Newark mum describes mental health provision as poor relation of the NHS following death of daughter Bethan Smith and says it's time for change
A mother described mental health provision as the poor relation of the NHS and called for change following the death of her daughter.
Speaking at the end of an inquest into Bethan's death on Tuesday, Lucy Millard urged more funding be made available for services.
She told the inquest one counselling therapy suggested for Bethan Smith had a year's wait to access.
Lucy, who worked at the Advertiser as a reporter and news editor for 40 years, spoke about Bethan, of Newark, at the inquest.
She said: "An A* student, a terrible speller but brilliant with maths and IT with an incredible eye for design. The world really was her oyster.
"She loved people and I believe they loved her.
"Bethan couldn't understand why she despaired. She described it as having a dread that was worse at night. She couldn't sleep and was lucky if she managed three hours.
"She reached out for help but I feel the system failed her. We have heard a GP tell her to get counselling and we have also heard there is a year-long waiting list.
"Speaking at this inquest hasn't been easy. I have done it in the hope that lessons are learned and others may be spared our life sentence of heartache."
She added outside of her evidence: "I believe that mental health services are the poor relation of the NHS, and that has to change."
Assistant coroner Mr Gordon Clow heard evidence from a GP at the Lombard Medical Centre, Dr David Watham, where Bethan was registered, and members of the Nottinghamshire Healthcare NHS Foundation Trust mental health crisis team.
The inquest was told that in February 2021 Bethan became acutely unwell with anxiety and depression.
She contacted the Samaritans and sought advice online about her feelings of being overwhelmed by life and wanting her life to end. Such feelings were always, however, in conflict with a desire not to die and to avoid the pain she knew it would cause those she loved.
Recording a narrative verdict, Mr Clow said Bethan had a loving, close family whose bond led them to doing all they could for her.
But, he said: "She consumed sufficient alcohol to severely compromise her ability to make decisions, following which she took her own life by hanging. At the time she did so she was not capable of making a decision to end her life due to the effect upon her of the excess of alcohol she had consumed.
"She suffered a horrific trauma while at university, which was compounded by a subsequent work situation (with a charity) which brought back to her consciousness the pain that would have associated that trauma. Miss Smith placed herself in that work situation as a result of her caring and thoughtful nature, but it took a significant toll on her mental health.
"At the time of her death, Miss Smith had suffered a history of anxiety and depression for about ten years. She had received treatment in the form of anti-depressant medication and, some years prior to her death, had pursued a lengthy course of therapy. I was advised she found the therapy difficult as it included reflecting on her history of trauma.
"The interaction between this condition and her mental health was significant and created additional challenges to Miss Smith and those treating her mental health. Miss Smith would suffer from significant anxieties and also a very deep-seated sense of dread which did not respond to the persistent endeavours of her family to help Miss Smith to develop a more positive frame of mind."
Bethan contacted her GP for help on March 18, saying she was really struggling and asked for a review of her medication.
Dr Watham expressed a view all of the medications were “much of a muchness” and recommended a course of counselling. He provided her with a telephone number but asked no questions about her condition.
Mr Clow said he did not undertake an assessment of her mental health or use any diagnostic tools. Miss Smith was not asked about if she was suffering from self-harm or suicidal thoughts or plans.
Lucy later called the GP to ask for help because she did not know what to do. The GP recommended the crisis team become involved. He provided a telephone number for a self-referral but did not offer to make the referral himself and gave no guidance as to what information to provide to the crisis team.
The crisis team accepted the self-referral and Bethan was spoken to by a psychiatric nurse and given an assessment. On March 23 Bethan then attended Millbrook, Sutton-in-Ashfield, to be assessed by the psychiatrist. This was a detailed assessment and her medication was changed. However, psychiatrist Dr Jonathan Gibson had no information on Bethan drinking and Bethan did not volunteer any.
Giving evidence, Dr Gibson said had he known, his course of actions may have been different.
She was seen three times in 11 days by psychiatric nurses, on two occasions for a matter or minutes, before being discharged at the third on April 6 with no plan agreed as to how she would manage her mental health post-discharge, except being told she could re-contact the crisis team in the future.
Bethan, 28, was discovered at home on Hardwick Avenue, Newark, on the morning of April 30.
The inquest was told she had recently lost her grandmother, but had told the crisis team she was coping well with the loss despite their closeness.
A former boyfriend died on the same day as she from a brain tumour and Lucy said Bethan may have found that out.
In evidence, Lucy described her daughter as a pleaser and believed had told clinicians what they wanted to hear rather than what was truly going on in her mind.
A clinical lead for the crisis team, Maria Randle, described Bethan as pretty, intelligent, articulate, and admitted she felt the team had been hoodwinked to a degree and had they appreciated what Bethan was really going through she would not have been discharged from their care.
She said Bethan had spoken of moving forward and had seemed positive, was working at Barcode Warehouse from home, lulling the team into believing she had made significant improvements.
Mr Clow said the trust’s initial investigation into Bethan’s death was deficient and the trust apologised unreservedly to Bethan's family for that.
The coroner said he was satisfied appropriate areas for improvement had been identified and were being acted upon.
Actions put in place included steps to improve communication with families of patients, with the patient's consent, because they may be able to assist in providing a truer picture of their mindset.
Dr Watham acknowledged his "professionalism came across as rather cold" and would be seeking training to help with his empathy towards patients. He himself acknowledged there were deficiencies in what he asked of her.
- If you need help, contact the Samaritans on 116 123 or online at www.samaritans.org/how-we-can-help/contact-samaritan/ The crisis team can be contacted on 0115 956 0860.