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Inquiry reports into tragedies in mental health care services often focus on how families were listened to (or in some cases not listened to). One of the case study materials I have used to deliver training in assessment of risk, is an inquiry report into the tragic killing of Adelaide Howard, 79, in Gloucestershire in 2002, following which Matthew Newland, a near neighbour, was convicted of her manslaughter, with diminished responsibility.
Listening to concerns
Matthew had been in the care of mental health services for two years before this tragedy. During the inquiry, Matthew’s family made a number of significant comments about what would have helped them. There’s no suggestion by the inquiry report that if all of these things had been done that Mrs Howard’s life would have been saved, but I think the suggestions I’ve picked out could all be useful pointers to health and social care staff.
- The family felt they were not given information about prescribed medication. If family carers are going to be involved in ensuring someone takes medication, it helps if they know how it works and things to look out for. Similarly the family were left confused as to what Matthew’s diagnosis was.
- Professionals talked to the family about sections of the Mental Health Act, and the Care Programme Approach but this just sounded like jargon to the family. Professionals are so used to using these terms they forget that family members often don’t know what they mean.
- The family said it would have been helpful to have a key person to talk to in hospital who had responsibility for keeping in touch with carers.
- The family would have wanted the opportunity to talk to staff before Matthew was discharged home. Confidentiality issues can make this difficult, but families often say it is difficult to tell the doctors the problems they are experiencing if the service user is present.
- Care planning for discharge should involve families. They are often the people who are providing the majority of care and support. Matthew’s family did not know what to look for if Matthew was becoming unwell, and what to do about it. As the inquiry report shows, when a social worker visited Matthew a few hours before the killing, he realised how unwell Matthew had become, but for the family this is how he had presented for a long time.