An Essex woman has died while a patient in a mental health ward.
Bethany Lilley, 28, was found dead as an informal patient at Thorpe Ward in basildon Mental Health Unit on the night of January 16, 2019, after years of admissions to the mental health ward.
Beth, a health care assistant, had been admitted to mental health services several times after years of battling mental health disorders and self-injurious tendencies.
READ MORE: Local news in Essex
The second day of Beth’s inquest, held in front of a jury at Essex Coroner’s Court in Chelmsford on Tuesday (March 1), it was heard how Beth was considered to be at “high risk” for self-harm and suicide following multiple incidents.
He was diagnosed with complex mental health difficulties and had a diagnosis of emotionally unstable personality disorder.
The court heard that Beth had a history of psychiatric hospitalizations as a result of her mental health issues, self-harm and drug problems.
Beth introduced herself to the team of mental health specialists at ColchesterEssex, part of the Essex Partnership University NHS Foundation Trust (EPUT), in December 2016, where she was placed on a waiting list for therapy.
You don’t have to suffer in silence if you’re struggling with your mental health.
As well as turning to close friends or family, there are many charities you can talk to or get advice from.
Here are some groups you can contact when you need help:
samaritans: Telephone 116 123, 24 hours a day, or email [email protected].
child line: Telephone 0800 1111. Calls are free and will not appear on your bill.
PAPYRUS: A voluntary organization that supports suicidal teens and young adults. Telephone 0800 068 4141.
Alliance Against Depression: A charity for people with depression. There is no helpline, but it does offer helpful resources and links to other information.
Students against depression: A website for students who are depressed, moody, or suicidal. Click here to visit.
Harassment UK: A website for children and adults affected by bullying. Click here.
Campaign Against Living Miserably (CALMA): For young people who feel unhappy. There is a helpline: 0800 58 58 58 or visit website.
He had his first therapy session in February 2017 and the court heard that she had a “clear and intentional plan to take her own life” but was “eager to participate in therapy”.
Over the next few months, Beth was frequently “in crisis” with an increasing risk of suicide. EPUT’s Home Treatment Team (HTT) identified her risks and stated that Beth frequently abused substances, self-harmed, and had suicidal thoughts.
However, after a few months, Beth stopped the therapy sessions. In September 2017, Beth was discharged and received no further therapy because the consulting psychiatrist believed “Beth was unable to make changes or was in contact to continue therapy.”
‘In crisis’
Beth’s mental health deteriorated once again and in January 2018 she was placed on Mental Health Act, where she was detained for a period of seven months.
During that time, Beth had frequent admissions or was in acute crisis, and was self-harming, stockpiling medication with the intent to overdose, as well as taking illicit substances.
The court heard that Beth’s illicit substance use and deteriorating mental health were a “vicious cycle,” with one impacting the other.
Questions were also raised about how Beth was able to gain access to illicit substances while in the secure Ardleigh Ward at Lakes Mental Health Hospital in Colchester, where she was confined, particularly the amount of drugs and how often Beth reported taking them.
Beth attended sessions to help her with her substance abuse at Ardleigh Ward, with the help of the Dual Diagnosis Team (DDT).
The DDT provides evaluation, treatment and consultation for acute or chronic patients for dual diagnosis of substance abuse and mental health problems.
Graeme Moxham, lead physician for EPUT’s Dual Diagnostic Team (DDT), gave evidence in court.
The court heard that Beth attended sessions to help her with her substance abuse, however, she was not referred to DDT during the early stages of her admission, despite ‘intentions’ to do so.
The court was told that a note was made in Beth’s file in 2016 that read: “Beth referred to Graeme Moxom, a dual diagnosis specialist, in support of cocaine use.”
Coroner Horstead said: “It would be reasonable to infer that the missing word is ‘to be’, the intention for something to happen in the future. It is not evidence that a referral has been made.”
The court heard that “identical” records were made on several different occasions, with the same typographical error.
Coroner Horstead said the documents “could be regarded as a cut-and-paste job and a replica of a future event and not evidence that anything has occurred.”
There were no records to show that she was actually referred to Mr. Moxom and only in March 2018 do records show that Beth was referred to Mr. Moxom and the DDT.
‘Plan to end his life’
On June 11, 2018, Moxom went on a date with Beth, who “felt down and had a plan to end her life.” Moxom told the court that Beth “hoped she was gone [from the ward] granted to follow the suicidal plan to the end”.
As a result of his meeting with Beth, Mr. Moxom wondered if it would be safe to grant her a license if she planned to take her own life. Mr Moxom told the court that he informed the Ardleigh ward staff of his plans.
He also expressed concern about Beth’s drug use and self-harm.
The inquests do not investigate every death that occurs, but they will hear of unexplained or suspicious deaths of people. They will hear from witnesses from organizations, health services, as well as officers and police who investigated the incidents.
The law says that the medical examiner must open an inquest into a death if there is reasonable cause to suspect that the death was due to something other than natural causes.
An inquest is a limited fact-finding inquiry to establish:
- Who died;
- When they died;
- where they died;
- how they died; and
- Information needed by the Death Registrar in order to register the death.
There is a formal court setting and everyone must stand as the coroner enters and exits the court.
It is in the great public interest to have an effective investigation system, as it safeguards the legal rights of the family of the deceased and other interested persons. It highlights lessons to be learned and advances in medical knowledge.
Many families also find it helpful to have the opportunity to question witnesses and, at the end of the process, to know that they have complete and accurate facts about their loved one’s death.
“I expected my records and phone calls to be taken seriously and acted upon,” Mr Moxom told the court.
But on August 13, Beth was released as a patient from the ward.
Beth then went into a ‘breakdown’ again in December 2018 and January 2019.
The court heard that “it probably would have helped [Beth] if the DDT was previously involved and involved in discharge planning and that Beth was not discharged. Those shortcomings probably contributed to her crisis.”
Moxom stated that if he had been consulted about Beth’s discharge, he would not have discharged her and would “consider it important to continue working” with her.
Dr. Al-Hillawi, who was a consultant psychologist on the Ardleigh ward during Beth’s admission, also gave evidence in court.
The court heard that Dr. Al-Hillawi was the doctor responsible for Beth when she was discharged in 2018.
Coroner Horstead raised questions regarding Beth’s substance use as plans to take her own life just weeks before she was to be released.
Dr. Al-Hillawi stated that he “did not recall” seeing notes in connection with Mr. Moxom’s appointment that described Beth’s suicidal intentions and drug use.
However, Dr. Al-Hillawi confirmed to the court that “it would be important” for him to be aware of the notes and that “it could have had an impact” on rescinding his detention.
He added that there were also “lessons to be learned” in relation to preventing Beth from accessing “very substantial amounts” of medication while on the ward.
However, on January 15, 2019, Bethany was transferred to Thorpe Ward, Basildon. A day later, on January 16, she sadly passed away.
The investigation continues.
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