A psychologist practising on Sydney’s North Shore has come before the NSW Civil and Administrative Tribunal (NCAT) after a referral from the Health Care Complaints Commission (HCCC).
Dr Elise Lowick, a specialist in emerging psychosis, was facing suspension or deregistration over a string of inappropriate communications with a troubled year 12 student, including one which suggested he commit murder.
The patient began having homicidal thoughts in year 7.
Five years later, when school counselling proved ineffective, the 17-year old’s family privately engaged Dr Lowick over concerns about his anti-social expressions and conduct.
The psychologist diagnosed the teen with major depressive disorder, generalised anxiety disorder, adjustment disorder and narcissistic personality traits.
Subsequent commentary expressed the view that the teen’s diagnosis may be consistent with that of a psychopath – which is a person who possesses an antisocial personality disorder characterised by traits such as impaired empathy, egoism and sometimes interpersonal violence.
Over about a fortnight, the psychologist sent several text messages to the troubled teen including:
‘‘If your [sic] planning on murder, can you come kill the jack hammer guy outside my house”.
In another, Dr Lowick mocked the school counsellors, suggesting they:
‘‘have to say hi so that they seemingly care about your well being’’. The doctor added that one of the counsellors is so inept ‘‘you could probably play with her head! Ha!’’.
Lowick even told the teen she had been discussing his case with her family at the dinner table, a clear breach of patient / doctor confidentiality.
The HCCC submitted the conduct fell so far short of that expected of a medical practitioner the doctor should be found guilty of professional misconduct.
The body further submitted that deregistration or at least suspension should follow that finding.
However, Dr Lowack contended that the messages were “an attempt to use humour”, while admitting they were “both in poor taste and in poor clinical judgment”.
She pointed out that the communications occurred over a relatively short period of time – two weeks.
She further submitted that, despite discussing the teen’s case at the dinner table, her conduct did not involve a breach.
The NCAT ultimately found that although the conduct was concerning, it was not serious enough to warrant a finding of professional misconduct.
The tribunal found the doctor guilty of the less serious act of unsatisfactory professional conduct and ordered that she meet a mentor, attend a professional boundaries course and submit to supervision.
The finding was despite the tribunal saying it was “particularly concerned” by the message about killing the jackhammer operator.
‘‘The reference to murder, and the suggestion to kill someone, to a 17-year-old patient with homicidal ideation is not appropriate in any circumstances or for any reason,’’ the tribunal stated.
‘‘We find that the sending of this message in and of itself amounts to unsatisfactory professional conduct.’’
Concerns have been expressed that the ruling is so lenient that it does not act as a deterrent to others who might also consider crossing professional lines in such a blatant and potentially dangerous manner.