Northern Ireland

James Fenton: Psychiatrists question report's findings

James Fenton Image copyright Fenton family
Image caption James Fenton's body was discovered on hospital grounds, less than 40m from the ward

Senior psychiatrists have questioned the findings of a report previously commissioned into the death of a man who left a mental health unit and later died in hospital grounds.

James Fenton, 22, left the ward at the Ulster hospital in July 2010.

His body was found in hospital grounds 10 weeks later, less than 40 metres away.

After the incident, a report was commissioned from Prof Seena Fazel.

Prof Fazel, currently a professor of forensic psychiatry at the University of Oxford, has yet to give evidence.

However, it is understood that his report questioned the way Mr Fenton was assessed and treated when he was voluntarily admitted to the mental health ward.

'Would have been accompanied'

It suggested that Mr Fenton should have been diagnosed as depressed, and placed under special observation in the ward.

The court heard that if that had happened, he would have been accompanied in the ward smoking area and would have had little opportunity to leave, as he ultimately did.

Prof Fazel reported he believed that Mr Fenton most likely took his own life after leaving the ward.

But two senior psychiatrists have questioned elements of his report.

Dr Neta Chada, a psychiatrist at the neighbouring Southern Trust, also issued two reports, including comments on Prof Fazel's findings.

She told the court she believed the clinicians at the Ulster Hospital had made the correct diagnosis not to consider Mr Fenton as clinically depressed and had made a reasonable decision to place him under general observation, rather than the higher level of special observation which Prof Fazel had considered to be appropriate.

'Lack of evidence'

The court also heard from Dr Nial Quigley, a consultant psychiatrist and director of mental health for the South Eastern Trust.

Dr Quigley said he also considered that the junior doctor and other clinicians who oversaw Mr Fenton's admission to the ward did make a reasonable diagnosis.

Both doctors disagreed with Prof Fazel's conclusion that Mr Fenton most likely took his own life and both considered this conclusion to have been speculative given the lack of evidence.

Neither the cause of Mr Fenton's death, nor the date, have ever been established.

Later in evidence, Dr Quigley said that the mental health ward at the Ulster Hospital was a "poor ward for the 21st Century", explaining that an application for a more appropriate facility had been waiting for action for several years.

He also said that Mr Fenton's behaviour suggested a low likelihood of his absconding whilst on the ward.

'Too much security'

Dr Quigley also explained that the fence around the smoking area was as much for the privacy of the patients as to discourage them from leaving the area, and was not intended to be "prison-like".

A month before Mr Fenton left the ward, he said, an external body had criticised the ward's smoking area for having "too much security".

Replying to a barrister for the Fenton family, Dr Quigley said he did not accept that James was at high risk of taking his own life after he had left the smoking area of the ward.

He confirmed this, even though nursing staff at the ward had informed the police officers making the initial search for James that he was at high risk.

The inquest later heard from Don Bradley, the assistant director of mental health at the South Eastern Trust.

He gave more details of the level of patients leaving or "absconding" from mental health units.

At Ward 27 at the Ulster in the year before Mr Fenton left it, there had been eight absconding incidents from the smoking area, involving five patients.

Seven of the incidents occurred within just three months when the gate to the smoking area was unlocked.

The gate was later locked using a device which opens in the event of a fire alarm.

The majority of patients in the ward are there voluntarily and can ask to leave if they wish.

Mr Bradley confirmed that there is now more controlled access to the smoking garden, and fewer patients are now absconding from it.

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