Teenager’s hospital move ‘unusual and concerning’
This article contains details about suicide and self-harm
It was “unusual” and “worrying” that a teenager was moved to an adult mental health hospital days before he fatally injured himself, a psychiatrist told the inquest.
Emily Moore, of Shildon, County Durham, died while in the care of Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) in February 2020.
Two days after she turned 18, the teenager was transferred to Lanchester Road Hospital’s youth ward after a doctor said the transition was against the rules.
The inquest in Crook heard Emily’s emerging emotionally unstable personality disorder (EUPD) meant that her relationships with medical staff were vital and any changes had to be carefully managed to avoid triggering self-harm.
Jurors heard Emily began experiencing mental health problems in 2017 when she was 15, resulting in her being sectioned and diagnosed with EUPD in March 2019.
He spent four months at TEWV’s West Lane Hospital in Middlesbrough. what he complains about And his father described it as a “hell hole”Jurors heard the trial before it moved to Ferndene in Prudhoe, run by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW), in July 2019.
Emily Moore died just days after her 18th birthday [Family handout]
She was Development in Ferndene but jurors heard that he had to be transferred to an adult hospital run by TEWV two days after he turned 18 in February 2020, and Lanchester Road was deemed the “least worst” option for him.
The inquest heard that planning for Emily’s transition to adult services began more than three months before her birthday, but uncertainty about her future destination continued until several days before the transition.
Dr Peters, a consultant psychiatrist at Lanchester Road’s 20-bed women-only Tunstall Ward. Eman Arebi said she was first told of Emily’s impending arrival in an email on January 28, a week before the teenager moved out.
He said Emily’s case was the first he had seen of an inpatient being moved from the children’s ward to the adult ward, and he and his colleagues at Tunstall were “concerned” and had “reservations”.
“I didn’t know Emily at this stage,” Arebi said, adding: “I didn’t know anything about her. [her]”I was told he had been in hospital for a long time.”
While it is “very unusual” for someone to move without consulting their team, Arebi said, a proper transition is “very important” so clinicians can learn who the person is.
“The problem was the way Emily arrived,” he said, and “at least a few weeks of collaboration would have made her more comfortable.”
Emily’s father David Moore (left) previously told jurors West Lane Hospital was a “hellhole” [BBC]
The jury heard the aim would be to “close any gaps in care” and make the potentially destabilizing movement “as gentle as possible” for the patient.
The investigation stated that national guidelines state that the transition between child and adult services should be made “carefully” and in a “stable period”, not exactly on children’s 18th birthday or just because they have reached that age.
Bridget Dolan KC, barrister for coroner Crispin Oliver, asked whether the rules were “at all followed” during Emily’s passage.
“I don’t think so,” Arebi replied.
Emily was transferred to Lanchester Road Hospital days before her death [Google]
TEWV clinical psychologist specializing in personality disorders, Dr. Rachel Smith said “ideally” Emily should be introduced to her new carers gradually to minimize instability.
The inquest heard Emily’s relationships with staff were “crucial” to the teenager’s sense of “validation and emotional calm”, while the perception of being “dismissed or criticized” was a trigger for self-harm.
Smith said Emily’s transition was “very uncertain” for a number of reasons, including a “breakdown in trust and relationship” between her family and TEWV.
The inquest heard her parents’ preference was for Emily to “go anywhere other than a TEWV bed” after her West Lane experience.
Asked by Dolan whether uncertainty was “a good thing” for an EUPD patient, Smith replied: “No, that wouldn’t be the preferred situation.”
The inquest heard Emily visited Tunstall Ward eight days before moving there.
When asked what other preparations were being made regarding Emily, Smith said it was “limited, if any.”
Emily Moore died while in the care of Tees, Esk and Wear Valleys NHS Foundation Trust [Supplied]
Jurors heard Emily was placed under constant surveillance when she arrived in Tunstall on February 6, but after 72 uneventful hours this was reduced to just one night.
According to the investigation, he was under general observation in common areas throughout the day and was checked on at least every 15 minutes while in his room.
The jury heard that Emily had six incidents of self-harm in her last month at Ferndene, all of which required restraint or rapid sedation, but none during her time at Tunstall until she fatally injured herself on February 13.
The inquest heard Emily’s father had called the ward that morning to express his fears after reading his daughter’s concerning Facebook post reminding her of a friend who had died in West Lane.
Staff said they would keep an eye on her but jurors heard the woman lost consciousness hours later and died two days later.
Arebi said that he was not notified of Emily’s father’s call, otherwise he would have gone and talked to the young man.
The investigation continues.
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