The Northern Territory Coroner has released damning findings in relation to the suicide death of a 53-year-old worker at the Department of Children and Families.

Key points: Paula Schubert worked for an NT Government Department before she died by suicide

Paula Schubert worked for an NT Government Department before she died by suicide The NT Coroner has found the Department bullied and concocted a plan to demote her

The NT Coroner has found the Department bullied and concocted a plan to demote her The coroner described his findings as a "damming indictment" on the organisation

Paula Schubert, described by friends and family as a kind and quiet person who was eager to please, had worked for the department for 32 years, before she died by suicide in November 2016.

She had reached out to mental health services after developing anxiety and schizophrenia late in her career.

Following a three-day coronial inquest into Ms Schubert's death, coroner Greg Cavanagh found that while she was supported during a period of ill-health in 2014, when her symptoms returned in 2016 her managers bullied her and concocted a plan to demote her — conduct he labelled "shocking".

"There might be a tendency to wonder how a scheme to demote an employee because of mental health issues could operate in a modern government department," he said.

"The HR unit should operate to prevent such actions.

"However, far from counselling against the scheme to demote Paula, HR supported the managers in that endeavour.

"That is a damning indictment on the organisation."

Mr Cavanagh also found the Department showed no empathy and no awareness of appropriate managerial practice.

Ahead of meetings to discuss Ms Schubert's demotion, she was not advised of her right to bring a support person.

Ms Schubert's manager, Patricia Butler led the plan to demote her, and sought assistance from her own manager, Marnie Dillon and HR to make it happen.

The pair also decided not to give Ms Schubert advanced warning of meetings they scheduled to discuss her work plan, because they believed it would invite anxiety.

The coroner noted that Ms Schubert had spoken to her psychiatrist, GP and psychologist about the suggested transfer to the lower position, and that they were all in agreement that it may help reduce her anxiety levels.

In her evidence, Ms Butler said she had not been "aware" that under the department's own guidelines, Ms Schubert could have put on lighter duties without a reduction in pay.

"It seems that the department thought it appropriate because they gained the consent of Paula," Mr Cavanagh said.

"It was clear that the financial impact would cause anxiety — however, her employer proceeded in a manner that took advantage of Paula's meekness, willingness to please and fear of being pushed out of her workplace.

"To do that to any employee would have been insensitive and inappropriate. Doing so to an employee with 32 years of service and suffering a health episode magnified the inappropriateness of the conduct."

Mr Cavanagh said that beside the fact the department staff "must have known their conduct was inappropriate", it also contravened the anti-discrimination act which bound them to accommodate a person's psychiatric needs.

Prior to commencement of the inquest it was recognised by the Department of Territory Families that seeking to demote Ms Schubert was inappropriate.

Paula Schubert (L) worked for the Department of Children and Families for 32 years. ( Supplied: Schubert family )

Coroner outlines instances of bullying

After Ms Schubert had agreed to the demotion, Ms Butler "joked" that she wouldn't be able to afford take-away coffees.

"Ms Butler, referring to Paula's impending change of roles (and less pay), said to her that she would have to bring a plunger to work," Mr Cavanagh noted.

Just days before Ms Schubert died, she had been observed being in a "zombie-like state" and had experienced an anxiety episode at work.

Mr Cavanagh described the conduct of Ms Butler at a team meeting on the 15 November 2016 as "shocking" and "extraordinary".

"On Tuesday 15 November 2016 she [Ms Schubert] sat in a team meeting and apparently did little else other than draw a picture," Mr Cavanagh said.

"At the end of the meeting Ms Butler said 'Paula will share her minutes with everyone'. Paula looked surprised. Ms Butler said it was a good drawing and she should share it with everybody."

Two days later Ms Schubert died by suicide.

Ms Schubert's psychiatrist, Dr David Chapman described the incident as a "critical event".

"To expose somebody who was already under a degree of stress … to then have a public, effectively a public humiliation in the workplace, given the fear that she would lose her job, that's critical," Dr Chapman is quoted in the findings.

Mr Cavanagh agreed the incident had been humiliating, and that Ms Schubert's treatment at the hands of her manager amounted to bullying.

Paula Schubert, pictured with family, had reached out to mental health services before she died by suicide. ( Supplied: Schubert family )

Mental health services 'made no real effort'

The coroner also found that the mental health services Ms Schubert engaged with took poor notes, and didn't seek to work with each other on her care plan.

Shortly before death, the Territory's Mental Health Service informed Ms Schubert that her case had been closed.

She called them back a short time later.

"Paula said she thought that she needed ongoing mental health management. The call-taker told Paula she should go to her GP. Paula is said to have 'begrudgingly terminated the call'," Mr Cavanagh found.

"She said she was feeling abandoned by her psychiatrist and that her case was being closed by Mental Health.

"There were no further notes on the Mental Health file from that date until she killed herself three or four days later."

ABC has approached NT Health for comment.

In a statement, the Department of Territory Families declined to comment on whether the staff members named by the coroner were disciplined, but it said "we can confirm that two of the employees have resigned and one is on extended leave".

"Paula Schubert's death in November 2016 remains a profound tragedy," it said.

"Territory Families acknowledges the ongoing grief, loss and sadness that Paula Schubert's family has experienced, and may experience anew during the coronial process.

"Territory Families accepts the coroner's findings and is ensuring both recommendations are rigorously implemented."