Coroner's Court of Western Australia

Inquest into the Death of Child J (Name Subject to Suppression Order)

Inquest into the Death of Child J (Name Subject to Suppression Order)

Delivered on :15 December 2021

Delivered at : Perth

Finding of : Deputy State Coroner Linton

Recommendations : N/A

Orders/Rules : N/A

Suppression Order : Yes

The deceased’s name, and any evidence likely to lead to his identification, is suppressed from publication.  The deceased is to be referred to as Child J in ay publication.

Summary : Child J was a young Aboriginal boy who was taken into the care of the Department of Communities when he was a couple of years old when he was placed into foster care.  He lived with the same foster family for a large part of his life.

It was suspected from an early age that Child J had FASD and early trauma issues, which manifested in significant behavioural issues.

Child J was referred to paediatric and mental health services many times and in 2013, when Child J was approximately 12 years old, he was diagnosed with clinical depression.  In January 2014, he attended hospital twice in one month after threatening to cut his throat.  He was prescribed various medications over this time, but he generally reported that he did not like taking them.

His foster care placement became untenable, and he then spent time in different temporary care arrangements until 2014, when Child J moved to Carnarvon to live with his father.  While in Carnarvon, Child J had little contact with the Department or intervention by any health service, as both Child J and his father appeared reluctant to engage with the services which were available.  It is reported that he chose to cease to use all of his medications at this time.

Child J returned to Broome in early 2016 to visit family.  He was expected to return to Carnarvon, but his father did not come and collect him.  It was decided that Child J would remain in Broome.  Child J lived with his maternal aunt and her partner and family from that time.  Child J began attending high school in Broome, where he made friends and started a relationship with a girl.  During this time, his school performance was improving and he was making plans for his future.

In March 2017, Child J began to struggle to cope as his first relationship ended.  On the evening of 24 April 2017, Child J sent a text message to his former foster mother indicating that he was struggling.  This message was not thought to be a message that Child J was experiencing suicidal thoughts.  He seemed otherwise happy and well, so no one close to him was concerned about his welfare at that time.

In the early hours of 25 April 2017, Child J left the house he was living at the time, with a rope.  He tied the rope to a tree and used it to hang himself.  Child J was found by two passers-by who cut him down.  They found he was not breathing and had no pulse.  Police and ambulance officers attended and confirmed that he had died.

The Deputy State Coroner found the evidence supported the conclusion that Child J committed suicide by hanging.  The Deputy State Coroner noted Child J took his life in an impulsive act due to an inability to cope with his feelings over his first significant relationship breakdown.

The Deputy State Coroner made no specific criticisms of any individual involved in Child J’s care, but did note that there were opportunities for more to have been done to support Child J.

Catch Words : Death in Care : Treatment, Supervision and Care : Suicide

Last updated: 22-Mar-2022

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