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First posted on Antidepaware
The Portsmouth News
by Jeff Travis & Ellie Pilmoor, firstname.lastname@example.org
Published on the 04 December 2013 11:00
The tragedies of Mark O’Shaughnessy and Craig Greer are entirely separate, but both grieving families believe they highlight shortcomings in the way the NHS treats depressed people.
Southern Health NHS Foundation Trust – which treated both men – has admitted more support should have been offered to Mark and his family.
As a result of his death, the trust said it has made a number of improvements to its service following an investigation.
Mark, 28, from Williams Close, Gosport, hanged himself the day after telling health professionals that he wanted to kill himself and hurt his mum, Julie.
The mental health services decided to keep him at his house rather than section him in a psychiatric ward.
Mark’s mother, Julie, also of Williams Close, Gosport, said: ‘We feel let down by the mental health services.
‘Mark told them that he was thinking about killing himself but they ignored him. They ignored all of us.
‘He was a caring and loving individual who always found the time for others, especially his grandparents.
‘Mark had been ill since 2006 and had said a few times that he wanted to die but had never acted on it. No-one knows what made him do it this time. We will never know.’
Craig, a 33-year-old dad-of-one, of Woodcot Crescent, Havant, also died earlier this year after gassing himself with noxious fumes.
Three weeks previously he had been discharged from Elmleigh Hospital in Havant after a two-day stay.
Craig had admitted himself to the hospital after having suicidal thoughts and his family believe he should have been kept in for longer to fully assess the danger he posed to himself.
Craig’s father, David Greer, 58, of Warren Park, Havant, said: ‘I don’t think they treated him properly at all. They failed him miserably.
‘He fooled a trained team of psychiatrists – it’s pretty amazing.
‘He was hiding it from me because he knew I would not let this happen. He lived with me more or less.
‘I would have done everything in my power to save my son. He was having a breakdown and should have been committed. It’s a tragedy.’
Mark’s case sparked a detailed investigation at Southern Health NHS Foundation Trust.
Officials said improvements have been made since the tragedy, including enhanced risk assessment training for the mental health team.
A Southern Health spokesman said they have ‘reinforced the need for teams to offer support and condolences to relatives in a more timely way following a tragedy’ and ‘improved the emotional support available to staff following incidents’.
The spokesman added: ‘Mark’s tragic death shocked and saddened the nurses, social workers and doctors who had been supporting him. Mark suffered from complex problems including mental illness and had been receiving daily visits for some time.
‘Mark was assessed under the Mental Health Act shortly before he died. At the time he was assessed, the health professionals involved decided admission to hospital was not in his best interests, and may cause his condition to deteriorate.
‘Each Mental Health Act assessment is carried out by two experienced doctors and a social worker, who consider the specific situation carefully. Community-based care must always be attempted and hospitals only considered as a last resort.
‘At the time, it was agreed that continued support in his home was the most appropriate course of action.
‘We have sent our condolences to Mark’s mother, and continue to offer support.
‘We also want to express our regret that more support was not offered to his mother sooner by the team that cared for Mark directly.’
He added: ‘It is important to say that the decision not to admit Mark to hospital was not related to any changes in the way our services are structured. Decisions on the type of care somebody receives are based entirely on clinical need and are made on an individual basis.
‘There is lots of support available for people who are feeling distressed or overwhelmed by difficult thoughts or emotions.’
Regarding Craig’s death, a spokesman said: ‘We would like to express our condolences to Craig’s family and friends at what must be a very difficult time for them.
‘Craig was assessed by a team of mental health doctors, nurses and social workers. He seemed well and was keen to return home and get back to work.
‘He also said he had good support from his brother. Craig gave us no reason to believe he intended to harm himself and it was agreed for him to return home with support from our community mental health team.
‘Decisions like these are made very carefully and on an individual basis. We take into account many factors, including past behaviours and symptoms, and the amount of support available from friends and family.
‘We cannot hold people against their will unless they are refusing to engage with treatment and there is an immediate and severe risk to their safety.’
A consultant psychiatrist at Craig’s inquest said there was a percentage of people where you would never be able to predict they might commit suicide.
Dr Khalil Ajel, who works at Havant’s Elmleigh Hospital, added: ‘If someone decides to take his own life, you can’t do anything about it.’
MEDICAL NOTES OF 33-YEAR-OLD WEREN’T SENT TO HOSPITAL
EARLIER this year, karate instructor Craig Greer split up from his girlfriend and was feeling depressed after the break-up.
He was also feeling down about his job as a refuse collector in Portsmouth and had never got over the death of his grandmother several years ago.
An inquest at Portsmouth Guildhall heard the 33-year-old went to see his GP to say he was having suicidal thoughts and, on the GP’s advice, admitted himself into Elmleigh Hospital in Havant on Friday, July 19.
He was examined by the team and kept in over the weekend, being discharged on Monday, July 22 as Craig said he was feeling more positive about things.
