A psychiatrist who reviewed the care of a man who drowned after leaving the mental health unit at Waikato Hospital unsupervised stands by her criticism of the man's care.
An inquest opened on Wednesday in Hamilton for 21-year-old Nicholas Taiaroa Stevens, who was known as Nicky.
He walked out of the Waikato DHB's mental health unit - the Henry Rongomau Bennett Centre - unsupervised in March 2015. His body was found four days later in the Waikato River.
Described as a philosopher, environmentalist, musician, artist and free-spirit, Mr Stevens first came under the wing of community mental health services in his teens.
He was diagnosed with disorganised schizophrenia.
In her report prepared for the Coroner, Dr Margaret Honeyman said all the markers of a high-risk of suicide were present but were ignored or at least given little significance.
In cross examination, the lawyer for one of the psychiatrists who looked after Mr Stevens suggested to Dr Honeyman that her report was based on hindsight and relied solely on reviewing clinical notes.
Dr Honeyman said that without being there, it was not possible to form a clinical impression apart from what was in a patient's clinical notes.
But Dr Honeyman's views have been contradicted by another psychiatrist.
Dr Murray Patton said the psychiatrist recognised Mr Stevens was unwell, but thought that an approach to his care was carefully considered.
The psychiatrist, who has name suppression, opened their evidence with a personal message of condolence to Mr Steven's whānau.
The lawyer representing the Stevens' family, Richard Fowler, told the witness that the family were grateful and touched by the psychiatrist's message.
The clinician, who has both name and gender suppression, told the inquest that unescorted leave given to sectioned mental health patients was consistent with allowing them to have a bit of control in the decision making around their treatment.
The psychiatrist believed they had a good rapport with Mr Stevens and that he did not try and manipulate his clinicians.
Mr Stevens' lead psychiatrist did not accept Dr Honeyman's criticism of the care provided to Mr Stevens.
The inquest before Dr Wallace Bain continues through until Friday.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email firstname.lastname@example.org
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.