'Ray of hope' faded as Roger Schnelle felt trapped inside Nolan House clinic, inquest told

Roger Schnelle critically injured himself at the Albury mental health clinic on the morning of April 28, 2021.

His life support was turned off two days later.

A coronial inquest in Albury is examining the treatment provided to the 63-year-old before his passing.

Family members have filled the court this week as details of the case have been examined.

Doctor Jessica Liu, who was on placement at Nolan House, on Thursday, October 26, told the inquest Mr Schnelle would ordinarily have been granted leave to see his family.

The inquest heard he had been highly embarrassed and ashamed to be at the clinic.

But measures implemented during the pandemic had prevented Mr Schnelle from exiting and taking breaks with his family.

"He was managed on a very restrictive setting," Dr Liu said.

She told the inquest she "felt the setting was not good for him", and said having patients leave gave an important insight into how they were progressing in the community.

The inquest heard Mr Schnelle had expressed a desire to go home and feared he would be trapped in the clinic forever.

"I should have killed myself two weeks ago," he said during his stay.

Concerns have been raised about suicidal ideation and Mr Schnelle expressing nihilistic and hopeless thoughts during his stay.

"He found it quite claustrophobic as well," Dr Liu told the inquest on October 26.

"There was just nothing enjoyable about it."

Yvonne Schnelle reported that her husband made a self-harm attempt on April 27.

Dr Liu said monitoring should have increased at that time to checks every 15 minutes.

Concerns have been raised about how the service responded to the incident.

Dr Abhijith Krishna said it was assessed that Mr Schnelle's symptoms were environmental.

He said there was a good chance if he was in a different environment at that point, his thoughts of harming himself would have diminished.

He felt Mr Schnelle had been catastrophising, which involved "a severe exaggeration of one's conditions and one's fears".

His nihilism was thought to have been explained by worsening anxiety.

Dr Krishna said he was active and had had many friends in the community.

"For Roger, it was very shameful," he said of the Nolan House admission.

Dr Krishna said Mr Schnelle had been making improvements in the first week "but the longer he stayed in the hospital this ray of hope started diminishing".

"This was a big concern for Roger," he said.

"The fact that he was unable to access any kind of outside environment throughout his stay in hospital made him feel that to some extent his autonomy was taken away from him, that he was losing his sense of agency.

"All of this was added onto the distress that he was already experiencing.

"Roger felt that the onus was on him to demonstrate that level of improvement."

Dr Krishna said his "sense of hope kept getting diminished" when his condition failed to improve and his "fear of getting institutionalised got more consolidated".

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The inquest heard Mr Schnelle had nothing to spend his time on at the clinic.

Dr Krishna said for a high functioning, intellectual person like Mr Schnelle, there were no measures to keep him busy.

It was feared putting him in the High Dependency Unit would make those issues worse.

Dr Krishna said it was a complex case.

He said increased monitoring could have had a detrimental impact on Mr Schnelle due to it being intrusive for patients.

The inquest continues on Friday.

Call Lifeline 24/7 for crisis support and suicide prevention services.

Help is available by calling 13 11 14. Text support is also available on 0477 13 11 14.

Call Beyond Blue 24/7 on 1300 22 4636 for advice, referral and support from a trained mental health professional.

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