Belfast Telegraph

Mental health unit risk evaluation forms 'a joke', inquest into nurse is told

By Lesley Houston

Doctors believe filling in risk assessment forms for psychiatric patients is a waste of time and a joke, an inquest into a patient who took her own life has heard.

Aoife Ni Uallachain (33) died on February 11, 2010, four days after attempting suicide at the Bluestone mental health unit at Craigavon Area Hospital.

At Ms Ni Uallachain's inquest in Belfast, senior coroner John Leckey (right) heard how doctors in mental health units had little regard for risk assessments. Mr Leckey yesterday referred the matter to the Department of Health.

Aoife, originally from Dundalk but who had been a midwife in Essex, was suffering from depression and anxiety after her break-up with fiance Darren Porter. She had also learned her mother had been diagnosed with cancer.

Dr Helen Harbinson, a consultant psychiatrist, told the coroner that Aoife's forms "had gaps" in the information included.

She said research had revealed that when doctors were asked whether risk assessment forms had improved patient care, some 80% had said no.

The independent witness said doctors added they were "a waste of time", saying that some medics had described them as "a joke".

Dr Harbinson said she was told the forms "interrupt the relationship" between patient and doctor.

The witness said she regarded Aoife to have been at a higher risk of self-harm than those treating her at Craigavon appeared to.

Aoife was not classed as a high-risk patient before her death.

But Dr Harbinson said that given her feelings of hopelessness and how she had said it would be easier if she weren't here, she would have described her a higher, rather than lower, risk.

If her risk was regarded as higher, hospital staff could have increased her medication, she said. The doctor added that the mental health unit could have applied increased observations.

Consultant psychiatrist Dr Brian Fleming, from the body providing legal services to the health sector, stated that even then, patients "with enough determination" could take their lives.

He said there was "no evidence of deliberate self-harm up to that time that the people assessing Aoife were aware of".

Dr Fleming said risk assessment forms had not been intended to be used at the expense of the relationship between patient and doctor.

In Aoife's case, he said what he gleaned from her form was "a sense of staff who were taking their time with this patient".

"She was one of their own; she was a nurse," he added.

He added the forms showed they were attempting to "get to the core of the issue" and possibly help to eventually cure her.

The psychiatrist agreed to co-sign the document to be prepared by Dr Harbinson to be sent to the Department of Health.

Dr Fleming added that Dr Simpson had declined to increase Aoife's medication as it was regarded as potentially addictive.

He said that the hospital also thought she had appeared to respond to "talking" therapy.

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