In-depth report: 'Cuts to mental health services killed my son' says mother of man who took his life following withdrawal of support
PUBLISHED: 17:54 08 February 2016 | UPDATED: 17:54 08 February 2016
A grieving mother feels her son was “totally failed” by mental health services before he stabbed himself to death.
A coroner concluded that Jeffery Mann was suffering from depression which was exacerbated by worries over the threatened withdrawal of the mental health support he received from the Highgate Day Centre, which had its funding halved by Camden Council last year in a round of social care cuts.
Mr Mann, who was 46, had used the therapeutic services at the day centre since 2011, and was under the care of Camden and Islington Trust when he was found dead at his flat in Warren Street on September 3 last year.
He had been told two weeks earlier that his “associate membership” at the centre was set to end.
Reaching a narrative conclusion, Assistant Coroner Richard Brittain said: “It is clear that he was concerned about many issues in his life which contributed to him taking this action. Some of these issues were not as real as he may have perceived, but it is apparent that planned changes to the care at his psychiatric centre were a genuine concern.”
Coroner’s findings - fears around day centre were “a directly contributing factor”
Mr Mann, known as Jeff to his family, stabbed himself multiple times in the abdomen.
A toxicology report found he had no drugs or alcohol in his system, and no traces of prescription medication, indicating that he may have stopped taking his anti-depressants.
The police officer who discovered his body at first considered that the death could have been a murder, but this was quickly ruled out as it was clear the wounds were self-inflicted.
In his conclusion, Dr Brittain said there was insufficient evidence for suicide because Mr Mann hadn’t left a note.
He said: “Jeffery Mann died from the consequence of self-inflicted injuries. This arose from a background of major depression.
“I am satisfied that he alone took the action that did end his life, however it was not clear from the evidence that he intended his life to end.
“No concerns were present amongst the psychiatric team who cared for him that the risk of such an incident was increased above his baseline.
“It is clear that he was concerned about many issues in his life which contributed to him taking this action.
“Some of these issues were not as real as he may have perceived, but it is apparent that planned changes to the care at his psychiatric day centre were a genuine concern.”
The coroner asked to see a report into the funding of the day centre, which had its annual funding cut from £270,000 to £130,000 last year, and said it concerned him that the council, as a non-health body, was funding a health service, and that this arrangement “should end”.
In his summary, he said that although Mr Mann feared having his benefits stopped and becoming homeless, the only “real, concrete concern” was the ending of his associate membership at the Highgate Day Centre.
He said: “That was a directly contributing factor which seems to have influenced his thought process to take the action he did, albeit along with many other factors”.
The cuts in funding had been in the offing since 2014, but it was at a meeting on August 18 that Mr Mann was told he would no longer be able to use the centre from September.
He took his own life sixteen days later.
Mother: “Jeff was a very gentle, sensitive soul”
Speaking after the inquest, Mr Mann’s mother, Liz McGinlay, said: “My boy should still be alive. Why was he only seeing a psychiatrist once a year when he had serious mental health problems?
“I think he has been totally failed by mental health services.”
She added: “I don’t want Jeff to be known just as someone with mental health problems. He was a very gentle, sensitive soul.
“He had a degree in music from Middlesex University, he could play the saxaphone and the piano, and he was a qualified landscape gardener.”
Mrs McGinlay, who lives in Dartmouth Park Hill, said she didn’t feel that his carers at the Trust really knew her son.
She said: “I’m not saying it is any one person’s fault, but maybe if one carer isn’t getting through, they should be offered a change.”
Mrs McGinlay worked for Camden Council for 24 years, as the resident caretaker in Holly Lodge, and said she felt angry that the day centre had seen its funding halved.
She said: “We were on holiday in Wales for two weeks before he died, and I could tell something wasn’t right. He was very worried about being abandoned. I think that was a major reason why he did what he did, and the coroner agreed.”
Her son’s depression was apparently caused partly by childhood trauma, where he witnessed a murder in Scotland with his mother, and the family were temporarily homeless before being housed in Camden.
Giving evidence, Mr Mann’s brother, Barry, said he thought Jeffery may have suffered from post-traumatic stress disorder, but this was never diagnosed.
He said that his brother always feared homelessness because of his unstable childhood, and was terrified of losing housing benefit.
