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21 June 2007 Edition

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Suicide : Catalogue of failures resulted in young man's death

Proper strategy on suicide essential — Adams

BY LAURA FRIEL

Commenting on Tuesday on the findings of the inquiry into the death of teenager Danny McCartan Sinn Féin West Belfast MP Gerry Adams today said it detailed a catalogue of failures which resulted in the loss of a young man’s life and the grief and hurt which his family have had to carry since then. Danny McCartan was passed from pillar to post by a health service, which failed to respond to his needs with compassion, consistency and urgency.
“This tragedy underpins the need for a strategic integration of services intended to help those at risk of taking their own lives. No one feeling suicidal should be left to negotiate their own way through the labyrinth of the health system to find someone who will help them. The health system needs to be person-centred and responsive”, Adams said.
“The McCartan family are not the only family to have been subjected to such an ordeal. The priority now must be to ensure that no family is ever again left abandoned in the face of suicide. The Health Service is under a heavy onus to make the changes necessary to ensure this tragedy can never happen again”, he said
The West Belfast MP added:
“There is still a serious problem in under-provision of psychiatric and community services for children, adolescents and young adults in the Six Counties. Sinn Féin has raised this problem in the past, especially in North and West Belfast. We now need to see a strategic shift in the Health service response to suicide prevention. The outworking of the regional suicide prevention strategy must involve urgency in relation to care and support services for children and young people.
As a first step, Sinn Féin wants to see the rapid extension to the whole of the Six Counties of the suicide help-line and referral service presently being piloted in North and West Belfast. I will be seeking a meeting with both health Ministers on this island to ask what they are doing to co-ordinate suicide prevention, in conjunction with families and support groups, across the 32 counties.”

Assembly motion
Speaking in the Assembly last month Sinn Féin's spokesperson on children Sue Ramsey tabled a motion expressing concern at the current state of child and adolescent mental health services, “the lack of child and adolescent in-patient beds and dearth of trained staff to run these services”.
The West Belfast MLA called on the Department of Health, Social Services and Public Safety to take urgent action to implement the recommendations of the Bamford Review and called for the establishment of a children’s task force for areas of high deprivation.
“In 2005 213 people died as a result of suicide in the North. Of those around 35% were aged between 15 and 34. In 2006 there were 291 reported suicides with some of the highest levels within north and west Belfast. The suicide rate in west Belfast stands at twice the regional average,” says Sue.
“Around 10 to 15% of adolescents face mental health difficulties, within Belfast this means about 16,000 children and young people. If we include young people with eating disorders, substance and alcohol abuse and developmental problems the figure jumps to one in five under eighteens. And yet the provision of services no way reflects this established need
“In 2005 Daniel McCartan from North Belfast died as a result of suicide on the evening of the day on which he had requested admittance into a psychiatric unit.  Daniel’s request had been denied because there were no adolescent in patient beds available at the time,” said Ramsey.
“Last month Bronagh Gallagher, a teenage mother of an 11-week-old baby died after taking an overdose. Bronagh had struggled with mental health difficulties and had been previously admitted into hospital twice before following overdoses. At the time of her death she was still waiting for a referral to a psychiatric nurse.”

Bamford Review
“In the two years that span these two tragedies what has changed for those young people who badly need access to professional care and support? Well we’ve had the Bamford Review and the formulation of a suicide strategy and there has been a small injection of funding but in practical terms very little has changed,” says Sue.
“Accessing appropriate help can be very difficult. There’s a dearth of adolescent inpatient beds in the North. Every year around 60 young people in Belfast end up being placed in adult psychiatric beds because of the lack of appropriate facilities.”
“Worse still even when beds in children and adolescent psychiatric units are available they cannot be allocated because of a lack of trained staff. In January there were 30 vacant posts in the mental health profession. That requires a radical and urgent response.
“Add to that the pressure on community based services and you begin to understand the enormous difficulties many young people and their families face when trying to access help with mental health difficulties. Providing young people with early intervention can prevent at least some of them from needing more intense services.”

Evaluate effects of anti-depression drugs
“We also need to urgently evaluate reports that some anti-depression drugs prescribed to children and young people may have adverse effects and increase the risk of suicide,” says Sue.
A report into the death of Danny McCartan due to be published this week offers a damning indictment of the provision of services in the north.
Danny was a troubled teenager who was bullied at school and began to self-harm at the age of fifteen. He was prescribed anti depressants by his GP but became bloated as a result of the medication and stopped going out.
At 17 a suicide attempt brought him to A&E from where he should have been admitted to an adolescent psychiatric unit but no beds were available. He spent 15 days in an adult unit before being transferred. Danny was one of 500 children and teenagers treated in adult wards over the last five years.
Between his first suicide attempt and his subsequent death nine months later Danny had contact with three separate services but there was no continuity or sustained care.
“On the basis of the experience of Danny McCartan, the organisation and management of services for both young people and adults were fragmented, disunited, focused on issues of maintaining service boundaries rather than on the well being of patients who had to cross the boundaries. When continuity of care above all else was required it was not available to him,” says the report.

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