We were 'on our own’ - heartbroken mother of suicide victim calls for change in policies

Seamus Enright

Published: Fri 20 Nov 2015, 11:43 AM

Last updated: Fri 20 Nov 2015, 11:51 AM

The heart-broken family of a young Cavan man who died through suicide says they feel “abandoned” by the State and the HSE and are calling for a major review of the country’s policy on mental health, which they believe failed their son, prior to his tragic death.
“Abandoned is possibly too tame a word to use,” Bernie Smith, mother of Patrick Smith (29), right, of Aughagoldrick, Stradone, who died September 9, 2014, told The Anglo-Celt. She made the comments after the inquest into her son’s death was held at Cavan Courthouse last week, where a letter was read out by County Coroner, Dr Mary Flanagan.
Detailing the perceived shortcomings and failings in the care Patrick received in the wake of two previous suicide attempts, the letter has been sent to a number of mental health services in the State, including to Minister for State, Kathleen Lynch, in March of this year.
In the letter, mother Bernie Smith asks for an explanation as to how her son, who made two significant attempts to take his own life within a three-day period, was discharged twice by mental health assessors.
“Whilst I fully appreciate that nothing can be done to turn the clock back on the situation I and my family find ourselves in, I do feel that the examination of Patrick’s care has the potential to identify areas of practice where change may be indicated, thereby both improving the quality and safety of the service for others who may need to access it,” she wrote.
Almost eight months later, the Smith family have received just one reply, a brief acknowledgement that the letter was received from the Minister’s own office. “It’s very disappointing,” said Bernie.

Internal review

In April of this year, the Smith family did, however, discover that the HSE was in the process of conducting its own internal review into Patrick’s care, and subsequent discharge, the outcome of which has not yet been made known to the family.
Patrick Smith was one of five siblings, most of whom were present at the inquest hearing held in Courtroom One last Wednesday, the former IT manager at a local meat factory was also a keen GAA player. “Like many young men of his age, he enjoyed an active social life in which he drank excessively on occasions. Though I would at times have classed his relationship with alcohol as 'dysfunctional’, he was holding down a demanding job,” the inquest heard, as Bernie’s letter was read out by Dr Flanagan.
It was after Bernie and husband Vincent brought Patrick to Cavan General Hospital on Saturday, August 29, 2014, that they discovered he had tried to take his life two days earlier also.
From the medical records received since by Bernie, a psychiatric nurse who saw Patrick noted '..both attempts have been alcohol related...’
“I would contend that rather than the attempts being alcohol related that Patrick had used alcohol as an enabler to facilitate his suicide attempts,” Bernie states in her letter.
Almost eight hours after his referral to the Psychiatric team, Patrick was discharged given his alcohol levels had not subsided sufficiently, with a promise the Home Based Team would be in contact.
Bernie tells the Celt in the week up to, and at the time Patrick took his life, he had not consumed any alcohol.
Incidentally, while at the hospital, a woman approached Bernie and Vincent saying she had a relative who had also attempted suicide.
He too, she said, had been sent home from Cavan General in the same circumstances as Patrick.
“Her relative subsequently took his life. She pleaded with me not to take Patrick home as she had done with her relative. She told me that 'he did it again and that Patrick would too’. She actually begged me not to take him home and to insist he be admitted that night. I was disturbed over this,” Bernie wrote in her letter.
Speaking to the Celt, she said: “I’d love to know today who that woman was. What we were thinking was 'we have Patrick here, he’s safe, it’s under control’.”
Bernie continues in her letter that, despite a meeting with the home team, at which Patrick’s relationship with alcohol was the primary focus, he was discharged from their service, this time with a recommendation that the Smiths contact a GP or Cavan Family Resource Centre in cases of emergency. “It was the weekend, when things were closed,” Bernie told the Celt.

'Disappointed’
Bernie states in her letter: “Patrick left that meeting totally disappointed. I told Patrick 'we’re on our own with this’, but we promised we wouldn’t let him down.”
A subsequent appointment with a local GP on September 1 saw Patrick diagnosed as severely depressed and an urgent referral made to psychiatric services.
Patrick also met with an alcohol counsellor and, in the meantime, visited his ex-girlfriend and also his flatmates, who all gave him their full support during this difficult time. “It is now clear that he was saying his goodbyes as he was writing his suicide note at the same time,” Bernie says in her letter. The inquest heard how, less than a week later, on September 8, Patrick attended a local GAA pitch, with evidence from paramedic Des Brennan stating that ambulance services received a phonecall from him shortly before 3am.
Arriving at the pitch at 3.08am, after searching the area, they found Patrick’s body. He had left a suicide note with instructions that it be given to his parents.
Attempts were made to resuscitate Patrick’s body and he received further treatment at Cavan General Hospital but for a CT scan to show effects of oxygen deprivation to his brain. Patrick died at 6:50am the following day.
The inquest also heard evidence from Garda Kevin Conneely, Garda Christine Gallagher, Doctor Kieran Hannon of Cavan General Hospital, and pathologist Dr Muna Sabah, who clearly stated that during her examination that all organs were “normal, including the liver, which showed no signs of chronic alcohol abuse”.
Ruling the death to be as a result of suicide, the inquest jury also asked that Patrick’s mother’s letter be added as a ryder to the verdict, the chairman stating: “It says everything.”
Condolences were expressed by the jury, gardaí and by Dr Flanagan who told the Smith family: “[Patrick’s] death is most tragic, and it’s clear you did your very best by him.”
Speaking afterwards, Bernie told the Celt: “The terrifying thing is we believe Patrick’s case is not an isolated one. If my letter works, even in some small way, to change policy and stop the same situation as happened Patrick, and have the lives of everyone around him pulled apart as a result, then it will have done some good.”
Minister Lynch and Cavan-Monaghan Mental Health Services through the HSE have been contacted by The Anglo-Celt regarding Patrick’s case and other issues concerning admissions to acute mental health services, but, as yet, no response has been received.