A CORONER HAS called for the next of kin of patients who have attempted suicide or expressed suicidal ideation to be notified by hospitals about their condition at the time of their discharge from emergency departments.
Meath county coroner, Nathaniel Lacy, made the recommendation following the death of an elderly Meath man who drowned in a lake near his home shortly after being discharged from hospital after an episode of self-harm and telling doctors he wanted to die.
The body of Patrick Mooney (78) of Normanstown, Carlanstown, Kells, Co Meath was found in Whitewood Lake near Kilmainhamwood, Co Meath on 25 October, 2017.
Mr Mooney’s family have called for improved mental health services for older people based on the circumstances of his death.
The deceased’s daughter, Cathríona Molloy, welcomed a series of recommendations by the coroner but claimed mental health of the elderly is “neglected.”
“It should be taken more seriously to prevent future fatalities,” said Ms Molloy.
An inquest at Meath Coroner’s Court heard that Mr Mooney had twice been admitted and discharged from Our Lady of Lourdes Hospital in Drogheda in the fortnight before his death, including just four days earlier when he received treatment after slitting his wrists.
He had also been referred on that occasion to the Drogheda Department of Psychiatry where he was assessed and discharged with follow-up care to be provided in the community.
The deceased, who was a retired worker in Tara Mines, and his wife had been living with their daughter for the previous two weeks following a fire in his home on 11 October, 2017.
Ms Molloy said her family had become concerned about his welfare after he failed to return from a scheduled visit to his GP earlier on the day his body was discovered.
Mr Mooney’s vehicle was subsequently discovered later that evening with the keys in the ignition at the car park at Whitewood Lake.
A small bottle of whiskey and some tablets to treat insomnia were found in the vehicle.
Mr Mooney’s body was located following a search of the lake by emergency services, with the results of a postmortem confirming he died due to drowning.
The inquest heard that he had been admitted to Our Lady of Lourdes Hospital in Drogheda on 21 October 2017 after his grandson, Seamus, had found him “lying in a pool of blood” at around 2am.
Mr Mooney was subsequently discharged from the hospital after treatment for superficial cuts but referred to the Drogheda Department of Psychiatry where he was assessed and discharged but given no medication.
Ms Molloy said she was not happy about bringing her father home and noted his appearance had “gone very wild and he wasn’t eating properly.”
She told the coroner that he had been very down since the fire at his home where everything had been destroyed, while his last remaining brother had also died six weeks earlier.
Ms Molloy said she was very disappointed that the Drogheda Department of Psychiatry had not encouraged him to stay in for a few days.
“They were very dismissive of him. There is something wrong when a 78-year-old man cuts his wrists,” she added.
The inquest heard that Mr Mooney had also gone to hospital after suffering a cut to his face and smoke inhalation during the fire in trying to save his wife by breaking a window.
A registrar, Claire Murphy, said he told her that he had intentionally started the fire as well as deliberately throwing himself off a trolley in the hospital.
She said Mr Mooney had also admitted having a low mood and expressing a wish to die.
A medical consultant at the hospital, Rosemary O’Brien, said he was assessed as not being psychotic and had also denied any suicidal ideation.
Dr O’Brien said psychiatric staff who had assessed him had found no evidence of clinical depression and had suggested counselling with his GP with no further psychiatric input required.
She said the clinical impression was formed that his previous statements regarding a wish to die had been retracted and they could have been caused by high carbon monoxide levels which had resulted in the patient experiencing some confusion.
A registrar at the Drogheda Department of Psychiatry, Junaid Bin Ashraf, who assessed Mr Mooney on 21 October 2017 said the patient was initially very anxious.
Dr Bin Ashraf said the deceased had told him that he did not want to kill himself as he loved his family.
The psychiatrist said Mr Mooney showed good insight into his situation and admitted he had not been himself lately but denied any intent to harm himself.
Dr Bin Ashraf said both the deceased and his daughter agreed with the treatment plan to refer him to an old-age psychiatric outpatient services team in the community.
In a written ruling, the coroner said a narrative verdict was the most appropriate verdict in the case.
Mr Lacy said he was satisfied that there was no intention by the deceased to take his own life.
The coroner also issued recommendations that had been proposed by counsel for Mr Mooney’s family, Doireann O’Mahony BL, including that next of kin should be notified about patients treated in an emergency department for self-harm or suicide ideation.
Mr Lacy also recommended that hospitals should ensure that all clinical notes from emergency departments accompany a patient on transfer to a connected mental health unit.
He further proposed that hospitals should ensure there is a mandatory referral to a consultant psychiatrist in an acute psychiatric unit for any patients who had attempted suicide or expressed suicidal ideation.
Mr Lacy acknowledged there were practical, resource and GDPR implications in his recommendations.
The coroner added: “It will be a matter for those bodies to consider and hopefully implement my recommendations within their legal and practical parameters.”
If you have been affected by any of the issues mentioned in this article, you can reach out for support through the following helplines. These organisations also put people in touch with long-term supports:
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