Suicide mum Frances McKeown's jail 'had extremely poor mental health care'
Mental health resources in a prison where a woman killed herself in her cell were "extremely poor" at the time of her death, a former jail medic has said.
Nurse Caroline Kilsa, a mental health specialist, told Belfast Coroner's Court nursing staff did not have "adequate time" to deal with inmates suffering from a psychological issues.
She also accepted that Frances McKeown (23) made a "clear call for help" in the weeks leading up to her death when she told a nursing colleague that she was determined to carry out a suicide plan she had made.
Mrs McKeown, who had a lengthy history of mental illness, was found dead on her cell floor at Hydebank Wood on May 4, 2011.
An report into her death highlighted a litany of failures by the Prisons Service in dealing with inmates who suffer complex mental health issues.
Nurse Kilsa, who was a key worker to the mother-of-two, claimed that the health system within Northern Ireland's prisons had since changed in that mental health has been ring-fenced and staff are assigned to care for women and young men in Hydebank who suffer from psychological problems.
"It has made a significant difference," she told the inquest. "The resources (in 2011) were extremely poor for mental health. I got to know Frances well. I would usually ask how she was feeling and how things were going. Nothing formal, just general chit-chat."
The court heard that nurse Kilsa was "surprised" Mrs McKeown did not see a psychiatrist in prison for almost seven months despite two referrals being made, one of which was marked urgent.
On March 20, some six weeks before her death, Mrs McKeown told a nurse that she was determined to "complete a suicide plan" she had formulated.
The nurse noted that she was "very worried" about Frances, adding that she needed to be seen by a psychiatrist as soon as possible.
The note also stated: "Please (which was underlined six times) see this lady."
However, Mrs McKeown did not meet with the prison psychiatrist, Dr Rosemary Ali, until April 12.
Nurse Kilsa said: "I was quite shocked and found it hard to believe that she was not seen for seven months. I did believe she had been seen. She should have been seen a lot sooner than that."
She also told the inquest that Mrs McKeown was put on a Spar (Supporting Prisoner At Risk) plan, which she believed would have kept her safe during that crucial time.
Meanwhile, one of the prison's doctors, Dr Anna Gallagher, admitted in court that she should not have stopped Mrs McKeown's medication after it was discovered to be "missing" from her cell on February 14 2011.
Dr Gallagher said she was concerned about why Mrs McKeown's anti-psychotic drugs had gone missing.
"I should probably not have stopped the medication," she told the inquest.
"I should have arranged to have a supervise swallow. Yes, there are lessons to be learned from this case."
The inquest continues.