Steve and Lizel Ramsay say system failed them after death of their beloved daughter Giaan
The parents of a teenage girl who took her life after being treated for an eating disorder at a Gold Coast hospital claim the health system removed their rights to care for their daughter. WARNING: DISTRESSING CONTENT
The parents of a teenage girl who took her life after being treated for an eating disorder at a Gold Coast hospital claim the health system removed their rights to care for their daughter.
Giaan Ramsay, 17, was the third teen to die after being treated at Robina Hospital’s mental health ward.
Police, the coroner, the Health Ombudsman and Gold Coast Health are investigating the death of Giaan, whose family found her body just 200m from the door of the hospital on July 27, just days after she was discharged from the inpatient ward of the Gold Coast Health facility.
The teenager had been under an involuntary compulsory treatment order at the hospital, despite her parents actively seeking treatment for their daughter.
Giaan’s parents Steve and Lizel Ramsay have claimed the issuing of the Treatment Authority had removed their child’s rights, as well as their own as guardians, to prevent, object or cease treatment that they believed was harmful.
The investigation into Giaan’s death comes as police and the coroner continue to investigate the death of 17-year-old Neve Chapman, who took her life on November 19, 2024 while she was under the care of Gold Coast Health and had previously been an inpatient at the hospital where she had previously been subject to a Treatment Authority.
Another youth, who the Bulletin has chosen not to name, who was also placed under a Treatment Authority at the hospital, took his own life shortly after discharge.
His mother made a submission to the Mental Health Select Committee saying she was unhappy with his treatment but unable to stop it, and believed it contributed to his death. The coroner investigated his death but declined to comment further.
Mr Ramsay said Giaan had exhibited escalating suicidality and self-harming behaviours after she was prescribed an antidepressant SNRI medication with a black box label warning of ‘suicidal thoughts and behaviours’.
Mr Ramsay claimed when he cited Giaan’s increased suicidal ideation, including multiple attempts on her own life — all of which occurred at the hospital, as well as increased incidents of self-harm as a reason to stop prescribing the drug – her dosage was instead quadrupled from 37.5mg to 150mg.
A Gold Coast Health spokesperson said as the matter was subject to ongoing investigations and was before the coroner, it was inappropriate to provide further comment on the specifics of the case.
“Losing a loved one to suicide is always heartbreaking and we acknowledge the profound grief the family is experiencing as they come to terms with their passing,” the spokesperson said.
“The consumer was provided appropriate trauma-informed and comprehensive evidence-based care in line with clinical best practice throughout their treatment with a high level of clinical oversight and governance.”
In a letter sent to Mr Ramsay by Gold Coast Health just 11 days before Giaan’s death, it said concerns around suicidality on antidepressants had been considered in weighing up the pros and cons of Giaan’s treatment.
“Regarding (the prescribed drug), I am willing to question whether it remains the most suitable option, but this is the advice provided thus far. They have considered all the negative aspects you’ve highlighted but see a counterbalancing positive side that outweighs these.”
‘Treat the trauma, not the symptoms’
Mrs Ramsay, who is a qualified and professional counsellor, said Giaan, a gymnast, became withdrawn in 2021 and they realised she had lost a lot of weight.
They discovered she had been self-harming and during an admission to hospital she was diagnosed with anorexia nervosa. She later disclosed she had been sexually assaulted when she was eight years old.
Mrs Ramsay said they were shocked to hear of the assault and wanted to focus on treating Giaan’s underlying trauma, as well as the symptoms of her eating disorder, but the advice was that she did not have the cognitive capacity for psychological treatment until she achieved a ‘safe weight’.
She said once her daughter reached that safe weight, she was discharged without further treatment, would then stop eating, which would trigger self-harming episodes, and then she would be admitted back to hospital.
She said Giaan was voluntarily admitted to the hospital in 2022, where she later met Neve Chapman, in an effort to provide her with ongoing inpatient support, with regular visits and stays at home.
Mrs Ramsay said Giaan came home for the weekend in November 2022, and was anxious about returning to the ward on the Sunday night, so the family phoned and received confirmation she could return instead on Monday morning.
Despite regular reviews, the TA remained in place until her death.
‘She lost her rights and so did we’
A 2020 Griffith University study found involuntary admissions in Queensland rose from just under nine per cent in 2005-06 to 22 per cent in 2016-17, while in WA they never exceeded four per cent. A 2024 study said involuntary treatment remained over-utilised.
