Prevention of Future Deaths reports · 2014

Tallulah Wilson

Regulation 28 report to prevent future deaths, reference 2014-0047, written 30 Jan 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report30 Jan 2014
Reference2014-0047
DeceasedTallulah Wilson
CoronerMary Hassell
Coroner areaInner North London
CategoryOther related deaths
Organisation namedTavistock and Portman NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Regulation 28:  Prevention of Future Deaths report 

Tallulah Mary Scarlett WILSON (died 14.10.12) 

THIS REPORT IS BEING SENT TO: 

1.  The Right Honourable Jeremy Hunt MP 

Secretary of State for Health 
Department of Health 
Richmond House 
79 Whitehall 
London  SW1A 2NS 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

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

3 

INVESTIGATION and INQUEST 

On  18  October  2012,  one  of  the  assistant  coroners  for  Inner  North 
London commenced an investigation into the death of Tallulah Wilson, a 
fifteen year old schoolgirl.   

I  concluded  the  investigation  at  the  end  of  the  inquest  on  22  January 
2014.    The  jury  made  a  narrative  determination,  finding  that  Tallulah 
jumped in front of a train, taking her own life.   

I attach to this report a copy of that narrative. 

4 

CIRCUMSTANCES OF THE DEATH 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 The  jury  found  that,  as  a  result  of  Tallulah’s  dissatisfaction  with  her 
friendship group, she created an online persona.   

She posted about self harm and suicide.  She included photographs that 
she said were of herself following cutting.   

Her  consultant  psychiatrist  gave  evidence  that,  with  hindsight,  it  seems 
that  when  her  Tumblr  account  was  deleted  (following  her  mother’s 
discovery  of  the  damaging  nature  of  her  posts),  Tallulah  may  have  felt 
herself  to  be  in  some  way  deleted.    Thousands  of  people  had  read  her 
posts  and  she  had  gained  great  satisfaction  from  that.    So  on  the  one 
hand,  her internet  use  may  have  had  a  negative  impact;  and  yet  on  the 
other hand, preventing her internet use may have had a negative impact. 

The jury included the following in the narrative determination. 

“This case has highlighted the importance of online life for young people.  
We all have a responsibility to gain a better understanding of this, which 
needs to be achieved through appropriate dialogue.  This is a particular 
challenge for health professionals and educators.” 

5 

CORONER’S CONCERNS 

During  the  course  of  the  inquest,  the  evidence  revealed  matters  giving 
rise to concern. 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.  

Although  Tallulah  was  treated  by  a  number  of  healthcare  professionals, 
and her mother was extremely concerned about her wellbeing, no person 
who gave evidence felt that, at the time they were looking after Tallulah, 
they  had  a  good  enough  understanding  of  the  evolving  way  that  the 
internet is used by young people, most particularly in terms of the online 
life that is quite separate from, but sometimes seems to be used to try to 
validate, the rest of life. 

Research;  the  development  of  improved  clinical  practice  at  a  national 
level, details of which are then disseminated by national training; and risk 
assessment refinement, all seem to be key.   

Digital lives basic training and audit is already available, but is not part of 
standard  induction  training  to  raise  awareness  for  all  in  psychiatric  and 
psychological fields, let alone for all doctors. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I  heard  at  inquest  that  the  Department  of  Health  has  taken  the  lead 
nationally on youth suicide prevention, commissioning research exploring 
the use of the internet and trying to understand the role of social media in 
youth suicides.  It is for this reason that I direct this report to you.  

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that the Department of Health has the power to take such action.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of this report, namely by 31 March 2014.  I, 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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales; 
  Ms Sarah Wilson, Tallulah’s mother; 
  Dr Caroline McKenna, associate medical director,  
Tavistock and Portman NHS Foundation Trust; 

  Professor Sir Bruce Keogh, national medical director,  

NHS England; 

  Professor Dame Sally Davies, Chief Medical Officer for England; 
  Dr Maggie Atkinson, Children’s Commissioner for England; 
  Professor Sue Bailey, president, 
Royal College of Psychiatrists; 

  Dr Richard Graham, consultant adolescent psychiatrist, 

technology addiction lead, Tavistock Clinic; 
  UK Council for Child Internet Safety (UKCCIS). 

