Prevention of Future Deaths reports · 2013

Michael Irlam

Regulation 28 report to prevent future deaths, reference 2013-0224, written 4 Sep 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Sep 2013
Reference2013-0224
DeceasedMichael Irlam
CoronerAndrew Bridgman
Coroner areaManchester South
CategoryMental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1. a... Manager, Trafford Crisis Resolution and Home

Team (CHRTT)
2. Manager, Improving Access to Psychological Therapies (IAPT)

1 | CORONER

! am Andrew Bridgman, assistant coroner, for the coroner area of Manchester South.

2 | CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

3 | INVESTIGATION and INQUEST

On 20th November 2012 an investigation was commenced into the death of Michael
Stuart Irlam. The investigation concluded at the end of the inquest on 8th August 2013.
The conclusion of the inquest was

Killed himself whilst the balance of his mind was disturbed.

Medical cause of death 1a Hanging

4 | CIRCUMSTANCES OF THE DEATH

Mr Irlam was suffering severe depression and anxiety, diagnosed mid-August 2012. He
was in the care of his GP. After an attendance at A&E at Trafford General on 22nd
August 2012 Mr Irlam became engaged with the CHRTT. He was visited daily initially,
later reducing to alternate days.

On 20th September 2012 Mr Irlam took and overdose and was admitted to Trafford
General overnight.

He continued his engagement with the CHRTT.

He was discharged from CHRTT on 8th October 2012. He was told that IAPT would
contact him by letter.

Almost 2 weeks passed before a letter came. He under took a telephone assessment in
order to expedite his hoped for treatment as it was quicker than having a face to face
interview. He was advised to await another letter advising him of treatment. He did not
get such a letter, simply a duplicate of the first letter.

Mr Irlam then consulted and received treatment from a private psychologist.

On 13th November 2012 Mr Irlam hung himself from the banister at his home while his
wife was out. His daughter was at home.

5 | CORONER’S CONCERNS

Senior Clinical and Forensic Psychologist was engaged to
conduct a Post Incident Review & Report.

That report concluded at page 31 - ‘Putting the patient first - perceived gaps from
the patient perspective’ that a waiting time of 24 days between discharge from CRHTT
and the first appointment with IAPT could not be construed as a delay.

This issue that arose at the Inquest hearing was the potential for a feeling of
abandonment because of the discharge without any knowledge of how long it would be

before the next contact; of having to wait for the next stage/step without knowing when
that would be. Mrs Irlam was clear that her husband deteriorated over this period
despite the close, and loving, support provided by her and their family. That her
husband found this a most distressing and difficult time.

Even if the Review Panel do not consider a waiting time of 3 weeks plus to be a delay
for someone with mental health issues | take the view that a waiting time of 2 weeks
without knowing the next contact for help/treatment will be is not appropriate.

My concern is for the welfare of other patients who will fall into this gap between
treatments/counselling who, unlike Mr Irlam, do not have a close and supportive family
and the effect on them.

During the course of his evidence HR explained that the two organisations
were working closer together administratively. He was not, however, able to respond to

my line of enquiry as to why a patient could not be given an appointment with IAPT on
discharge from CHRTT.

My concern is this. It seems to me most important and appropriate that a vulnerable
patient with mental health issues ought not to be exposed to a feeling of abandonment,
likely to lead to a deterioration in their condition, and that they should (where possible)
be given an appointment with IAPT on discharge from CHRTT, if that is the agreed next

step.

That would also deal with the issue that upon receipt of the awaited letter from IAPT the
patient has to be proactive to engage the referral to IAPT.

In my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) That if a follow-up with or referral to APT (or any other organisation) is deemed
appropriate upon discharge from CRHTT then such an appointment should be
arranged before or upon discharge.

(2)

(3)

[6

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
respective organisations have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 17th October 2013. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner.

| have also sent it to P| wife of the deceased, who may find it useful or of
interest.

| am also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, the coroner, at the time of your
response, about the release or the publication of your response by the Chief Coroner.

9 | [DATE] Lays [SIGNED BY CORONER]

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