Mrs McGinlay said: “Jeff was really frightened that he was going to be found fit for work, as lots of people with mental health problems have been, and that he wouldn’t be able to pay his rent.
“He was asking me if I thought he could get work as a painter and decorator, but he obviously wasn’t well enough to work and he couldn’t have held down a job full-time.
“The Scottish episode left him with a lot of fears around housing that stayed with him throughout his life. Of course, you wonder if you’re to blame, you blame yourself. But he was supposed to be under the care of professionals. I don’t think they took much care of him.”
The last message on his mobile phone was from his mother, and said simply: “Are you OK?”
Contact with mental health services
St Pancras Coroner’s Court heard that Mr Mann first came to the attention of mental health services after a serious self-harming incident in 2011, when he was admitted to the Whittington Hospital.
He was referred to the Highgate Day Centre for a two-year programme of therapy, and when this ended, he was given “associate membership”, meaning he could continue to attend workshops and classes there.
Last summer, it was announced that ongoing support for those who had finished their prescribed treatment programme would be withdrawn after Camden Council slashed the funding for the centre from £270,000 to £130,000.
Giving evidence, Highgate Day Centre manager Tony Creedon said the announcement had caused “significant stress” to many vulnerable people who used the facility.
Mr Creedon said that Mr Mann had made good progress in the four-year period when he used the day centre, particularly enjoying art therapy.
Mr Creedon said when he first met him in 2011, Mr Mann was very withdrawn, but became more “engaged and engaging” towards the end of his life.
Giving evidence, Mr Mann’s brother, Barry McGinlay, said: “It was an important place for him. He had nothing but praise for Tony and the centre.”
In the period leading up to Mr Mann’s death, meetings were called by the Trust to explain to associate members that they would effectively no longer be welcome at the centre.
Mr Creedon said: “I think the Trust managers did as good a job as they could, given the circumstances they were given.”
Mr Mann’s care co-ordinator at C&I, Tracy Holloway, last saw him on July 8, where she said he seemed a little subdued but did not display overt signs of being at heightened risk.
In addition to seeing his care-co-ordinator each month, Mr Mann saw a consultant psychiatrist once a year.
He last saw psychiatrist, Dr Nadia Davies, in April 2015, where she thought he was showing signs of improvement. Dr Davies said he had never displayed signs of psychosis to her.
Dr Davies said she was aware of the impending changes at the day centre because 80 people would be affected, and all of them had significant mental health difficulties.
She said: “All the consultants in Camden were concerned. But with mental health services, there are always concerns.”
She said that some of the service users were reacting badly to the news, but Mr Mann was not one of those showing obvious signs of distress.
Dr Davies said she was not aware of any problems with Mr Mann’s benefits, but that he may have been made anxious by talking to others who had been found fit to work under government tests.
She said: “We would have supported him continuing to claim benefits, but there is a climate of people being switched from income support to ESA (employment and support allowance).
She said that Mr Mann had been collecting his anti-depressant medication, but could not say for certain if he had actually been taking it.
C&I Trust statement
The coroner asked to see a report into Mr Mann’s care by the Trust, which was not ready in time for the inquest, within a week.
C&I Trust said in a statement that there were no warnings Mr Mann would take his life.
It said: “Camden and Islington NHS Foundation Trust would like to offer our sincere condolences to Mr Mann’s family at their tragic loss. Mr Mann’s care plan and its delivery was robust and ongoing and staff had detected no warning signs prior to this tragic event.
“We will, of course, provide the coroner with the additional information he has requested.”
Camden Council statement
Sally Gimson, cabinet member for adult health and social care services, said on behalf of Camden Council: “We would like to offer our deepest condolences to the family of Jeffery Mann. This is obviously a tragic death.
“We have not yet had sight of the coroner’s report, but we will try to learn any lessons we can from it.”
Cllr Gimson said that the council had halved the funding to the Highgate Day Centre because they have lost half their funding from central government, but said the council had tried to protect mental health services as best it could.
She said: “Camden still spends £60 million on community care. The Highgate Day Centre is focused on recovery, and care is still being delivered there, based on the recommendations of the clinical professionals at the Trust.”
Last September, Cllr Gimson said it was “clinically correct” to end associate membership at the centre because consultant psychiatrist, Dr Vincent Kirrchner, said that ongoing membership could lead to dependency rather than recovery.