A mental health support worker has been found to have "seriously violated" professional boundaries by engaging in sexual relations with the former partner of a vulnerable patient and continuing to provide treatment to that patient during the relationship.
The worker had supported her female patient through numerous difficulties, including a break-up with a male partner, which the worker used to launch her own relationship with him in mid-2022.
In a report on the incident released by the Health and Disability Commissioner (HDC) on Monday, the patient said she became suspicious when her ex-partner referred to things she had only divulged to the mental health worker.
The investigation, however, could not "conclude with certainty" that the worker had disclosed personal information to the patient's ex-partner.
When the patient became suspicious, she asked to be discharged from the support worker's care and complained to the mental health service provider she worked for.
The support worker, referred to as Ms B in the HDC report, resigned during the provider's subsequent investigation, which ended with the provider offering an apology to the patient (Ms A).
"[I]t was entirely unacceptable for [Ms B] to continue in a therapeutic relationship with you whilst having sexual relations with [your ex]," the provider told the complainant.
"[The service] wishes to offer its profound apologies to you over what happened. You should never have been placed in this position, and we understand entirely your sense of betrayal.
"[Ms B] has also asked me to convey to you her sincere apologies for her failure to end the therapeutic relationship with you. At the time she felt she could manage the situation professionally, but she now realises that this was a mistake, and she should not have continued as your support worker once her association with [your ex] began."
Despite Ms A alleging Ms B had disclosed personal information to the man — referred to as Mr C in the report — neither the provider's investigation nor the subsequent HDC investigation was able to "conclude with certainty" that had actually happened.
Ms A said during the six months prior to finding out about the inappropriate relationship she was feeling positive, had been well and was actively working towards a better future for her and her children, including developing a business plan.
However, she said finding out Ms B was having sex with her ex destroyed her confidence. After that she said she became depressed and angry, suffered anxiety that made it difficult to leave the house, and contemplated taking her own life four different times.
The HDC report is the opinion of Deputy Health and Disability Commissioner Dr Vanessa Caldwell, who asserts Ms B would likely have known her actions would negatively impact both Ms A and her children.
"Ms B used information gained from her sessions with Ms A in respect of the initiation of the relationship itself. Ms B knowingly entered into a sexual relationship with Ms A's ex-partner, Mr C, and she did not adhere to the fundamental ethical standards of a support worker in New Zealand," wrote Caldwell.
"In doing this, she breached the trust of her client, Ms A, who Ms B knew was vulnerable. Ms B used this information for personal gain, and I consider that this action was reasonably foreseeable as something that would affect Ms A's well-being and did not respect her dignity.
"In my view, the impact on Ms A's well-being could have extended to the welfare and well-being of her children."
She also said the mental health worker did not understand just how badly her actions impacted her patient.
"I remain unconvinced that Ms B has an awareness of the gravity of the situation and the impact this type of breach of trust could have on a vulnerable client."
HDC recommendations
Caldwell said Ms B should write Ms A a personal apology letter that details the changes she's made to her practice since the incident, and that this letter should also be provided to the HDC.
Ms A should also enter into a "mentoring relationship with a senior colleague for at least one year", said Caldwell, with the mentor asked to confirm to the HDC that Ms B is "maintaining appropriate professional boundaries with patients and their families".
The HDC also had recommendations for Ms B's former employer to try and ensure such a breach does not happen with the mental health service provider again.
Further punishment may be coming for Ms B as the HDC has referred the case up to the Director of Proceedings.
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