Clinical notes from the Central Regional Eating Disorder Service (CREDS) showed Lucas was losing weight and had a “low” mood, but it was not enough to get him admitted to Piko, the children’s inpatient medical ward at Wellington Hospital.
When he did finally end up in Piko after a fainting episode, he was not treated for his eating disorder, but for mental health, after doctors found evidence of self-harm.
Lucas’ anorexia emerged a year ago, when he went from refusing to take lunch to school, to skipping dinner, to not eating anything for several days.
He was first admitted to Piko for a fortnight in December for a medical refeeding treatment, where his condition improved, but he relapsed post-discharge.
“We watched his eating disorder morph from no food intake to food intake but extreme exercise,” Robert said.
In an email sent in April, CREDS contacted Wellington Hospital to “discuss a [second] potential admission to Piko ward”, which the parents supported.
A day later, they ended up having to seek urgent care for Lucas after a severe self-harm incident.
The parents told CREDS they were “completely out of their depth” and felt “helpless” at their inability to keep their son safe.
“We need to stress the absolute urgency of getting Lucas admitted to Piko today,” their email to the service read.
They were told the hospital would not admit him because his condition was not bad enough and his vitals were “not unstable”.
Lucas was instead offered weekly appointments with the hospital paediatrician, during which Jennifer said his weight was “dangerously low”.
In these appointments, they continued to ask for admission to Piko but said they were told Lucas was not sick enough.
Meanwhile, Robert had to push for mental health services to give Lucas an in-person appointment despite allegedly being told he met the criteria for support.
Two months later, Lucas was taken to the emergency department after he passed out.
Doctors found self-harm marks on him and admitted him to Piko under a mental health hold.
The hospital planned to discharge Lucas after one night but Robert refused and argued for him to stay longer.
Lucas remained in Piko for four nights and Jennifer said “the rooms around him were empty right up until the day he was discharged”, despite the parents claiming they were told Piko did not have enough beds to take him.
While Lucas had been offered care from a range of services through the hospital, his parents said his treatment felt disjointed until his emergency admission in June, when a multi-service plan was created.
Now, his school attendance rate was the highest it had ever been, and Robert said he was “much happier” because he could “see a way forward”.
“It feels like because I pushed back with the crisis team, we are now getting the help that we needed,” Robert said.
“Don’t take no for an answer if you know your child is sick.”
Hospital says some young patients better treated in the community
After the Herald contacted Health New Zealand for comment on Lucas’ treatment, a woman from CREDS called Robert and Jennifer, and reportedly acknowledged the parents had been given conflicting reasons for why he was denied admission.
In the brief call, she offered the parents a meeting with the hospital to discuss their issues with Lucas’s treatment.
She also told them the hospital would send them a written statement addressing all of their concerns.
Meanwhile, the Herald received comment from Health New Zealand central mental health and addiction regional director Paul Oxnam.
Oxnam declined to answer questions about Lucas’ case, but said admissions to Piko were based on clinical criteria.
Young people with eating disorders who did not meet that criteria could be best supported in their community and could still be offered support from specialists, he said.
In the last six years, Oxnam said CREDS was not aware of any child who met admission criteria being declined admission to Piko because of capacity issues.
He said CREDS would form treatment plans for patients and worked closely with other services to “provide coordinated, wrap-around care for young people with eating disorders”.
If a young person’s mental health concerns posed the greatest risk to them, they could be considered for admission to the regional rangatahi adolescent inpatient service.
Ultimately, Robert said he had an issue with the process for getting his son support, not the “wonderful” healthcare workers who were supporting him.
“We won’t be the only ones struggling to get the help that their child deserves.”
*To maintain the family’s privacy, the name of the teenage boy has been changed and the family’s last name has been omitted.
Janhavi Gosavi is a Wellington-based journalist for the New Zealand Herald who covers news in the capital.