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Man took his own life after he was denied mental health care

A man who suffered from anxiety and depression did not receive the help he needed before he killed himself.

Twenty-eight-year-old David Power had suffered from mental health problems since the death of his parents when he was a child, revealed South Manchester assistant coroner Anna Morris.

In September 2022, he tried to hang himself and was treated in accident and emergency before being referred to the Home Treatment Team.

The team then referred him to receive psychological and talking therapies at an organisation then called Healthy Minds.

However, he was not accepted by the service because it had a policy of not accepting patients they did not consider to be 'sufficiently stable'.

One of the criteria for stability was that the patient should not have attempted suicide or serious self harm for three months - meaning Mr Power did not qualify for help.

Instead, he was referred to the Living Well Neighbourhood mental health team who sent him to a peer support coach provided by the Big Life Group.

But he was discharged by both groups after he failed to engage with treatment.

The coroner said: "It is now accepted by the neighbourhood mental health team that he should not have been discharged on that date.

"On May 9, 2023, the deceased was sent a letter by the neighbourhood mental health team which stated that they were discharging him and they did not provide the psychological services he had requested.

"This was incorrect. It is likely that the deceased interpreted that letter to mean that he would not be provided with the help he had requested.

"I found that the impact of this letter contributed to a deterioration in his mental health in the period leading to his death and that the deceased became withdrawn and isolated."

Mr Power's grandmother discovered his hanged body during the early hours of August 7 last year.

The coroner found that Mr Power intentionally took his own life following a decline in his mental health which was exacerbated by receiving a letter on May 9, discharging him from the neighbourhood mental health team.

Now Ms Morris has sent a report to prevent future deaths to the Pennine Care NHS Trust.

In it she says: "I am concerned that the Home Treatment Team (HTT) referred David for a service to receive psychological/talking therapies. This was then called Healthy Minds.

"This referral took place when the HTT discharged David as they considered him to be sufficiently 'stable' under their HTT definitions.

"However, David was not accepted by Healthy Minds because they had a policy that they would not accept referrals for individuals who they did not consider to be sufficiently 'stable'.

"One of the criteria for stability was that the individual should not have not attempted suicide or serious self harm for three months. This was not known by the HTT at the time they made the referral."

The Pennine Care NHS Trust has until November 13, to respond.

Tim McDougall, director of quality, nursing and healthcare professionals at Pennine Care NHS Foundation Trust, said: “We are extremely sorry for what happened to David and our deepest sympathies go out to his family.

"We carried out a thorough internal investigation into the care David received and recognise that there are lessons to be learnt. 

"We are grateful that the coroner has raised her concerns with us. We are reviewing these concerns and will make all necessary changes to improve patient care.”

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