Butterfly Foundation CEO Jim Hungerford said while involuntary admission for the treatment of an eating disorder could be necessary on occasion, the group would always endorse a person-centred treatment plan in collaboration with the family and/or individual wherever possible.
“As soon as they issued the TA to Giaan, she lost her rights and so did we,” Mr Ramsay said. “We were actively seeking treatment for her, but this just turned it into an us versus them situation.
“We called Ryan’s Rule (a Queensland Health process to support patients, families and carers to raise concerns) … but we were ignored.”
It is understood that medical records indicated that Ryan’s Rule was discussed but never enacted.
A Gold Coast Health spokesperson said a Treatment Authority was issued when a patient lacked the capacity to consent to treatment, including in extenuating circumstances for minors to ensure safety and their right to treatment.
“This enables clinical teams to provide appropriate care in the patient’s best interests regardless of personal or circumstantial barriers,” the spokesperson said.
“The person’s views, wishes and preferences are considered, and in instances involving a minor, there is an opportunity for parents to discuss any concerns with the treating team.”
The spokesperson said previous complaints submitted by the Ramsays to the Mental Health Review Tribunal and the Health Ombudsman were not upheld, although a new investigation has since been opened.
‘Locked in an isolation room for weeks on end’
Mr Ramsay said he felt unable to help his child as he was locked out of her treatment.
He said he could not admit Giaan into any private clinic for eating disorder-specific treatment because she was under the Treatment Authority.
“There were plenty of good people who worked in the (hospital), but it was a one-stop shop, they were treating multiple issues and some of the behaviours of other residents would trigger her, especially around mealtimes.
“She had to eat the given meal within 30 minutes or else drink two Ensure poppers or else be fed via naso-gastric tube and if she did not do so she would have ‘privileges’ like her phone or outdoor time removed.
“Later on, after she was prescribed Effexor, she attempted to take her life multiple times and she had a one-on-one ‘special’ watching her, and then she was placed in ‘low stimulation’ rooms which were effectively like solitary confinement.
“She was not allowed outside or in the area with other patients, her phone was confiscated and she was left on her own with a ‘special’ for several weeks at a time.
“On at least one occasion Giaan was found curled up on the floor at the interconnecting door with a blanket around her just to be close to the other patients.
“(They) listed Giaan as ‘severely depressed’. How does being locked in an isolation room for days or weeks on end, or being punished, help a severely depressed person?”
According to a report issued by the Office of the Health Ombudsman, Gold Coast Health said Giaan was unable to go outside as her behaviour was deemed high risk due to suicidality.
It also stated there were more than 100 physical restraints, including when she was being fed by tube.
“Prior to the consumer’s suicide attempts she was accessing the outdoors twice a day for 30 minutes. Since the complaint (by the Ramsays to the OHO), the consumer has gained access to her mobile phone and has access to the ward phone and iPads with internet.”
Butterfly Foundation CEO Mr Hungerford said he encouraged healthcare providers to approach people with eating disorders with compassion, sensitivity and the understanding that they were not being ‘difficult’ — they were experiencing a severe, complex and potentially life-threatening mental illness.
He said providing opportunities for connection with others and the outdoors was important.
“We know that connecting with nature can help stimulate our senses, activate our minds and bodies, and enhance our wellbeing,” he said.
“Additionally, we know that experiencing an eating disorder can be an isolating experience and that connecting with people who have lived experience can help reduce isolation and loneliness, while also demonstrating that recovery is possible.”
‘How did they miss this?’
Mr Ramsay said Giaan was allowed home in October 2024 and discharged into the care of a Queensland Health outreach service, with a representative to visit her at home twice a week, where she would be weighed once a week.
He said because of Giaan’s history of sexual assault they specifically requested that she did not have a male as her contact, but a man was still sent to conduct the visits.
“Giaan was allowed home under the premise that if she hit 45 kgs she would be readmitted to (the hospital). We told the contact that Giaan was losing weight, we could see it before our eyes,” he said.
“We raised the issue several times verbally and by written correspondence, but we were told repeatedly that her weight was above the 45kg minimum.
“Then in November, while the team member was in our house and we were at work, Giaan cut herself. No one noticed until my wife returned home for lunch and noticed how lethargic and pale Giaan was, then she saw dried blood on her hands, found the cuts and an ambulance was immediately called.
