Resigned . . . Former mental health consumer adviser Graham
Roper. Photo Peter McIntosh
It is wrong for off-label prescribing of ketamine in
Dunedin's mental health service to continue while that practice
is under investigation, former mental health consumer adviser
Graham Roper says in a letter to the Southern District Health
Board explaining his resignation.
Mr Roper is concerned that two patients are still being
treated for depression with ketamine, which is not licensed
for that purpose.
The National Health Board (NHB) announced last July it was
investigating whether use of the drug in the Dunedin mental
health service was experimental.
The NHB handed the matter to the Health and Disability
Commissioner, where it still lies. The commissioner is yet to
Southland chief medical officer David Tulloch told the
Otago Daily Times in a statement this week that
ketamine as a treatment for depression was stopped while the
commissioner's investigation was under way.
However, two patients requested to resume the treatment after
"positive clinical responses".
"This request went through a thorough process to ensure its
clinical appropriateness and fully informed consent," Mr
Clinicians can prescribe drugs off-label, but not for
Chief executive Carole Heatly said in a statement that issues
raised in Mr Roper's letter were strongly disputed, and the
DHB was seeking legal advice.
"I have met with Mr Roper to discuss the letter and am
satisfied with the DHB's conduct concerning his employment."
In the letter, Mr Roper said he took a stand in 2010 over
ketamine, which eventually led to him choosing whether to "do
my job and lose my job or don't do my job and keep my job".
He left the DHB on June 1, after more than six years as Otago
mental health consumer adviser.
Not all of Mr Roper's claims can be reported, as they relate
to a clinical case. However, he claims senior managers
carried out "attempted cover-ups" .
"The substitution of this treatment for more accepted and to
date better-evidenced treatments is unconscionable," he
"[For] almost 18 months the SDHB has acted as though it is
actively [seeking] to suppress discussion, [and] refused to
debate or acknowledge the issue of informed consent of people
who are clearly unable to give the degree of consent
Mr Roper felt "targeted and victimised" by an investigation
into his personal business interests, which he felt was
linked to his being a whistle-blower.
Ketamine is licensed by Medsafe as a fast-acting general
anaesthetic, and is used for pain relief in milder doses. It
is a class C-controlled drug, used recreationally for its