Concerns regarding safe staffing levels, appropriate training and policies at a mental health unit for children were raised in a report in the months prior to the death of a West Belfast teenager.
The second day of the inquest into the death of Annaleece McAlorum took place on Wednesday, September 16, at Banbridge Courthouse. She passed away on April 8, 2022, and had been receiving treatment at the Beechcroft Unit in South Belfast in the days prior to this.
In the afternoon session, Dr Sarah McGivern, Consultant Child and Adolescent Psychiatrist, gave evidence and said she had worked with Annaleece for a number of years prior to her admission to the unit in March 2022. She said she was aware of the teenager’s history of self-harm, trauma and complex needs, with her saying she also had a “turbulent homelife” and had been living in a children’s home at the time of her admission.
She said Annaleece’s behaviour and moods could be unpredictable with “rapid emotional shifts” with moods that were either elevated or depressed. Dr McGivern said this made care for Annaleece challenging but her behaviour was similar to that of other patients at the unit.
Dr McGivern said Annaleece had been anxious about the prospect of moving from children’s to adult mental health services, along with her future accommodation, as she would have to leave the children’s home when she turned 18. However, she was aware Annaleece was going to be getting news regarding her next steps in the coming days.
The doctor said she was made aware of an incident on April 4 where Annaleece had snatched medication from a nurse, which prompted a search of her room the following day. The hearing heard Annaleece was upset about this but was cooperative with staff.
Dr McGivern had her last formal discussion with Annaleece later that day on April 5, where Annaleece told her that she had batteries hidden but was “calm, pleasant and future orientated”.
The doctor was asked why Annaleece was kept on general observation, where she would be checked by staff every 15 minutes, following the admission about the batteries and the medication incident instead of moving to 1-1 observation. She said that despite these incidents, Annaleece’s wider behaviour did not lead to increased concern as she was engaging with staff and exhibited high-risk behaviour openly in front of them in the past.
The doctor said Annaleece has been deemed a high risk of self-harm or suicide throughout her admission on the ward in risk assessments.
Dr McGivern was also asked about a RQIA report that was released following an inspection in March 2021 which raised significant concerns regarding the Beechcroft Unit. This noted concerns about staffing levels, staff training and knowledge, restraint practices and unit policies.
The doctor told the hearing that at the time of Annaleece’s admission in 2022, she did not have any concerns regarding staff levels or their training.
She was asked if there was anything she would have done differently with regards to Annaleece’s care on April 5 and she said she would not. Dr McGivern was also asked if she believed Annaleece intended to take her own life and she said she could not say what her intention was.
With regards to Annaleece’s observations, Dr McGivern was asked if someone with experience of the mental health unit would be able to know the times they are likely to be checked on every 15 minutes, which would give them a window to harm themselves.
She said this could be the case and it is now policy on the ward to constantly change checking times during general observation.
The hearing continues.
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