THE FAMILY OF a vulnerable Meath woman who repeatedly tried to take her own life within a short time of being discharged from hospital has expressed concern about the care provided by mental health services.
An inquest heard Linda Kennedy (56) of Cardrath, Collon, Co Meath was found dead in her home on 26 August, 2021, just hours after being discharged from Drogheda Department of Psychiatry – a HSE-run facility operated as part of Louth-Meath Mental Health Services.
It was the fourth time the woman who had been classified as a “moderate to high risk” had tried to take her own life in the space of seven weeks.
A pathologist, Muna Sabah, said post-mortem results showed the mother of two had died as a result of asphyxia due to a ligature around her neck.
Although Ms Kennedy had a “toxic level” of an anti-depressant in her blood, Prof Sabah said it did not mean she had taken more than the amount prescribed as such readings can occur due to how the drug breaks down in a body after death.
In a statement read out at the hearing in Trim Courthouse today, the deceased’s daughter, Sarah Kennedy, outlined how her mother had attempted to take her life on three other occasions in the weeks before her death.
The coroner, Nathaniel Lacy, heard that each attempt occurred shortly after Ms Kennedy had been allowed to return home after seeking medical care.
The inquest heard Ms Kennedy’s brother, Patrick Dixon and her son, Jack Kennedy brought her to the emergency department in Our Lady of Lourdes Hospital in Drogheda, Co Louth on 9 July, 2021 and then to the Drogheda Department of Psychiatry.
However, she was not admitted and was allowed to return home.
Ms Kennedy took an overdose of prescription medication three days later and was brought back to the hospital on 12 July, 2021 by her family but was not admitted.
The corner was informed that the reason she was not admitted on her second presentation at the hospital was because she had an appointment with the Louth -Meath Mental Health Services the following day.
Just hours after returning from Our Lady of Lourdes, Ms Kennedy took another overdose which required her to be returned to the hospital for the second time that day.
Ms Kennedy remained a patient at the hospital until she was discharged a week later on 19 July, 2021.
While she was in hospital, Ms Kennedy sent a suicide-like note to her son.
Although hospital staff were informed about this, a registrar subsequently incorrectly claimed that the text had been sent before her admission to hospital.
Her daughter said she had difficulty in finding out from the hospital who had signed her discharge form.
Ms Kennedy said her mother was brought back to the Drogheda Department of Psychiatry after suffering several injuries when she threw herself off the roof of her dormer bungalow in the early hours of 20 July, 2021.
She said her family had expressed concern to medical staff on 20 August, 2021 that Ms Kennedy was due to be discharged back to a house where she lived on her own.
Ms Kennedy said her mother hung herself within hours after she was discharged from the hospital five days later.
She noted each of four suicide attempts had occurred just hours after her mother had been discharged or allowed to go home.
Yvette Giblin, a consultant psychiatrist from Louth-Meath Mental Health Services, said she and two other consultants had assessed the patient in the two months before her death and had all concluded that she did not suffer from clinical depression.
In evidence, Dr Giblin said Ms Kennedy was suffering from a number of long-standing psycho-social stressors including concerns about her finances and divorce proceedings, while also having feelings of isolation.
However, Dr Giblin stressed that nothing could be done in an in-patient setting to address such stressors.
The psychiatrist said Ms Kennedy also suffered from stress, anxiety and weight loss, while also having a negative outlook on life but had “limited coping skills.”
Although Ms Kennedy was anxious about being discharged home after being in hospital following the fall incident, Dr Giblin said she was satisfied a robust care plan was put in place for her that involved her family and “intensive nursing support.”
The inquest heard just days before her discharge, Ms Kennedy had refused to eat breakfast as it “would end things quicker”.
Dr Giblin observed that Ms Kennedy admitted that she would say all sorts of things when in a panic and the comment was regarded as part of her coping mechanism.
She told counsel for Louth-Meath Mental Health Services, Rebecca Graydon BL, that she felt Ms Kennedy’s issues were primarily linked to personality traits or difficulties.
Dr Giblin said the majority of such patients were treated in the community and not in hospital.
She pointed out to the coroner that 20% of suicides occur within seven days of being discharged from hospital.
The psychiatrist also noted that 50% of suicides occur among people classified as low risk.
However, she accepted she had assessed Ms Kennedy as being “moderate to high risk” of suicide or self-harm.
Dr Giblin testified that Ms Kennedy admitted to having fleeting thoughts of suicide but had repeatedly denied having any plan or intention of taking her life.
She regarded Ms Kennedy’s risk as “dynamic”, which she explained meant “changeable and unpredictable.”
However, the psychiatrist stressed that in-patient services could do nothing to mitigate the risk.
Dr Giblin said it was important to understand what was the cause of a person’s mental distress as there were different pathways for treatment.
Under cross-examination by counsel for Ms Kennedy’s family, Doireann O’Mahony BL, Dr Giblin said a test for a personality disorder had to be done by a psychologist which was not available in an in-patient setting.
She said Ms Kennedy had agreed to having such a test.
Asked if it was safe to allow someone who might have a personality disorder to leave hospital, Dr Giblin replied: “It is not a reason to keep someone in hospital. Had we done [a test], it would not have changed her discharge plan.”
The coroner, Nathaniel Lacy, returned a verdict of self-inflicted death and offered his condolences to Ms Kennedy’s family.
Speaking after the inquest, the deceased’s daughter said she remained concerned that someone who was assessed as being a “moderate to high risk” was allowed to leave hospital.
Ms Kennedy said there was “a glaring gap” in the provision of mental health services if someone could not be tested for a personality disorder without being discharged from hospital.
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