‘My brother took his own life 48 hours after discharge from NHS mental health care’ ...Middle East

Content warning: This article contains references to suicide which some may find distressing

Daniel Fairman was enjoying a hiking trip with friends by Lochinver, Scotland when he was bitten by a tick and developed Lyme disease. Within weeks, he was struggling to sleep and gradually became more unhappy and irritable.

“Dan was incredibly popular – the life and soul of the party,” his eldest sister, Jane Maier, told The i Paper. “He had a very happy family background, was close to our parents, all his siblings, nieces and nephews and we’d all holiday together every year on the Isle of Wight. There was nothing in his background to indicate what would happen next.”

On a subsequent family holiday with his siblings Dan, a university-educated property developer, was “quite ratty” with Jane which surprised her “as he was charm personified”. His sudden descent into mental illness became particularly apparent to his younger brother, Nick, as they worked together.

Although they cannot say for sure, Dan’s family suspect his Lyme disease was the cause of his sudden change in personality. The tick-borne infection has been linked to a range of mental health issues, including depression, anxiety, and even psychosis, according to studies.

“Dan became so unhappy he sought psychiatric help and was prescribed drugs, but we didn’t know what drugs and they didn’t help anyway,” Jane said.

When the bus deposits me back in Puigcerdà, it’s still another three hours until my return train ambles into the station. It’s a schedule that enforces a relaxed pace, giving time to discover Puigcerdà’s charming maze of streets, run up to see the views at the top of the 18th century Campanar de Santa Maria, as well as enjoying a celebratory glass of cava in the square below. Essentially, allowing you enough time to have it all.

Dan had lived in London but started staying at his mum Valerie’s house in Stock, a village in Essex, where Nick also lived, with a nearby office where the pair worked. He was admitted to The Priory Hospital in Chelmsford, on 11 April 2018 suffering from delusional paranoia, yet was never sectioned.

“From the moment of his arrival, Dan thought of the psychiatric hospital as a prison and repeatedly tried to take his own life,” said Jane, a 66-year-year-old make-up artist now living in Hastings.

“At no point from that time onwards did he get back to his normal persona. We’d go and visit him, telling him he was in hospital being cared for but he accused us of tricking him and insisting he was in prison. It was a horrible and distressing time.”

When Dan’s private medical insurance money ran out, he was transferred to The Lakes Hospital, Colchester, run by Essex Partnership University NHS Foundation Trust (EPUT), the following month on 23 May. The family did not have a power of medical attorney so were not always informed of changes or updates to their brother’s care and treatment.

‘Daniel was failed by those who were supposed to look after him and it ended in tragedy,” his sister Jane said.

“I’d asked them not to transfer him that far away, as I lived in London at the time and mum was 30 miles away from the hospital and we needed to visit him. Dan just thought he was being taken away to prison and saw it as ‘part of the punishment’ – absolutely deluded and paranoid. As soon as he got there, he tried to take his own life – and even wrote a book about how he would do it,” Jane said.

“I had done basic-level counselling in the past, and as the older sister, I took it upon myself as the one who was going to be responsible for Dan. So I asked his doctor at one meeting I attended if he was ever going to get better, and the doctor said ‘no’, he was always going to be like this.”

Hospital discharge

On 15 August, Jane was called into a meeting with Dan and his psychiatrist at the Colchester hospital, who claimed her brother was “getting better” and that it was time to discuss his discharge. According to Jane, when the doctor asked her brother about having suicidal thoughts, Dan said he would not contemplate that and hoped the medication would soon start to help him.

Jane added: “So they decided to discharge him – that afternoon – despite his nightmarish paranoia. At no point did his delusions go away. I was absolutely panic-stricken and texted my sister Ruth to say, ‘What are we going to do? Where is Dan going to go?’ I was working. My mother was 83 at the time, but we thought Dan should stay with mum for a day or two until we sorted something out.

“Ruth and I took Dan out for a walk that day. We tried to raise his spirits by telling him the doctors think he’s better and that we would make it all work, but he was like a ticking time bomb; his paranoia and delusion was clear. We just didn’t know what to do. It felt like mental health services had just run out of ideas, needed the bed, and it was over to us to look after him. He lasted two nights before he killed himself at my mum’s house, where Nick found him.”

Dan died on 17 August 2018, less than 48 hours after he was discharged. He was 53. His death is one of at least 2,000 being investigated by The Lampard Inquiry, the largest public inquiry into mental health services in the UK, and Jane is a core participant. The Inquiry is looking into deaths at NHS-run children and adult inpatient units in Essex between 2000 and 2023.

All died either under the care of EPUT, the North East London Foundation Trust (NELFT), or their predecessor organisations, or within three months of being discharged. Hearings at the Inquiry resume on 7 July.

The Lampard Inquiry

The Inquiry will make recommendations to improve mental health services nationwide. Jane hopes this will include a requirement for a panel of experts to decide whether a patient is fit to be discharged, rather than a single medic as occurred in her brother’s case.

“If my brother were a puppy, he would have been given more checks as to where he was going to live. There was no aftercare. If my brother had cancer or had a heart attack and was going into the care of family, there would have been advice for them on what to look out for,” Jane said.

“There would have been a hotline to call. I know now that the first 72 hours are critical for someone who is discharged and who has attempted to kill themselves. It is the biggest time of risk, but I was not warned at all and given no number to call. Things could have been done differently for Dan that could have saved his life.”

Jane said mental health services remain the “poor relation” to the rest of the NHS, which leaves “gaping holes” in people’s care. In Dan’s case, there was no proper risk assessment, no proper support for the family and no advice given.

“And it’s risk and aftercare where we were totally and utterly failed,” she said.

“All these mental health deaths [that the Inquiry is investigating] come with inquests, and there are supposed to be lessons learned, but mental health services are incredibly defensive following a death, and that is not going to help anybody. It is about making the system better, but there is no accountability. The things that could have made Dan’s situation were quite simple and straightforward, but he was failed and it ended in tragedy.”

Christina Jose, lawyer at Hodge Jones & Allen, the firm representing Jane and a further 125 families at the Lampard Inquiry, said: “The circumstances surrounding Daniel’s death is yet another damning example of how our clients, and thousands of others, have been drastically let down by EPUT. The evidence is clear – Daniel was failed on every level, and the shambolic, effectively non-existent aftercare contributed to his tragic death.

“To feel as if your loved one was treated with less aftercare than an animal speaks to the importance of this inquiry and the urgent need for interim recommendations to be made during the hearing process. If changes are not made and lessons are not learnt, as a matter of urgency, we will continue to see further deaths at the hands of the state. This cannot, and must not, be viewed as anything less than a national emergency.”

EPUT chief executive Paul Scott said: “I want to say how sorry I am to Daniel’s family for their loss. As the Lampard Inquiry progresses, there will be many accounts of people who were much loved and missed over the past 24 years, and I extend my apology and condolences to their families, friends and loved ones. All of us across healthcare have a responsibility to work together to improve care and treatment for all and to build on the improvements that have already been made.”

NHS England has been approached for comment.

In the UK contact Samaritans on 116 123 for 24/7 support or email [email protected]. If you have lost a loved one, you can also call Cruse Bereavement Support on 0808 808 1677.

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