Another death, this time a friend’s son, highlights the need for an urgent review of psychiatric services

Published by The i paper (2nd May, 2022)

More than three decades ago I joined The Sunday Times in the wake of the Wapping dispute, which broke the stranglehold of print unions on the newspaper industry. I was a callow 26-year-old reporter, struggling to survive in a tough newsroom under the driven editorship of Andrew Neil. Despite the pressure, it was great fun as our young team took on vested interests in business, journalism and politics. I formed strong friendships that persist, including with a blond-haired character in horn-rimmed spectacles who arrived shortly after me from the Daily Mail.

His name was Richard Caseby. As our career paths diverged and families grew, we became less close but it was always good to see him at industry functions or bump into him around town. Then six months ago he sent me an email that arrived when I was holed up in Kyiv with Covid, feeling a bit sorry for myself until I read his words. He told me of a tragedy that had befallen his family: his youngest child Matthew, a personal trainer, had taken his own life at the tender age of 23.

The death of any child is the most terrible trauma. Yet the pain for Richard’s family was intensified by the shocking circumstances of their loss. Matthew was a super-fit man with a first-class university degree who did not drink or use drugs. He had been a bit withdrawn and had some counselling over the previous year, but there were no signs of major disturbance or diagnosis of mental illness. Then one day in September 2020 he had to be sectioned under the Mental Health Act for his own safety after being found “running on train lines”, picked up by the police and telling doctors he was “hearing voices and receiving messages.”

Matthew was having a frightening psychotic episode. But this should have been the start of his road to recovery after he was taken into protective care of the state to receive treatment for a mental health crisis. Instead, four days later he was dead. The National Health Service despatched the troubled young man into the hands of the Priory Group, as it does many other patients entrusted into its care. And now it has been confirmed by an inquest verdict that failings amounting to neglect by this famous private healthcare provider contributed to the death of my friend’s son. The Priory Group has apologised.

But the details that emerged over the “care” from Britain’s biggest independent provider of psychiatric services are disturbing, including inadequate record-keeping and risk assessments. While left unescorted, Matthew was able to flee over a low courtyard fence although staff had raised fears he might abscond and there had been two other recent absconsions. Despite the Priory claiming “improvements”, another patient escaped over the same fence during the course of the inquest. No wonder the horrified coroner declared that she was writing to the Department of Health demanding an urgent review of security at acute mental health units. 

Once again, a patient safety scandal only emerged due to the determined efforts of a distressed family – in this case, after a grief-struck father used his journalistic skills for 18 months to probe his own son’s death. Richard made at least 20 Freedom of Information requests, half a dozen Subject Access Requests and sparked an independent investigation by a senior psychiatrist. As he discovered, and I have previously exposed, the NHS spends £3bn a year outsourcing chunks of mental health care to poorly-regulated private firms that skim big margins – yet we keep seeing similar lethal failings, harmful practices and needless fatalities. Such was the lack of grip one NHS official told the family Matthew was being treated still at the Priory six weeks after his death.

Last week, The Times revealed this group has been criticised for failings in the care of 30 patients who died over the past decade – including one young woman who hung herself from a ligature point identified in an internal audit four months earlier. Last year I wrote here how in little more than two years this same provider had been fined for neglect over a teenage girl’s suicide; exposed for dreadful failings by an undercover television investigation; and criticised by a coroner over staff falsifying records to hide supervision flaws after a teenage boy killed himself. I have spoken also to a traumatised 16-year-old  left naked apart from a blanket for weeks in one clinic, then confined to her room until her parents made her safe clothing to avoid attempts at self-harm.

Yet blasé health chiefs – backed by complacent politicians and weak watchdogs – divert torrents of cash to some voracious private operators who provide dire care for patients with mental illness, old folks suffering dementia, teenagers with eating disorders, autistic people and citizens with learning disabilities. These firms sweep aside such failures and fatalities as they build mountains of debt to fund expansion, hiding profits and bosses’ pay behind opaque corporate structures that routinely go offshore. Just look at the Priory Group: built up by a leading Labour party donor, then passing through a bank, private equity player and US healthcare giant before being sold for £1.08bn early last year to a Dutch private equity outfit. 

Richard wants an independent strategic review of such outsourcing. This would be welcome since taxpayers are being fleeced by fat cats. Yet this should be just the starting point for serious discussion over the chronic state of mental health care. Instead, there is simply a smug belief that society has become more accepting of this issue along with a glib debate fixated on budgets rather than raising profound questions over the nature of provision. Sadly, there is little chance of serious reform when the flailing health secretary is a former banker who exploited non-domicile tax status and Labour, crippled by caution, ignores an open goal. Instead, the death toll rises – and families suffer from the deepest pain when it is avoidable.

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