Nurse Stephen Douglas was fatally stabbed by a client in attack his son says was 'preventable'
Sean Douglas is pushing for community mental health care reform after his father was stabbed to death by a client. (ABC Illawarra: Penny Burfitt)
In short:
Stephen Douglas was stabbed to death by a mental health client in 2019, just one year after a similar, but non-fatal, stabbing at his workplace.
Stephen's family say his death was preventable, as a coroner found "inadequacies" in decision-making and "unreasonable" workloads at his workplace.
What's next?
Stephen's family has called for an increase in mental health pay to address workforce shortages.
Sean Douglas remembers feeling "a kick to the stomach" when he heard his father had been stabbed to death at work in 2019.
When he learnt his father was not the first worker at the community mental health service to have been stabbed by a client, disbelief turned to anger.
"It was quite confronting to hear," Sean said.
"There was a near miss just before my Dad's passing where there was an opportunity to make changes [in the workplace] that seemed to have been lost."
Stephen Douglas was a mental health nurse at the Camperdown Community Health Service (CCHS), in Sydney's inner-west, when he was killed by a client in a 7-minute attack during a home visit in September 2019.
The client was found not guilty of murdering Stephen on mental health grounds.
Stephen Douglas was stabbed to death during a home visit that he attended alone. (ABC News)
The family decided to pursue an inquest after Stephen's colleagues approached them at his funeral with a plea for help.
Sean said they told him the scenario "would be repeated again and again" if changes were not made at the workplace.
"[Dad's colleagues] told us they were so overburdened, [that there were] high caseloads and that their voice wasn't being heard," Sean said.
During the inquest, the family listened in disbelief to evidence that another CCHS worker had been stabbed in the neck by a client during an in-community visit at a cafe the year before.
It was described as a "huge near miss" by a coordinator.
In her final report, handed down earlier this month, Deputy State Coroner Kasey Pearce said the 2018 stabbing could have been fatal.
"The September 2018 incident bore significant similarities to the incident that later resulted in Stephen's death," she said.
Sean agreed.
"I felt like my dad's death was preventable," he said.
Inquest hands down findings
The inquest heard 62-year-old Stephen was "much loved", "always smiling" and possessed a "wonderful sense of humour".
"It is a sadness that hits harder than normal grief," Sean said.
Stephen Douglas pictured with his grandson before his death. (Supplied: Douglas family)
Following Stephen's death in 2020, SafeWork NSW issued the Sydney Local Health District (SLHD) an improvement notice to investigate ways to reduce the risk of violence and aggression towards workers during home visits.
The order was complied with.
In August, the coroner made 13 recommendations for the SLHD and NSW Health to further improve safety for workers.
In her report, Magistrate Pearce described decision-making around home visits as "inadequate", noting that safety huddles, required under NSW Health policy, were not implemented daily at the CCHS when Stephen died. She also said caseloads in the team were "unreasonable".
"The volume of allocated client caseloads together with other duties expected of staff, gave rise to a workload that was extremely and unreasonably high, particularly for more experienced staff like Stephen," Magistrate Pearce said in her findings.
Stephen was visiting the client's home alone when he was stabbed, and the client had been experiencing deteriorating mental health in the weeks prior to the attack.
In the final report, the coroner noted the health district did not support most recommendations in full during the inquest, and cited budget and resource constraints in response to increasing psychiatric reviews.
It has six months to submit a formal response.
Sean said the family felt the health district did not take Stephen's death "as seriously" as they did.
Stephen Douglas with Sean Douglas (right) and Sean's wife Emma Douglas (left). (Supplied: Douglas family)
"When you're asking for changes around the safety and wellbeing of frontline workers and you're hearing [it's] not cost effective or there's not enough resources, it boggles the mind," he said.
"How can safety and welfare be considered constrained by budget and resources?"
SLHD did not respond directly to the family's criticism but said in a statement that Stephen's death was a "profound tragedy".
"The district remains firmly committed to providing a safe and supportive workplace for all staff and will rigorously review the coroner's recommendations," they said.
SafeWork participated in the coronial investigation, and said it was "reviewing the coroner’s report and recommendations".
Pay reform
Stephen's death preceded a huge push for reform to mental health care in the state, with two-thirds of psychiatrists threatening to quit this year.
Meanwhile, the NSW Nurses and Midwives Union has been at loggerheads with the state government for more than a year over pay and working conditions negotiations.
Stephen Douglas is remembered as a loving grandfather. (Supplied: Douglas family)
Stephen's family has called for the pay of mental health nurses, psychiatrists and in-community workers to be increased.
"It's acknowledgement of the work they do, it's remunerating them and the sector to drive more people into the workforce," Sean said.
"Our biggest desire is that this doesn't happen to anybody else's family simply because their dad went to work to do a job that he loved doing, caring for the most vulnerable people in our community."
Stephen Douglas's family says he loved his job as a mental health nurse. (Supplied: Douglas family)
In a statement, NSW Nurses and Midwives Union general secretary Shaye Candish supported the family's calls for improved pay and called for the recommendations to be implemented statewide to "ensure Stephen’s passing was not in vain".
"Almost six years on, little has been done to improve the safety and wellbeing of mental health nurses working in community settings," she said.
In a statement, Minister for Mental Health Rose Jackson acknowledged Stephen's "incredible contribution" to community health care.
She said the state government was committed to improving pay and conditions for essential health staff.
"We acknowledge the urgent need to address systemic challenges in community mental health care and we will rigorously review the recommendations made by the Coroner," she said.
Sean said an unfair burden fell on impacted families like his, or that of murdered paramedic Stephen Tougher, to create change.
"We've had to carry quite a big burden as a family, it's prolonged our grief," he said.
"If workers had been listened to by the health district before my dad's death, then potentially, we wouldn't have had to do what we did."