“Highly intelligent” man died after “unfulfilling” mental health treatment

Tuesday 27 August 2019

The family of a "highly intelligent" Jerseyman, who died after a stay at Orchard House where he was denied access to quizzes, intellectual TV shows and music, has blasted the facility for doing him "more harm" by leaving him "unfulfilled" at a time when he needed therapeutic help.

The comments came last week during the inquest of Peter*, who took his own life in 2018 after a long battle with obsessive compulsive disorder (OCD), depression and anxiety, which was worsened by a bereavement earlier in the year.

An inquest into his death, held in Morier House by Relief Coroner Dr Martin Barrett, heard that Peter was a “well-learned man” with a “kind and caring personality” who had struggled all his life with his mental health.

A local consultant psychiatrist who was Peter’s responsible medical officer at Orchard House at the time of his death, explained Peter had first been admitted to Cedar Ward at St. Saviour’s Hospital several years ago after a suicide attempt.

Pictured: The inquest into Peter's death heard he had spent time at Cedar Ward and Orchard House.

Peter was admitted again last year after being reported as a missing person. He explained he had spent a night contemplating suicide and appeared severely depressed.

The psychiatrist said Peter had been under the care of the acute mental health team who described his engagement as poor, adding he was only partly compliant with his medication.

Peter was transferred to Orchard House where he remained on observation as the team was concerned he would harm himself. Over the following months, his mental health state fluctuated, showing signs of improvement before the suicidal thoughts returned.

Shortly before his death, Peter said he wanted to have more time away from Orchard House and asked to be allowed to stay a few days with his partner. He told the psychiatrist “part of him wanted to live” and that, if any suicidal impulses returned, he would tell someone.

Pictured: Peter liked listening to music on the radio.

The doctor said the team agreed as Peter was showing signs of improvement and had the full support of his partner. Although he had “blips” when his mood deteriorated, the psychiatrist said they happened when Peter was not taking his medication.

She explained that there were no grounds to detain Peter as he was engaging with the service, agreeing to come back and had the mental capacity to make the decision. However, shortly after leaving the facility, Peter died by suicide.

Peter’s partner and soulmate of nearly 20 years described him as a “kind and calm” man who was “brilliant and gentle” with her daughter. “His good qualities outweighed his bad,” she said in a statement.

She said Peter enjoyed quizzes, intellectual programs and music - all of which he had no access to whilst in Orchard House, as they would only play programs he had no interest in. He was also denied use of a radio over safety concerns. “He was interested in all sorts of things,” she said.

Pictured: Peter hated being on Orchard House, his partner said.

She explained that Peter hated being on the ward at Orchard House and that his time there had been of no benefit at all. “In fact, I think it did him more harm,” she said.

The woman was critical of the decision to allow that Peter to leave the facility and travel alone to get his medication from the hospital, just a day after leaving Orchard House. “I wasn’t impressed with that,” she said.

The state of Orchard House and the possible impact it may have had on the man’s recovery was largely discussed during the inquest.

Referring to Peter’s family comments, Dr Barrett noted that it was an unpleasant environment, which Peter had found boring and where he lacked stimulation.

Peter’s brother described Orchard House as “a very unstimulating environment.” “Every time I asked him who he had seen, what he had done, he said, 'No one, nothing.' He had an assessment once a week. It was totally unstimulating.”

He described his brother as “a highly intelligent and very well-read man” and “the best friend to have to 'phone a friend'”, adding that several of the other patients had spoken of Peter in “very complimentary" terms.

He admitted that Peter made it difficult for those trying to help, saying he seemed to resist treatment. “He never seemed to cope with life as a whole,” Peter’s brother said, adding: “It was very sad to see him so unfulfilled at Orchard House,”

Pictured: The inquest was heard at Morier House.

“How do you manage people’s different interests or capacity to take life seriously?” Dr Barrett asked the Head of Mental Health Services, Consultant Psychiatrist Dr Miguel Garcia.

Dr Garcia admitted Orchard House was not fit for purpose, adding that money was due to come into the Mental Health Service to address this. He said this would include the appointment of a full-time occupational therapist on the ward and a new ward environment being devised opposite the road.

He explained that having a TV or radio in every room “comes with its own risks”, but admitted that giving patients access to them would be helpful.

One of Peter’s friends also asked whether a more modern building would make it less likely for patients to express a desire to go home. Dr Garcia answered by promising: “Going forward, I am doing everything I can to make sure the environment is as therapeutic as possible.

A recent critical report of the island’s mental health service found Orchard House to be in a highly “dilapidated” state, with the rooms inside described as being similar to “prison cells”.

In the wake of the report, a government spokesperson confirmed that “a capital plan which amounts to £5.5million has been developed to make improvements to Orchard House, Clinique Pinel, Rosewood House and La Chasse”, adding that the refurbishment “would see all of our inpatient and outpatient services brought up to modern standards.”

*Name changed to protect anonymity.