Questions over mental health care after suicide of St Leonards man
A young man from St Leonards who took his own life was discharged from a mental health ward just an hour and a half beforehand, an inquest heard.
Reece Lapina-Amarelle, of Celandine Drive, died aged 20 at Beachy Head on June 25 2018 after long-term treatment for emotionally unstable personality disorder that saw him admitted to hospital 26 times in just two years.
He had been sectioned several times for his own safety during that period, including after the death of his brother in 2017, but had not responded well to treatment or engaged with in-patient therapy, the court heard.
On being discharged on June 25, he told nurses that he intended to end his life but was allowed to leave unaccompanied and without his family being informed by the hospital as requested.
Over the course of five hours on Thursday, coroner Alan Craze questioned mental health professionals on why Reece had been discharged by nurses, who made a precautionary call to the chaplain at Beachy Head.
He read in full a statement from Reece’s parents, who attended the inquest, that said the hospital had ‘opened the door, knowing what his intentions were and let him go without question’.
Treatment options ‘exhausted’
His family described how Reece had changed during his illness and treatment.
They said: “Most people loved his personality and he made friends easily.
“He would always want to make people laugh so he would act the clown or just get the giggles which were contagious.”
But they said Reece had gone from someone who made people laugh to being filled with ‘anger and hatred’ and that he had blamed himself for his brother’s death.
The court heard that Reece, although not addicted to drugs, had recreationally taken cocaine and had been discharged from Woodlands care facility in Hastings due to issues with him bringing drugs onto the ward.
There had also been instances of him encouraging other in-patients to abscond.
Consultant psychiatrist at Bodiam Ward in Eastbourne Dr Connie Meijer said Reece had not been safe in hospital and had put other patients at risk.
On being discharged from hospital, medical professionals said Reece would frequently say that he intended to hurt himself or die and would be intercepted or protected by family or friends and emergency services.
Fellow consultant psychiatrist Dr Daniel Chetcuti explained that due to the complexities of Reece’s condition, discharge from hospital was perceived as rejection and would itself provoke that reaction.
On the other hand, hospital staff explained long stays to hospital were typically considered detrimental for patients with emotionally unstable personality disorder (EUPD) and having ‘exhausted’ all in-patient treatment options, community care was considered better for his ‘chronic’ condition.
Julie Hultier, community mental health nurse who worked closely with Reece, said: “Reece always experienced suicidal thoughts, there was always a risk of him acting on them.
“There was also the argument that there’s a young man who needs to not live in hospital.”
Mental health facilities ‘lacking’
Representatives for Sussex Partnership NHS Foundation Trust apologised for not involved Reece’s family in the decision to discharge him from hospital but that they were now improving communication with families.
Coroner Craze asked what additional support could be created for people like Reece to prevent future deaths.
Paul Beynon, who reviewed the case as part of a serious incident report, suggested that the introduction of a few ‘high intensity’ mental health beds or a better integration of drug rehabilitation and mental health services could help.
He said everyone involved in Reece’s care had been very much affected by his death and gave his condolences to the family.
Coroner Craze said he would write to the government about the ‘stark’ case, which he said was one of the most tragic he had ever encountered.
“There are clearly facilities in the treatment of people such as Reece that might be lacking,” he said.