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Schizophrenia: A Preventable Death

Friday, December 26th, 2008 Schizophrenia: A Preventable Death

A distressing article by Sally Mountjoy of the BBC (18 12 08) and the circumstances of a young man’s death whilst suffering the treatable schizophrenia and a mother’s love that will not let her childs death merely become another statistic.

The mother of a young Devon man who died having escaped from an Exeter psychiatric unit has said she is not going to let his death be in vain.

Daniel Heard, was diagnosed with schizophrenia at the age of 18.

Schizophrenia is a chronic mental health condition that causes a range of different psychological symptoms, which include both hallucinations and delusions. These symptoms are often referred to as psychotic symptoms, or symptoms of psychosis. Psychosis is when somebody is unable to distinguish between reality and their imagination.

The exact cause of schizophrenia is unknown. However, most experts believe that the condition is caused by a combination of genetic and environmental factors

Schizophrenia is one of the most common serious mental health conditions. One in 100 people will experience at least one episode of acute schizophrenia during their lifetime. Men and women are equally affected by the condition.

In men who are affected by schizophrenia, the condition usually begins between 15 and 30 years of age. In women, schizophrenia tends to occur later; usually beginning between 25 and 30 years of age.

For Daniel, over the next eight years, he was frequently admitted to the Cedars psychiatric hospital in Exeter and often absconded.

He was last admitted after being sectioned under the Mental Health Act in February 2004.

Eleven days on Daniel was described as in an agitated state, yet, despite being checked every 15 minutes, he walked out at 1420 GMT.

Just after 1600 GMT, he was seen about seven miles (11km) away, on the road near Stoke Canon, but minutes later he had disappeared - most likely through a gate into fields. It was bitterly cold and he was in shirt sleeves.

Daniel’s mother Linda Kelly assumed the police, alerted by hospital staff, would launch a major search.

She said: “I imagined that police cars would be homing in on the spot and there would be sirens.

In addition, she further adds, “I had in my head there would be police dogs there and the helicopter and everything would be happening.”

She realised the next day that had not happened.

She said: “It was unbelievable. We’d reported it and nothing had happened.

“I still can’t understand, still cannot comprehend how anyone thought he’d be OK.”

As it transpires, a full-scale search was not mounted until 29 February, five days after Daniel went missing. But it was a passer-by who spotted his body late that afternoon.

In fact, Daniel was found by the River Culm, near Hele. In the five days since he had left hospital, temperatures had often gone below freezing.

Pathologists said they could not be certain how Daniel had died but hypothermia was likely to have played a part.

He had been wearing just a shirt, jeans and trainers and temperatures had often dropped below freezing during the five days he was missing, the inquest heard. His body was found partially in water.

Notwithstanding, a Devon coroner has called for improved measures to prevent mentally ill people leaving hospitals at an inquest into Daniel’s death. Dr Elizabeth Earland’s recommendations included the use of swipe-card locks and the use of buzzers.

The Devon Partnership NHS Trust said it had improved, but a balance was needed between security and patient freedom.

Trust Chief Executive Iain Tulley said: “Psychiatric units are not locked areas. We have to balance the rights and liberties of some patients against the needs of others.

“We’ll continue to look at the security arrangements and look at minimising, as far as we can, the risk of such a tragedy happening again.”

The inquest at Exeter County Hall heard that Mr Heard, from Tiverton, had been diagnosed with schizophrenia in 1996 and had spent several spells in the Exeter psychiatric unit.

Nearly a year after he died, the Independent Police Complaints Commission criticised the way Devon and Cornwall Police had handled his disappearance. The force changed its search procedures and now trains officers in mental health awareness.

Eighteen months after Daniel’s death, an independent inquiry panel concluded in September 2005 that Daniel’s community care was a “disaster” and probably led to his decline. It said he probably would not have died if police and health staff had done their jobs properly.

Procedures and patient care have been improved, but the Cedars is not a secure unit. Research has shown that locked doors at such units increased aggression and self harm.

The doors at the unit remain unlocked during the day and patients are still going missing. On average it is one a week, although few come to harm.

But looking after people with mental illness remains a hard balancing act between providing therapeutic surroundings and keeping people safe. Daniel’s mother hopes the changes made are enough.

Linda Kelly said: “If Daniel’s death can help make things better and make it less likely to happen, then that makes his life count for more.

“I’m not going to let him die in vain. That’s not going to happen.”

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