Olympic cyclist Olivia Podmore died in 2021. Photo: Supplied / Dianne Manson
This story discusses mental health and suicide. A list of helplines is available at the bottom of the page.
A health practitioner who worked with Olivia Podmore has accepted it was "inappropriate" not to take notes from their sessions during her time in the Cycling NZ programme.
An inquest into the suspected suicide of the young Olympic cyclist heard on Wednesday that the practitioner could not produce any records from his sessions with Podmore.
The practitioner has interim name suppression while the case is being heard and RNZ has chosen to refer to him as Practitioner A.
He worked with Podmore for more than four years, meeting regularly over that period.
He told the Coroner's Court in Hamilton the nature of his role meant that some of his interactions with athletes were informal, and often "impromptu".
"In my role, I provide support to many athletes across different sports, in different cities and towns. Meetings are often impromptu, including on the track or in training facilities, but I also meet with athletes at prearranged times," the practitioner submitted in his brief of evidence to the court.
"The practicalities of my role have made it very difficult to keep written records of all of my interactions with athletes."
Addressing his lack of record-keeping in court on Wednesday, the practitioner apologised for his approach.
"I totally accept that's inappropriate. I should be better than that," he said.
Asked by counsel for the coroner, Joshua Shaw, whether note-taking was extremely important for continuity of care and to ensure details are not missed, the practitioner accepted it was.
The practitioner, whose specific role cannot be identified, said he has since changed his practices.
To assist with the inquest into Podmore's death, the practitioner was able to reconstruct a timeline of his sessions with the elite cyclist through his invoicing, calendar invites and emails.
Earlier this week, the court heard evidence from two medical personnel that they relied heavily on this particular practitioner's opinion when developing a plan to treat Podmore's ongoing mental health struggles.
Both also have name suppression and RNZ has chosen to refer to them as Practitioner B and C.
On Monday, Practitioner B told the court that in January 2021 Podmore reported very low mood for two weeks.
Podmore told the practitioner she felt flat, both physically and mentally since endometriosis surgery in October 2020 and that she sometimes wondered if she would be better off dead.
He said he assessed her risk of suicide as low and contacted his colleague (Practitioner A), who Podmore was comfortable with, and said he relied on him to take the lead.
Coroner Louella Dunn listens to evidence during the inquest. Photo: RNZ / Cole Eastham-Farrelly
In tandem, the two practitioners made the plan to put Podmore on antidepressant medication and refer her to an external counsellor.
In April 2021, the Rio Olympian reported to Practitioner C that she was again experiencing suicidal thoughts.
The practitioner diagnosed Podmore with depression and referred her to an external psychologist.
The court heard on Tuesday that in Podmore's first consultation with the external psychologist she reported that her feelings had escalated to forming a plan to how she might take her own life. Detailed notes were reported back to the health practitioner who referred her.
Podmore cancelled her second appointment with the psychologist, but met with her a week later in mid-May 2021, and told her she was feeling much better and did not feel a need to carry on with the sessions.
The young athlete's abrupt turnaround, after feeling "so low" only weeks earlier, troubled Practitioner C, who had initially referred her.
In an email read to the court, Practitioner C contacted Practitioner A seeking his opinion on whether this should be cause for concern.
"I've got double feelings, I don't know whether to be less concerned or more concerned, this could be masking what is really going on," she wrote.
Practitioner A responded that Podmore at times experiences "deep drops in mood, but they have occurred less frequently, and they last less and less time, and they are not as debilitating".
He added that Podmore was "going in the right direction".
"I believe her resolution over the last few weeks is in line with her development and her report will be accurate," the practitioner told his colleague.
Practitioner C responded by thanking him for "putting her mind at ease" about Podmore's mental health.
Asked by Shaw if he was aware that Podmore had seen the report from the external psychologist, detailing their consultation and an escalation in risk factors, Practitioner A said he had not.
"My response was really in line with the information that [my colleague] had provided," the practitioner responded.
"I thought I had the full picture."
Shaw then challenged the practitioner's assessment of Podmore based on the information he did have about the young athlete twice disclosing to other medical practitioners she had suicidal ideations.
"Are these drops in mood really one, occurring less and less frequently; two, lasting less and less time; and three, not being as debilitating for Olivia?" Shaw asked.
"Certainly my observations of Olivia on a day-to-day basis within the environment is in line with what I'm saying [in the email]. When you look at it like this, I can see the contrast," the practitioner responded.
"My experience with Olivia in the day to day environment doesn't match up with what's on paper."
Practitioner A told the court he was out of the country with another sports team from late May through to the end of June, but reconnected with Podmore on his return.
He said at that point the focus was ensuring she was supported during the Tokyo Olympic Games, which would likely be a difficult time for her.
"It was clear that the Olympics would be an emotional time for Olivia as she had her heart set on attending the Games. Hence, our plan was to begin support sessions with her the week of the Games, and then for that support to carry over to the New Zealand Olympic Team's return to New Zealand, as well as during the usual media and public hype in this period," the practitioner wrote in his brief of evidence.
The first meeting was not scheduled until 6 August 2021 - two days from the end of the Games.
Asked whether he thought this plan to support Podmore during the Games had been executed as intended, the practitioner accepted there could have been an earlier check-in.
Podmore cancelled her session with the practitioner on August 6, texting him that day to let him know she was in Queenstown on an "epic" snowboarding trip.
Three days later, the practitioner received the tragic news she had died in a suspected suicide.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 or email talk@youthline.co.nz
What's Up: free counselling for 5 to 19 years old, online chat 11am-10.30pm 7days/week or free phone 0800 WHATSUP / 0800 9428 787 11am-11pm
Asian Family Services: 0800 862 342 Monday to Friday 9am to 8pm or text 832 Monday to Friday 9am - 5pm. Languages spoken: Mandarin, Cantonese, Korean, Vietnamese, Thai, Japanese, Hindi, Gujarati, Marathi and English.
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
OUTLine: 0800 688 5463 (6pm-9pm)
If it is an emergency and you feel like you or someone else is at risk, call 111.