Prevention of Future Deaths reports · 2022

Lily Girton

Regulation 28 report to prevent future deaths, reference 2022-0262, written 11 Aug 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Aug 2022
Reference2022-0262
DeceasedLily Girton
CoronerNadia Persaud
Coroner areaEast London
CategorySuicide (from 2015) · Community health care and emergency services related deaths · Mental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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

MISS  N PERSAUD 
HER  MAJESTY'S CORONER 

EAST  LONDON 

Walthamstow Coroner's Court, Queens Road  Walthamstt:>w,  E17 8QP 

REGULATION  28:  REPORT TO  PREVENT FUTURE  DEATHS (1) 

Ref: 110868 

REGULATION 28 REPORT TO  PREVENT FUTURE DEATHS 

THIS REPORT IS  BEING SENT TO: 

1. 

2. 

3. 

NHS  England 
Ema i I:

Email : 

, Royal  College of Paediatrics &  Child  Health, 

,  Medical  Director,  Health  Education  England 

, President, Royal  College of Psychiatrists,  London  Office,  21 

Prescot Street, London,  E1  888 
Email :

1 

CORONER 

I am  Nadia  Persaud area coroner for the coroner area of East !London 

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) Re,gulations 2013 . 
httQ :LLwww. legislation .gov. u kLukQgaL2009L25Lsch ed ul eLSLQa ragra QhL7 
httQ :LLwww.legislation .gov.ukLuksiL2013L1629LQartL7 Lmade 

3 

INVESTIGATION and  INQUEST 

On the  13th  June 2019 I commenced  an  investigation  into the death  of Lily  May Girton. 
Lily was  17  years old  when  she  passed  away on  the  1st  June 2019 .  The  investigation 
concluded  at the end  of the  inquest on  the 9th  August 2022 . The conclusion of the 
inquest was a narrative conclusion: 

1 

 
 
 
 
 Lily Girton took her own life  whilst suffering from a mental illness. Her death  was 
contributed to  by a failure  of the  community CAMHS team  to  expedite an  assessment by 
a psychiatrist; to  carefully and robustly assess and manage her risk to  self and by a 
failure  to  titrate up  her anti-depressant medication to  an  effective dose. 

4 

CIRCUMSTANCES OF THE DEATH 

Lily  Girton suffered  from  anxiety, depression and  emotional dysregulation . She sought 
assistance from the Child and Adolescent Mental  Health Services in  December 2018 . 
She was  asked to  register with  a new GP  before she could  access the service. On  12 
March 2019 she was seen  for her first assessment with  the team . Later the  same day , 
Lily  presented in  distress at Euston station  and  required  detention  under section  136 of 
the  MHA for her own  safety.  She was taken  to University College Hospital where she 
was admitted to a paediatric ward  and where she  received  care from the  psychiatric 
liaison  team . Following this  brief admission , Lily was prescribed  antidepressants by  her 
GP who  expected the community CAMHS team to  continue  monitoring  and  prescribing 
this  medication . The community team  did  not do this and  Lily was  not seen  by  a 
psychiatrist within the  community CAMHS Team . Lily  was  seen  by  a social worker within 
the  CAM HS team , who had  been appointed  as her care co-ordinator. The care  co-
ordinator provided  cognitive behavioural therapy . She did  not take steps to  expedite the 
psychiatric appointment; did not take  steps to  ensure that Lily's medication was 
appropriately titrated  and  did not carefully assess,  document and communicate Lily's risk 
to  self. On the 29 April 2019 , Lily was admitted to  University  Hospital again , requiring  a 
longer admission and  presenting with  higher risk.  The concerns of the hospital team 
were communicated to the  community  CAMHS teams, but Lily's care  plan  was not 
materially altered . On  the  31  May 2019 , Lily  was involved  in  an  altercation with  a group 
of males  in  a kebab  shop . She was  mocked  by  the  males and  she reported  that one  of 
the  males had  hit her.  In  the early  hours of the  1 June 2019 , Lily was  discovered 

 partner's  home address . Her life was  pronounced extinct 

on  scene.  Police attended  and  deemed the circumstances as  non-suspicious. The 
altercation in  the  kebab shop  is  likely  to  have contributed to  a decline in  Lily's mental 
state on  the  31  May 2019 . The failings  in  the  care provided  to  her by  the  community 
CAM HS  team  left Lily  without the  resilience to  manage the  decline in  her mental state. 

5 

CORONE~SCONCERNS 

During the course  of the  inquest the evidence revealed  matters giving  rise to  concern . In 
my  opinion there  is a risk that future deaths could occur unless action  is taken . In  the 
circumstances it is  my  statutory duty  to  report to you . 

The MATTERS  OF  CONCERN are as follows .  -

The  Inquest heard  that CAMHS services  nationally have a lack of adequate staffing 
levels in  the form  of doctors, in  the form  of psychiatrists,  registered  mental  health  nurses 
and  psychotherapy staff.  The Inquest heard that consultants  often  have an  average of 
130 to  150 active cases on  their caseloads .  This is  substantially  higher than  the 
recommended caseloads  by  the Royal  College of Psychiatrists. 

The  lack of staffing  and  resources contributed to  Lily 's death and  there is a concern  that 
the ongoing shortages of suitably trained  staff within  CAM HS teams  poses a risk of 
future deaths of young  people. 

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, 

2 

 namely  by  5th  October 2022,  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, to the family  of Lily  Girton , to the 
other Interested Persons, to the  Care  Quality Commission (where the deceased was 
 the local director for public health who 
under 18)].  I have also sent it to 
may find  it useful or of interest. 

I am  also under a duty to  send  a copy of your response to  the Chief Coroner and  all 
interested persons who in  my opinion  should  receive  it. 

I may also send  a copy  of your response to  any  other person who I believe  may find  it 
useful or of interest. 

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. 

9 

[DATE]  11 th  August 2022 

[SIGNED  BY CORONER 

3

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