“Upon admission to the hospital, Giaan weighed in at 36kg.
“How did they miss this?”
According to the OHO report, Gold Coast Health reported she increased her weight on the scales by methods such as sewing weights into her clothing.
Mr Ramsay said after she was prescribed antidepressants, Giaan was found banging her head against a wall with such force the hospital was concerned she would lose her vision and needed a CT scan.
Gold Coast Health told the OHO that staff could not stop Giaan from her first head strike, but further attempts were stopped.
Mr Ramsay said photos taken of Giaan two weeks later made him question how long she had been allowed to hurt herself.
‘We were let down until the very end’
He said Giaan’s ultimate discharge on July 17 came without much warning, as the hospital had previously discussed transferring her to the over-18s ward, which he and Mrs Ramsay did not want as she was still a minor.
“The unit is for adults but they said they had to break Giaan’s unhealthy attachments to (hospital) staff. Bearing in mind, Giaan had been admitted for eight solid months, what else was supposed to happen?
“My wife protested this transfer vehemently, however, she was told the decision was made. A day before the transfer … was to take place we received a call that she was no longer going to be transferred, she was now going to be discharged.
“We did not even get a copy of the discharge letter, she was still under the TA, still on 150mg of Effexor and she had just one weigh-in appointment on July 22 and that was it. She was given a 1300 number to call if she needed help and was told not to call the ward again after she had reached out for help one night. She was cut off.”
It is understood that attachment can be considered non-therapeutic after a long period and that plans were in place for further treatment within the community.
The Ramsays said when Giaan was discharged, she initially seemed bright and relatively happy, but was experiencing acute anxiety.
She was visiting with friends on July 27 and her mother was to pick her up at 9pm, but she did not appear.
The family called police but said they were told they must wait 24 hours before she could be reported missing. Queensland Police said they could not comment as the matter was before the coroner but, in general terms, police were committed to investigating all reports of missing persons and no one had to wait 24 hours to report a missing person.
Giaan’s family found her near the river at Robina, just 200m from the doors of the hospital.
“We were let down until the very end, no one arrived to help us and so we had to search and find our darling girl ourselves,” Mrs Ramsay said.
“I do believe she took her life so close to the ward as a final message. Her last text to us said: ‘I can’t be stuck in this system on constant repeat, living tortuous days again and again getting nowhere’.
“We have not even begun to process this trauma, all we can think about is that we don’t want anyone else’s child to go through the suffering that Giaan did, or have their rights removed like we did.
“We’ll never know what might have happened with Giaan, but it would have helped us sleep at night to know that we did everything in our power to help her. But we never had the chance.
“This system is so broken it is hurting rather than helping. We only pray that Giaan’s death was not in vain, that something will change before it’s too late for someone else’s child.”
Treatment Authorities and Involuntary Admissions:
Australia has the second-highest involuntary hospitalisation rate among 22 countries, with an average annual increase of 3.4 per cent
Rising rates:
In Queensland, compulsory community mental health contacts in the public sector rose from 9 per cent in 2005–06 to 22 per cent in 2016–17. By comparison, Western Australia’s rate never exceeded 4 per cent over the same period.
Types of compulsory orders under the Mental Health Act 2016 (Qld):
Forensic Order (FO) – for people found of unsound mind or unfit for trial.
Treatment Support Order (TSO) – for people diverted from the criminal justice system.
Treatment Authority (TA) – the main civil order used when a psychiatrist finds that a person:
• has a mental illness, lacks capacity to consent to treatment, and;
• is at imminent risk of harm to self/others, or of serious deterioration without treatment.
Review mechanisms:
All orders are subject to periodic review (every 6–12 months) by the Mental Health Review Tribunal (MHRT), which includes a psychiatrist, a lawyer and a community member.
A TA can be revoked by the treating psychiatrist.
FOs and TSOs can only be revoked by the MHRT.
Criticisms:
Clinicians report that once someone is placed on a TA, it is rarely revoked, even after years.
The MHRT has been described as risk-averse, often deferring to the treating team’s recommendations rather than actively questioning the need for continued involuntary treatment.
Some argue that the system prioritises risk management over patient autonomy, despite the Act’s stated aim of using the least restrictive practices.
Join the conversation
I’m a neuroscientist. This is how you get hooked doom scrolling
Read more
Aussie star opens up about ‘horrible’ online abuse
Read more