Inquest hears teen was refused CAMHS care before suicide
‘Tyann had complex needs’
A TEENAGER with a history of self-harm was repeatedly refused care by the HSE’s Child and Adolescent Mental Health Services in the months before she died by suicide, an inquest has heard.
A sitting of Dublin District Coroner’s Court heard that the referral of Tyann Lee to CAMHS in Ballymun, north Dublin, from its service in Wicklow arose only because her foster family wanted to reduce the distance that she had to travel from her home in Santry to see a psychiatrist.
Tyann, 14, had been receiving ongoing care from CAMHS in areas other than Ballymun since the summer of 2017 after she had required four emergency admissions to Tallaght University Hospital over a period of seven months as a result of several incidents of self-harm.
However, the inquest was informed that CAMHS in Ballymun ruled Tyann had not met the criteria for accessing its services.
Tyann was found in an unresponsive state after trying to take her own life in the bathroom of the home of her foster family.
Paramedics were alerted but the teenager was formally pronounced dead a short time later on August 5, 2018, after being taken to Children’s Health Ireland hospital at Temple Street.
A consultant psychiatrist with CAMHS in Ballymun, Farzana Sadiq, told the inquest that she had received a referral about Tyann from CAMHS in Wicklow in January 2018 which she had not regarded as a request for transfer of care. Dr Sadiq said she had asked the girl’s social worker to arrange a referral letter from her GP as she did not believe Tyann met the criteria for accessing CAMHS services at the time. The inquest heard Tyann’s GP, Dr Aliya Rahim, believed Tyann warranted care from CAMHS because she regarded her as ‘vulnerable’ and she was receiving a large number of calls from different parties about her mental health.
Dr Sadiq said she had concluded Tyann was not suffering from moderate to severe mental illness on the basis of the GP’s letter which she received in April 2018.
She said she had recommended to Tusla that the girl should contact her GP or other service providers such as Pieta House.
Dr Sadiq said she still held the view that Tyann did not meet the criteria for receiving care from CAMHS after being asked to review her decision by the girl’s social worker in July 2018.
Dr Sadiq said: ‘She had complex needs that were not necessarily ones that were going to be met by CAMHS.’ The psychiatrist said she believed Tyann required ‘long-term psychotherapeutic interventions.’
However, the coroner, Aisling Gannon, noted that various other healthcare professionals had all believed that CAMHS was the appropriate service to provide care for the teenager.
Tyann’s foster parent, Pat Bellew, said: ‘We would not have asked for her to be moved if we thought she would not be seen by another [CAMHS] service.’
Another of her foster parents, Brendan McCarthy, said CAMHS had ‘passed oversight’ of Tyann’s mental health back to her GP and social worker.
Mr McCarthy – who spoke on behalf of two of Tyann’s siblings, Chelsea and Jason, who attended the inquest – pointed out that there had been no issue when Tyann had earlier been transferred between CAMHS in Kildare and Wicklow.
Garda Kevin Fenton said he was satisfied that Tyann’s death was an intentional, self-inflicted act carried out without any influence from a third party.
Ms Gannon advised the jury that it was ‘not appropriate to sit on the shoulders of people who provided care to Tyann’ in reaching their decision.
The jury of four women and two men returned a narrative verdict based on the evidence. They made several recommendations, including that CAMHS should evaluate its criteria for accepting transfers of patients moving between catchment areas.
The coroner said she would bring the recommendations to the appropriate authorities.