At a recent hearing, the Royal Courts of Justice approved settlement of a case brought by the family of a man who had been failed by his local Community Mental Health Trust, in the sum of £925,000.
Partner Kym Provan and Associate, Kerry Blomerus, members of the Enable Law Southampton Clinical Negligence team, represented Mrs L. following the tragic death of her husband Mr L, in September 2017.
What happened?
Mr L had a history of childhood trauma and depression and became more acutely unwell in early 2017. He was referred to the Mental Health Team at Berkshire Healthcare NHS Foundation Trust. The Trust failed to appoint a key individual as Mr L’s Care Co-ordinator. It is a Care Co-ordinator’s role to take overall responsibility for, and ensure continuity of a patient’s care and to make sure that treatment and therapeutic intervention is effective. Whilst Mr L was seen by various individuals from the trust, there was no clear plan of action to progress his treatment. In May 2017, it was recommended that Mr L should be referred for EMDR therapy, which has been demonstrated to be effective in treating PTSD. This referral was sadly not actioned until after Mr L’s death.
Mr L’s mental health continued to deteriorate. Both his wife and mother made several pleas to the mental health team to intervene as they were concerned that Mr L would take his own life, and there was clear and objective evidence that he may do so. The trust did not escalate Mr L’s case to senior members of the team, or offer him inpatient treatment, and there was a failure to recognise that the community programme in place and current medications were wholly inadequate.
Sadly, Mr L took his own life. He left behind a wife, two young children, and a disabled mother to whom he had previously provided support.
How did Enable Law help?
A Pre-Inquest Review was held on 7 September 2018. Associate, Kerry Blomerus represented the family and agreed the agenda, witnesses and advanced disclosure in preparation for the final inquest to be held on 25 and 26 February 2019 at Reading Town Hall.
The Inquest took place on the 25 and 26 February 2019. The family were represented by Counsel and supported by Kerry. The coroner held that Mr L died of suicide, but made several criticisms about the standard of mental health care provided to him and referred to a number of missed opportunities to provide more effective intervention.
Mrs L instructed Kym and Kerry to act on her behalf in a compensation claim for clinical negligence. Mrs L brought the claim on behalf of Mr L’s Estate, for the pain and suffering he had endured prior to his death, and the care he had required, and also on behalf of Mr L’s dependants, that is herself as his wife, his two young children, and his mother.
Kym and Kerry undertook further investigations into the circumstances surrounding Mr L’s care in the months preceding his death. This included making a Freedom of Information request to the trust for waiting list times for EMDR treatment at the time. They also obtained independent expert evidence in the fields of Community Mental Health nursing and psychiatry. These reports indicated that the care Mr L had received was below what could reasonably be considered acceptable, and that had he received an acceptable level of Community Mental Health support and psychiatric intervention, on the balance of probability, Mr L would not have taken his own life in September 2017.
Our psychiatric expert went further and advised that with appropriate treatment, Mr L would have made a full recovery and would have been able to return to his employment and to providing full parental and domestic support. The expert considered that Mr L would have been vulnerable to future episodes of depression which may have required treatment, but that these would have been identified and effectively treated. Overall, with appropriate treatment, Mr L’s mental health would have recovered, and he would have been able to return to the family home, return to work, and been able to fully resume his domestic and caring responsibilities to his wife, two sons and his mother as he had done previously.
A Letter of Claim was submitted to the trust. In response the trust admitted that there had been failings in the care provided to Mr L and that with appropriate care, on the balance of probabilities, Mr L would not have died on 14 September 2017. The Trust reserved their position as to the extent of recovery that Mr L would have made.
Following Mr L’s death, Mrs L found herself in an impossible position, trying to meet all the care needs of their children, and she had to leave her previously well-paid full-time job. She was eventually able to find some part-time work that fitted in much better around the children’s needs, but at a lower level.
One of Mr L’s children was subsequently formally diagnosed as having significant additional needs, which would have been present irrespective of his father’s death. His other child also had additional emotional needs and it was clear that had he survived, Mr L would have been ideally placed to provide a great deal of the additional support that his children require. In light of Mr L’s death, Mrs L was left to provide all of the care and support required by her children, as well as undertaking Mr L’s share of the domestic chores in addition to her own.
Settlement and lessons learned
Kym and Kerry worked on quantifying the claim. They got detailed witness and expert evidence as to the cost of commercial provision of the services that Mr L would have provided to his family, but for his death. This included the commercial cost of the help and assistance Mr L had provided to his disabled mother.
A settlement meeting took place on the 13 February 2024. The parties reached an agreed settlement in principle. However, given that the settlement included an element for Mr L’s children, who remained under the age of 18 at the time, court approval of the settlement was needed. At an Approval Hearing on 9 August 2024, the court approved the settlement of £925,000. Although the vast majority of the settlement will be paid to Mrs L in order that she can provide for the family going forward, smaller awards were also approved to Mr L’s mother and to Mr L’s two children, which will be paid into the Court Funds Office.
A key driving factor for Mrs L throughout the litigation process was to bring about changes in the way that the Trust cared for patients suffering from a mental health crisis. She was therefore heartened to be told about a number of changes that have been brought in at the Trust and nationally since Mr L’s death, that should improve communication, supervision and safeguarding for mental health patients. A representative for the Trust explained at a settlement meeting, that Mr L’s case, and sadly, similar cases, had highlighted weaknesses in the mental health care provision and that lessons had been learned and steps taken to improve this.
It is incredibly sad that it takes a case like Mr L’s before something is done to improve mental health care services. Litigation is a long and often difficult process, but it does bring failings in care to the attention of those that have the power to change the way things are run. Hopefully the changes that have been brought in as a response to the tragic circumstances of Mr L’s death, will result in better standards of mental health care and prevent another family having to suffer the loss that his family have.
