Shane Michael — the boy who fell between the cracks
No one is to blame for the tragedy that befell the Skeffington family, but people in crisis need a properly functioning system, writes Brendan O’Connor
DID you find yourself searching in Shane Michael Skeffington’s eyes for some clue? Did you find yourself looking into those slightly sad eyes to see if there is some bit of a want in him, or some warning of what was to come, to see if he looks like a person capable of killing his little brother, his mini me, whom he loved so much, whom he spoiled and was so caring towards, and then taking his own life?
But, of course, there is no clue there. No one could have predicted it. His parents certainly couldn’t, when he was sent home to them having spent most of a week in seclusion in the high dependency unit in St Columba’s Hospital. They said they felt out of their depth. “We’re not doctors,” his mother Carmel said. “We didn’t understand what was wrong. We didn’t know, and people need to know these things. They need to know what to watch out for.”
Carmel and her husband Shane say they were surprised and concerned, but happy Shane Michael was being sent home. Just days before, his mother says she had been warned not to visit him, as it wouldn’t help the situation. He had been aggressive to a member of staff on the day of his discharge.
In hospital, Shane Michael was refusing to take his medication, having to be restrained to have it injected into him. Carmel wondered how they would get him to take it orally at home. Carmel says she was told by the doctor discharging him, “It’s no big deal.” It was just a small dose of Olanzapine, they say they were told, for the paranoia.
The doctor in question said that Shane Michael had suffered cannabis-induced psychotic symptoms and that he would expect these to resolve even without the medication, as long as he stopped using cannabis. Shane Michael’s behaviour in St Columba’s was noted to be volatile and paranoid despite him not using any cannabis in there. The doctor said there was a plan in place, that a letter had been sent to the family’s GP and that he was satisfied everything was done correctly.
Shane Michael didn’t take his medicine at home.
Shane Michael had been admitted involuntarily to psychiatric care under the Mental Health Act after he attacked his father. He kicked his dad on the side of the head. It was reported that Shane Michael then fled the house and when gardai eventually found him, they had to use pepper spray on him. It was thought he had had an acute psychotic episode brought on by weeks of smoking cannabis, which was leading to erratic and paranoid behaviour. He was said to be agitated, uncooperative and laughing inappropriately when admitted to St Columba’s Hospital. When he absconded from the hospital the next day, he was brought back by the gardai and then he was put into the high-dependency unit.
After he was sent home on leave of absence on May 20, 2014, his parents say Shane was quiet. Shane Michael failed to attend his out-patient appointment on May 28 and his parents say that without any further review, Shane Michael’s involuntary admission was formally revoked on May 29.
On June 18, his file was closed on the basis that he did not wish to engage with the services.
His parents say they thought Shane Michael was doing well over the next while. He seemed to be making an effort, offering to collect his brother from school, going fishing with his dad. He was quiet, they say, but in general, they thought there were positive things happening. They think that Shane Michael thought he was OK too.
At 4pm on July 20, everything seemed fine when Shane and Carmel left Shane Michael at home babysitting his nine-year-old brother Brandon. The two boys were in the room they shared. They were very close and it sounds like Brandon was Shane Michael’s little shadow. Their sister Sharon heard them talking and playing ball in the utility room. When it went quiet, she assumed they were gone upstairs. At one point, Shane Michael had knocked on her door and called her. Her door was locked, as a teenage girl’s door can be when she wants privacy, and when she asked, “What?”, Shane Michael said, “Ah nothing. Just checking.”
When Shane and Carmel came home later, Carmel found Brandon lying on the ground at the top of the stairs. She thought at first it was a joke. Brandon was a real messer and joker. But as she got closer, she could see that he was too still, that his clothes were soaked in blood, he was pale, and his lips were blue. She knew by his colour that it was serious. His father performed CPR on him for 45 long minutes, being advised by the ambulance crew, but Brandon was pronounced dead shortly after being airlifted to Sligo Hospital. He had been stabbed twice in the chest by his adored older brother.
Meanwhile, Shane Michael had been discovered. He had taken his own life in a shed adjacent to the house
Shane and Carmel Skeffington argued there was a failure to provide adequate follow-up care for their son. They say the HSE refused to take reasonable care of him, to adequately investigate his prognosis, that it was negligent to discharge him when they did, considering him to be “no immediate risk of harm to himself or others”, given his behaviour in the hospital.
They claimed there was a failure to complete a formal risk assessment. They say when Shane Michael was discharged from the mental health system on May 28/29, that there had allegedly been no examination by a psychiatrist or a medical practitioner since his discharge on leave of absence from the hospital. They say if better treatment had been given to Shane Michael, he would not have killed his brother and taken his own life.
Carmel and Shane say their world is turned upside down. What shone out from what was said by their lawyer on their behalf last week was that they love their children enormously. “They are their beloved Shane Michael and their beloved Brandon, and they will remain forever so.” They say the trauma will live with them for the rest of their days. “But it is the pleasant memories of their beloved Shane Michael and Brandon that will never be forgotten.” In itself that speaks of an extraordinary triumph of the human spirit.
But as Carmel says plaintively of her two beloved boys: “They’re always missing.”
The HSE settled with the family last week, without any admission of liability. And in a sense no one is to blame here. You had parents who were out of their depth in trying to understand a boy whose mental health difficulties were gone beyond a place of ordinary comprehension. And you had a system that is creaking at the seams, where staff are just trying to do their best with the limited resources they have at their disposal.
We pride ourselves on being great at talking about mental health now. And models and influencers and celebrities all talk about their anxiety and panic attacks and how CBT helped them and so on. And it’s a great conversation, that no doubt helps many people who need to work on their mental wellness, but who can help themselves through lifestyle and good habits and trying hard.
And then there is another side to mental health, the really acute, dangerous end of it. And the truth is, all the talk and all the good intentions in the world won’t help with cases like that. What is needed to ensure that young people like Shane Michael do not fall between the cracks in the system is a functional system, full of people who have the time and the space to give every case the attention it deserves. Of course, no one could have foreseen what happened that awful day, and perhaps there is nothing anyone could have done to prevent it. But a properly functioning health system and a properly resourced mental health system would certainly be a start.