I  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 
interest.  You  may  make 
it  useful  or  of 
representations to me, the Senior Coroner, at the time of your response,  

find 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

30.01.14 

4

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Department of Health (PDF)
|
| Department
of Health

POC1_ 839561

Mary Hassell

Senior Coroner - inner North London district
St Pancras Coroner's Court

Camley Street

LONDON

NIC 4PP

Dev Ms. thasell

From the Rt Hon Jeremy Hunt MP
Secretary of State for Health

Richmond House
79 Whitehall
London

SIVIA 2NS

Tel: 020 7210 3000
Mb-sofs@dh.gsi.gov.uk

31 MAR 201%

Thank you for your letter of 30 January about the inquest into the death of 15 year
old Tallulah Wilson who jumped in front of a train, taking her own life.

In summarising your findings, you raised concerns about improved clinical practice
and training of healthcare professionals. You noted that no person who gave
evidence felt that, at the time they were caring for Tallulah, the health professionals
involved had a good enough understanding of the evolving way that the internet is

used by young people.

I recognise the increasing importance of the role of media and in particular social
media in the lives of young people. The first annual report on England’s cross-
government suicide prevention strategy, Preventing Suicide in England: One Year
On was published on 17 January and noted that the Policy Research Programme is
investing £1.5 million into six projects, one of which will explore the use of the
internet in relation to suicidal behaviour and identifying priorities for prevention.

This study is being undertaken by researchers at the University of Bristol, in

partnership with Samaritans and Papyrus. The research started in October 2013, and
is due to complete in March 2016. The aim of the research is to:

a) provide detailed empirical evidence about use of the Internet for suicide-related
purposes and how this beneficially and/ or detrimentally influences suicidal feelings
and behaviour;

b) use these findings to inform advice to policy makers, clinicians, voluntary sector
organisations, and the Internet Industry; and identify potential interventions to be
developed and future programmes of work with these groups.

The Royal College of Psychiatrists

As the body responsible for education, training, setting and raising standards in
psychiatry, the College is heavily involved in both development of the
government’s suicide prevention strategy, and research to support it. I have invited
them to comment on the report into Tallulah’s death.

The College is involved in the National Suicide Prevention Alliance Working
Group on the Online Environment. Over fifty national organisations have signed up
to the Alliance, working together so that fewer lives are lost to suicide and to
support those who are bereaved or affected by suicide. The Online Environment
Working Group is looking at possible areas of work that the group could undertake
relating to suicide and the online environment.

The College lead for Public Mental Health a has been working

with NHS England, the British Transport Police and the railways board to;
e consider appropriate training;
e consider necessary evidence to improve clinical practice; and
e establish a systems-based public health approach involving local authorities
and trusts as well police, media, NGOs and the rail industry.

Specifically on training on the role of media in the Child and Adolescent
Curriculum, in the current (2013) curriculum for Higher Training, there is a
selective Independent Learning Objective (ILO 19) on Public Health which
includes ILO 19.4 "Promoting mental wellbeing and prevention of mental illness,
including liaison with the media."

Within this ILO there is a post-Certificate of Completion of Training Mastery
performance objective that includes

"communication to the general public via public media”

"awareness of the impact of media coverage on mental well-being and the
responsibility of providing up to date accurate information"

and

"ability to explain complex ideas to children, young people and their families
and the media in a way that they can understand."

Although this is at present a non-compulsory part of the curriculum, in light of the
increasing use of, and issues surrounding, social media, the Child and Adolescent

S

O

|
| epartment

f Health
Psychiatry Faculty will recommend to the Dean that these competencies are made

compulsory in the next curriculum revision and recommended at pre-specialist
registration stage.

Oo

Finally, I believe that it is important that all professionals who work with children
and young people have access to information about mental health. Norman Lamb,
the Minister for Care Services, is launching an interactive e-learning tool for
children and young people’s mental health on 25 March. This is aimed at health
professionals who are not necessarily mental health specialists, teachers, social
workers and anyone working with children and young people. The Royal College of
Psychiatrists is part of the consortium of organisations headed by the Royal College
of Paediatrics and Child Health developing this exciting tool.

The loss of a young person in such tragic circumstances is always a matter for
concern, and J am grateful to you for bringing the circumstances of Tallulah’s death
to my attention.

I hope that this response is helpful.

tuo shacedh
a

JEREMY HUNT

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