Ensuring Adequate Care: An award  Sheds Light on Responsibilities in Mental Health Care of ward

In a recent clinical negligence case in Scotland, the Court of Session awarded £250,000 to the family of Mrs. Lynette Giblen, highlighting the significance of providing adequate care for patients with complex mental health issues.

Background: Care for mental health

This case revolves around the tragic death of Mrs. Lynette Giblen, a 30-year-old woman with a history of severe mental illness, including Emotionally Unstable Personality Disorder. She had previously been admitted to the hospital multiple times due to suicide attempts. In September 2016, Mrs. Giblen was admitted to Hairmyres Hospital and detained under a short-term detention certificate. Shockingly, this marked her third hospitalization for her own safety in less than two months.

During her September 2016 admission, Mrs. Giblen required constant supervision initially. Gradually, her condition improved, and she was allowed an overnight pass. Upon her return to the hospital, her clinical team noted significant improvement in her mental health. Consequently, she was reviewed by her consultant psychiatrist and discharged on 19 September 2016.

However, after returning to the community, Mrs. Giblen’s mental health deteriorated once again. Despite having multiple contacts with the Community Mental Health Team and her GP, she received no follow-up care from her consultant or the Community Psychiatric Nurse (CPN) assigned to her upon discharge. Shockingly, the consultant had conveyed to the CPN that any follow-up appointment with Mrs. Giblen could wait until 11 October 2016. Furthermore, Mrs. Giblen’s GP practice had not been informed by the hospital about her lack of additional support or CPN involvement.

Tragically, on 9 September 2016, Mrs. Giblen attempted suicide by hanging. She was discovered by her mother and taken to the Queen Elizabeth University Hospital in Glasgow. Regrettably, she passed away two days later in the intensive care unit.

LegalArguments: Update

Mrs. Giblen’s family (the pursuers) filed a lawsuit against the health board, arguing that it was vicariously liable for the consultant’s failure to ensure adequate care for Mrs. Giblen post-discharge. The pursuers presented expert evidence suggesting that, given Mrs. Giblen’s complex mental health history and the severity of her recent symptoms, it was inappropriate for her consultant to delay her follow-up care for over three weeks. They contended that, under these circumstances, the consultant had a duty to arrange intensive follow-up support promptly. The absence of such support, they claimed, created a foreseeable risk of Mrs. Giblen’s mental health deteriorating, ultimately leading to her suicide attempt.

The defender (the health board) disputed liability on several grounds. They relied on expert evidence to argue that the consultant had acted reasonably and that the pursuers failed to prove that even if intensive follow-up care had been arranged earlier, the outcome would have been different.

The Decision: An award for risk of life

Ultimately, Lord Arthurson found in favor of the pursuers, establishing that it was foreseeable that Mrs. Giblen was at risk of mental health deterioration post-discharge, potentially resulting in severe consequences, including suicide attempts. The consultant psychiatrist admitted in court that there was no clinical justification for delaying any follow-up care for Mrs. Giblen for over three weeks. Lord Arthurson concluded that the care provided to Mrs. Giblen was inadequate, and a reasonable psychiatrist would have taken steps to mitigate known risks, ensuring the patient received adequate support during the critical post-discharge period.

Lord Arthurson had no difficulty accepting that Mrs. Giblen’s suicide was a direct consequence of her deteriorating condition. He determined that if her recent improvements had been maintained through proper follow-up care, her deterioration and subsequent death could, on the balance of probabilities, have been avoided.

As a result, Lord Arthurson awarded £250,000 to the pursuers for loss of society (bereavement) under the Damages (Scotland) Act 2011.

Key Takeaways

This case serves as a vital reminder to both public and private healthcare providers about the importance of establishing comprehensive care plans for patients who may require post-discharge support. Individual patient needs should be carefully assessed to identify and mitigate potential risks. Clinicians must critically evaluate potential adverse events that may occur after a patient’s release and document their rationale for all decisions, including those related to follow-up care post-discharge.