Hospital staff had tried in vain to make contact with suicidal patient

A consultant psychiatrist from University Hospital Galway has sought to assuage concerns at the Coroner’s Court that there was no ‘follow up’ for patients once an appointment was missed.

The Coroner for Galway West, Dr Ciarán MacLoughlin, raised questions over the Psychiatric Unit’s procedure after an inquest into the death of a 36-year-old father-of-two found that he had failed to show up for an appointment and was subsequently discharged from the service.

Having sought further information on the circumstances leading up to the man’s death by suicide in January 2021, Dr MacLoughlin heard this week that a number of attempts were made to contact the man after a scheduled appointment on September 4, 2020 was missed.

Dr Elizabeth Walsh, Consultant Psychiatrist at UHG, said the man had attended the Emergency Department on August 7 following an assessment by his GP.

On assessment at ED, she said he had denied suicidal ideation. Ms Walsh said ‘no risk issues’ were identified and the man was not admitted, nor did he or his partner express a desire for him to be admitted.

She said a management plan was discussed and it was agreed that the best course of treatment would be through Community Mental Health Services.

If somebody presents as high-risk of harm or expresses suicidal ideation, they may be admitted, said Dr Walsh. However, in this instance, the man was deemed to be ‘non-urgent’.

A Community Mental Health Nurse attempted to contact the man on a number of occasions on August 21 and August 24 but failed to do so.

An appointment letter was then sent to his address for September 4, with contact details for the Community Mental Health Team enclosed.

After his failure to attend, Dr Walsh said further efforts to contact him failed and the case was discussed by the multi-disciplinary team on September 10.

It was then, following consideration of all the circumstances and on the basis that the man was classified as being non-urgent, that he was referred back to his GP, said Dr Walsh.

The Coroner said that in the initial inquest hearing, only the man’s records from his GP were available and it was not evident if any attempt had been made to check in with the now deceased man before his death.

After hearing from Dr Walsh, Dr MacLoughlin said he was satisfied that there were a number of attempts made to contact the man.

“I am happy now to have discovered that there is a protocol in place to make contact with a patient who presents to the psychiatric services through A&E, through their GP.

“What happened here was I just got a letter from his GP to say he had been discharged from the [psychiatric] services,” he said.

The man was discovered dead in his city apartment on January 4 after his friend gained access to his home, having not seen him since New Year’s Day.

■ If you’ve been affected by this story, please contact Samaritans on freephone 116 123, email jo@samaritans.ie or visit www.samaritans.org for information on how to support yourself or others in need.