Prevention of Future Deaths reports · 2020

Jennifer Spencer

Regulation 28 report to prevent future deaths, reference 2021-0010, written 18 Dec 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Dec 2020
Reference2021-0010
DeceasedJennifer Spencer
CoronerJames Healy-Pratt
Coroner areaEast Sussex
CategoryMental Health related deaths · Alcohol, drug and medication related deaths
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: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This from is to be used after an inquest.
REGULATION 28 REPORT TO PREVENT DEATHS

THIS REPORT IS BEING SENT TO:
1 CORONER

, CEO NHS England

I am James Healy-Pratt, Assistant Coroner for the area of East Sussex.

2 CORONER’S LEGAL POWERS

I 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 19/11/2019 16:15 I commenced an investigation into the death of Jennifer Sarah Myfanwy
SPENCER aged 29. The investigation concluded at the end of the inquest on 10 December 2020.
The conclusion of the inquest was:

I a Multiple injuries

I b

I c

II
4 CIRCUMSTANCES OF THE DEATH

This young lady's mental health deteriorated following ingestion of Shamanic Hallucinogenic Drugs
and Kundalini Yoga; resulting in her deliberately falling from Beachy Head on 16th November 2019;
intending to end her life; whilst the balance of her mind was disturbed.

5 CORONER’S CONCERNS

There is a lack of awareness amongst Mental Health Professionals about “Shamanic” hallucinogenic
drugs and their propensity to cause or exacerbate psychosis. This results in sub-optimal assessment,
treatment and care. Ayahuasca, DMT and similar “Shamanic” hallucinogens are becoming more
commonplace in the UK. Greater learning about them is required by Mental Health Professionals.
Ref – Therapeutic Advances in Psychopharmacology 2017, Vol. 7(4) 141-157, dos Santos, Hallak,
Mouso.

6 ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I believe you (and/or your
organisation) have 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 09 February 2021.

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 Chief Coroner and to the following Interested Persons

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

James HEALY-PRATT
Assistant Coroner for
East Sussex
Dated: 18 December 2020

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 NHS England (PDF)
Mr Alan Craze, HM Senior Coroner East 
Sussex) 
Coroner’s Office (East Sussex) 
Unit 56 
Innovation Centre 
Highfield Drive 
St Leonards on Sea 
East Sussex 
TN38 9UH 

National Medical Director 
Skipton House 
80 London Road 
SE1 6LH 

18th June 2021 

Dear Mr Craze, 

Re: Regulation 28 Report to Prevent Future Deaths – Jennifer Sarah Myfanwy 
Spencer (16 November 2019) 

Thank you for your Regulation 28 Report dated 13 January 2021 concerning the 
death of Jennifer Sarah Myfanwy Spencer on 16 November 2020. Firstly, I would 
like to express my deep condolences to Jennifer’s family.  My apologies for the 
delay in responding. 

The regulation 28 report concludes Jennifer’s death was a result of multiple injuries 
and death by suicide. 

Following the inquest, you raised concerns in your Regulation 28 Report to NHS 
England regarding a lack of awareness amongst Mental Health professionals about 
‘Shamanic’ hallucinogenic drugs and their propensity to cause or exacerbate 
psychosis, resulting in sub-optimal treatment and care. In this response I will set out 
the steps we are taking in NHS England/ Improvement to address the issues 
outlined in your report. 

Reducing suicide and preventing self-harm is a key priority for NHS England/ 
Improvement. We are working closely with partners, including Public Health 
England and the Department of Health and Social Care to support local areas to 
deliver multi-agency suicide prevention plans.  As part of the £2.3billion settlement 
for mental health in the Long Term Plan, we are providing targeted and ring-fenced 
funding to all Sustainability and Transformation Partnerships (STPs) so they can 
deliver their multi-agency plans. This includes suicide prevention activities, 
initiatives to prevent self-harm and putting in place postvention bereavement 
support. By 2023/24, this will total £57M additional investment in suicide prevention 
and bereavement. 

To support these STPs, there is a bespoke national suicide reduction support 

NHS England and NHS Improvement 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
         
 
 
 
 
 
 
 
 
  
    
 
                        
 
                         
 
 
 
                                          
 
 
                                       
 
 
 
                                                    
 
 
 
 
 
                                                         
 
                                           
 
 
 
 
 
 
 package with the National Confidential Inquiry into Suicide and Safety in Mental 
Health (NCISH) and National Collaborating Centre for Mental Health (NCCMH) 
working together to support STPs in their quality improvement plans, as part of the 
national suicide prevention programme. 

Key components of this support programme include supporting services with safety 
planning, using resources such as The National Confidential Inquiry into Suicide 
and Safety in Mental Health (NCISH) ‘Safer services: A toolkit for specialist mental 
health services and primary care’, which includes guidance for mental health 
services to work jointly with local substance misuse services and having specific 
training in place for staff on substance misuse assessment. I know that the South 
East region suicide prevention lead is working to raise awareness and escalate 
concerns regarding ‘shamanic hallucinogenic drugs’ via relevant forums to increase 
awareness and understanding of this risk factor. Furthermore, based on the insights 
provided in this report, the NHSE/I National team will share any outputs and 
learning generated by the South East regional team with all other suicide prevention 
regional leads and teams nationally. 

In addition to this, as part of the NHS Long Term Plan’s commitment to transform 
community mental health services, we are investing £181M in psychological 
therapies for severe mental illness (SMI). This includes the roll-out of 
‘understanding psychosis and bipolar disorder’ training, which will be rolled out 
across staff working in community mental health teams over the next three years. 
The aim of this training is to ensure those working with people presenting with 
psychosis recognise the diverse bio-psychosocial factors (including substance use) 
that can impact upon a person's mental health. 

Your concerns around the lack of awareness of Shamanic hallucinogens are noted. 
It would be relevant that colleagues at Public Health England are better placed to 
consider this in their work on “Misuse of illicit drugs and medicines guidance”.  I 
have shared your report and our response with my colleague Yvonne Doyle. 

Thank you for bringing these important patient safety issues to my attention and 
please do not hesitate to contact me should you need any further information. 

Yours sincerely, 

National Medical Director  
NHS England and NHS Improvement 

NHS England and NHS Improvement

Related reports

Other reports by James Healy-Pratt

See all →

More reports categorised “Mental Health related deaths”

See all →

Track Mental Health related deaths

See every Prevention of Future Deaths report matching Mental Health related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.