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A REVIEW HAS been launched after a man died by suicide the same day he presented himself to the emergency department at University Hospital Galway.
The body of Adam Loughnane (34), from Merlin Park in Galway city, was found on Tuesday afternoon. Earlier in the day he had presented himself to hospital expressing suicidal ideation.
HSE West and North West said in a statement that the hospital could not comment on individual cases and that management and staff offered their sincere condolences to Adam Loughnane’s family.
“As this matter is now under review and in the interests of patient confidentiality, it would be inappropriate to comment further,” a spokesperson said.
Speaking to The Journal, Adam’s brother, Joe Loughnane, said that Adam had packed a pair of pyjamas and socks before attending the hospital as he believed that he was “essentially sectioning himself”.
Joe said that his brother had told his support worker, who works for a local NGO, via text that he was “feeling low and numb” and that the support worker “realised quite quickly that Adam was in a bad place”.
They visited Adam’s home and asked if he wanted to speak to the mental health unit in the hospital, and he agreed to do so.
“He had to go to A&E, then triage and then you get seen by the mental health unit,” Joe told The Journal.
“Adam packed a bag, which is the part that will stay with me for the rest of my life. He packed a set of pyjamas and a pair of socks and went to the hospital.”
The support worker drove Adam to the hospital but couldn’t get parking, so they pulled up outside the emergency department entrance and watched him go in.
The worker also rang the emergency department to let them know Adam was arriving.
Joe said he was told afterwards that his brother had expressed a desire to die by suicide, and that he then repeated this to a triage nurse.
“They then said the mental health liaison team was needed,” said Joe, “but this team was busy with another person who also expressed a desire to take their own life.
“They asked Adam if he would be okay to wait in the waiting room, and Adam said ‘yes’.”
A short time later, according to Joe, “he just got up and walked out”.
Joe has raised questions as to how his brother was allowed to leave the premises.
UHG’s review, which is set to examine what actually happened at the hospital, is now under way.
HSE West and North West has been asked for details of the protocols in place in situations where a person awaiting a mental health assessment seeks to leave the hospital.
The HSE’s model of care for patients presenting to emergency departments with suicidal ideation recommends that all patients who present receive “a timely expert biopsychosocial assessment of need”.
It adds that “in some cases, those presenting may be reluctant to wait for such an assessment”.
“It is the responsibility of the ED, working with the mental health staff, to develop a clear protocol on contacting these patients’ GP and ensuring they have an opportunity to link with next appropriate care,” states the model of care.
Documents on the model of care also note that hospital admission “will only be required for a very small percentage of people – those presenting with symptoms of psychosis or extreme agitation or hopelessness caused by mental illness”.
Joe remarked that “a lot of people are dying with suicide in this country” and that he can’t let his brother “be just be another name”.
“I want his name to be associated with fundamental change in this area.”
Joe said that the foremost change he wants to see is that people with mental health problems aren’t asked to go to emergency departments.
“I think that has to be the bare minimum, that if somebody has called their GP or the ambulance to express suicidal ideation, there should be another part of the hospital you’re brought into, whether it’s the mental health unit directly, or a mental health A&E.
“There has to be a separate place for people who are suffering from physical health to those suffering from mental health.
“It’s not right to lump those two things in together, especially not for young people who are not used to navigating our health systems because they’re usually physically healthy, but they’re mentally unwell.
“People with mental health problems shouldn’t be left sitting there.”
The HSE’s model of care highlights a 2020 review of 50 people who had presented to emergency departments following self-harm or with suicidal ideation.
A number of people with suicidal ideation had found the ED environment to be unsuitable, the study said.
“They found it noisy and stressful,” and the delay between registering and being assessed was particularly difficult, states the model of care.
“Individuals reported feeling they were in the wrong place and yet they were not aware of anywhere else to present when they had suicide-related thoughts.”
Joe said his brother was highly intelligent and loved playing with words and language.
“It was always such a privilege to hear him speaking, because he thought carefully about whatever words he said.
“He loved poetry, and he was very bright, he studied mathematics and was top of his class in NUIG.
“He was just a deeply thoughtful person.
“Even when he was going through his own absolute horrible battle, he was still trying to think about the people around him.
“He was a timid man, a gentle soul, and had a softness and a niceness, but unfortunately, too many other things came up.”
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