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Patient died by suicide after A&E referred him back to his GP

A 21-year-old man having suicidal thoughts took his own life after a hospital sent him back to his GP, despite having initially been referred by the GP as an urgent case.

Joe Black was referred by his GP to Macclesfield District General Hospital after he presented with suicidal ideation over the summer, according to local reports.

The GP concluded that Mr Black was at risk of suicide and referred him to the hospital’s A&E department.

However, the psychiatric staff said hospital admission was not necessary and sent him back to his GP, advising him to work on self-care.

Mr Black died by suicide at his home on 12 August 2019, three days after he had been turned away from hospital.

The Manchester Evening News reported that the inquest, held last month at Cheshire’s coroner’s court, heard that Mr Black had previously made two suicide attempts – in 2017, when he took an overdose, and the following year, when he tried to drown himself. 

Holly Nettle, a registered psychiatric nurse at Macclesfield District General Hospital, told the court Mr Black said he was able to keep himself safe at the time and hospital staff advised him to go back to his GP.

She said: ‘Joe told me that he had suicidal thoughts in the past and they had reoccurred in recent weeks. But he had no current thoughts or intent to act and was actually talking about the future.

‘He was quite thoughtful and intelligent and seemed to understand himself quite well. I didn’t feel he required an inpatient admission to manage that risk. He felt able to keep himself safe at that time.’

She added: ‘The plan was he would go back to his GP and work on self-care and engage with the psychiatric services through the health care provision. He seemed like he wanted help and he was actively seeking it. He did feel able to engage in it.’

Cheshire and Wirral Partnership NHS Foundation Trust director of nursing Gary Flockhart said: ‘Our deepest condolences are with the family at this very difficult time.’

A recent Pulse investigation found that only a third of NHS mental health trusts in England accept patients with ‘severe’ or ‘significant’ conditions for specialist child and adolescent mental health services (CAMHS).

In October, a teenager died by suicide after his local CAMHS rejected his GP referral as it did not meet the threshold of ‘moderate to severe’ mental health issues


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