Coroner's Court of Western Australia

Inquest into the Death of Boris DRLESKI

Inquest into the Death of Boris DRLESKI

Delivered on :13 April 2022

Delivered at : Perth

Finding of : Coroner Jenkin

Recommendations : No

Orders/Rules : No

Suppression Order : N/A

Summary : Mr Boris Drleski (Mr Drleski) was 45-years of age when he died from bronchopneumonia and combined drug toxicity at his home in Balga.

Mr Drleski had an extensive mental health history and was diagnosed with schizophreniform psychosis and chronic drug use in September 2000.  He was subsequently diagnosed with treatment resistant chronic paranoid schizophrenia and anti-social personality disorder and his mental health conditions were complicated by his non-compliance with prescription medication and persistent polysubstance use, including heroin, methylamphetamine, cocaine and cannabis.

At the time of his death, Mr Drleski was the subject of a community treatment order (CTO) and was under the care of a community psychiatric service.  His complex needs were managed by means of a monthly depot injection of antipsychotic medication, which Mr Drleski frequently declined.  As he was on a CTO, Mr Drleski was obliged to receive treatment, and when he refused his depot injection he was taken to Graylands Hospital (GH) by police.  Once at GH, Mr Drleski invariably accepted the depot injection and was discharged after a few days.

A CTO was required in Mr Drleski’s case because he was non-compliant with his medication, lacked insight into his mental health conditions and lacked the capacity to make treatment decisions about his mental health.  The Coroner was satisfied that that the decision to place Mr Drleski on successive CTOs was justified on the basis that this was the least restrictive way to ensure that Mr Drleski was provided with appropriate treatment for his mental health conditions.

Mr Drleski may have benefitted from a long-term admission to a facility where his mental health and polysubstance use issues could have been tackled together, however, no such facility was available.  Since Mr Drleski’s death, a facility known as a secure extended care unit (SECU) has been designed for the treatment of patients with severe and chronic mental health illnesses who have co-occurring polysubstance use issues and/or challenging behaviours.  Treatment in the SECU will be provided on an involuntary basis with the aim of transitioning patients into a “community care unit”, which would offer long-term treatment, rehabilitation and recovery care.

The coroner concluded that Mr Drleski’s management while he was an involuntary patient at GH and whilst he was the subject of a CTO was reasonable when considered in the context of the resources available to clinicians at the relevant time.

Catch Words : Community Treatment Order Death : Treatment Resistant Paranoid Schizophrenia : Co-existing Mental Health Conditions and Polysubstance issues : Long-term Treatment Options : Accident

Last updated: 3-Aug-2022

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