go through what we're going through.”

Conclusion:

Amber Wraith’s story is a devastating illustration of the consequences of systemic failures within the mental healthcare system. The case highlights the critical need for accurate diagnosis, improved communication between healthcare providers and families, increased resources, and a more compassionate and responsive approach to individuals experiencing mental health crises. The White Light Foundation’s work represents a vital effort to translate this tragedy into positive change, ensuring that Amber’s legacy is one of hope and improved mental health care for future generations.