Dr Khalil Ajel, a consultant psychiatrist, said: ‘He was fearful but showed no psychiatric symptoms. He was willing to help.’
David Greer went to see his son late on the Saturday night, but was turned away as the unit was not open, the inquest heard.
The hospital did not receive the GP’s notes about Craig.
They outlined that Craig had been diagnosed with obsessive compulsive disorder and depression in 2010.
When asked about this, Dr Ajel said notes are normally faxed over, but were not this time because it was the weekend.
Dr Ajel said: ‘I don’t think it would have changed the decision to discharge him on that day.’
He said that Mr Greer presented as a ‘convincing’ individual who was ‘not self-neglecting’.
He added: ‘He did not make us suspicious that he was hiding anything.’
After being discharged from hospital, Craig had follow-up consultations over the phone. A message was left for him on August 2 and August 8, but neither were responded to by Craig. Craig was found dead in a tent in the communal gardens outside his flat in West Leigh on the morning of August 8 after gassing himself with noxious fumes.
Detective Constable Nicola Burton, from Waterlooville CID, said: ‘On opening the tent they were struck by the smell of smoke fumes.’
Coroner David Horsley said the suicide had been ‘quite clearly thought out’.
He said: ‘The risk was there.
‘Sadly it was not expressed in such a way that anybody could do anything about it.’
He added: ‘He’s taken his own life while suffering from psychiatric illness.’
MENTAL HEALTH SERVICES ADMIT MAKING MISTAKES
MARK O’Shaughnessy committed suicide in February this year.
He was found hanging, on February 21 at his family home, but after three days in hospital on life-support, the doctors could not save him and he died on February 24.
During an inquest into his death, his family revealed how Mark had told officials from the mental health service that he wanted to kill himself and hurt his mum, Julie.
It was revealed in the inquest that Mark had made allegations like this before and violent outbursts had caused the police to be called to their home in Gosport.
His mum Julie said: ‘I had a lock on my door and a police phone in case Mark got angry. His moods would change quite quickly.’
Detective Sergeant Gary Shirley, from Hampshire Constabulary, said: ‘We had reports of violent outbursts in his family home.
‘The day before he died, we were called because he had made threats to harm himself and his mother.’
The police went to the house and the mental health officials were called.
They assessed Mark under the Mental Health Act but decided to keep him at his house rather than section him to a psychiatric ward. The next day, he hanged himself.
Before his death, Mark had told doctors he wanted to change his medication as he felt it wasn’t helping him.
He met his doctor, Dr Georgia Prentice, and they spoke about his medication among other things.
But since his death, the doctors who treated Mark for his paranoia and other mental health issues admitted they got it wrong.
Dr Prentice said at the inquest that, in hindsight, the health officials should have taken him to a psychiatric hospital.
During his narrative conclusion at the inquest that was held at Portsmouth Guildhall, coroner for Portsmouth, David Horsley, said: ‘I have to record Mark’s death as a hanging as he died from hypoxia but the story is much bigger than that.
‘He suffered from complex mental health issues. Mark was assessed by the mental health authorities when they were called but they decided he was no risk to himself or others. They have admitted, in hindsight, this was a mistake on their behalf.’
‘MORE SUPPORT IS NEEDED TO HELP PATIENTS’
MORE resources, more money, and more staff are needed.
That’s the view of Portsmouth South MP Mike Hancock, who believes mental health services have become the ‘Cinderella’ of the NHS.
A recent investigation concluded at least 1,711 psychiatric beds have closed since April 2011 on a national scale.
NHS bosses say this is because more people are being effectively treated in the comfort of their own homes.
But Mr Hancock, who was awarded a CBE for his work with mental health charities, said: ‘There’s a deficit when it comes to mental health provision.
‘There has been since the NHS was formed 60 years ago – it’s always been the Cinderella of the service.
‘It’s very difficult to get access to it.
‘One of the real issues is that nobody knows the true size of the problem.
‘The truth of the matter is GPs know how many people really need this help, but there’s a limited amount of provision so people have to wait a long time to get access to it.’
He said there needed to be more resources put into providing one-to-one counselling with people.
He said there was a shortage of space within psychiatric hospitals.
He added: ‘We need more one-to-one help for people, but it’s very difficult at the present time.
‘I am not surprised that people continually fall through the net. It’s a very important issue.
‘I can’t understand why they are not getting the treatment they seek.
‘It’s difficult to get into the service until you are sectioned.
‘There is a significant deficit which is not being recognised sufficiently – because of that people will continually be beaten by the system.’
Vicki Nash, head of policy and campaigns at Mind, the mental health charity, said: ‘In a mental health crisis, you need help urgently.
‘Mental health services are struggling at the moment and, while excellent crisis care does exist, we know that many people aren’t getting the help and support they need.
‘This isn’t acceptable – an emergency is an emergency and we need good crisis care to be available to everyone.’