Concern for teens in 'inappropriate' adult psychiatric wards

A sheriff says a teenager's "wholly inappropriate" placement in an adult psychiatric ward may have contributed to his reluctance to speak to health professionals before his suicide.

Harris Macdonell died age 19 in 2020, near his family home in the Scottish Borders.

Two years earlier, he spent nine nights at Huntlyburn psychiatric ward in Melrose as there was no space in Young people's Units (YPU) in Glasgow, Edinburgh or Dundee.

In a fatal accident inquiry (FAI) determination, Sheriff Peter Paterson said that while "no precautions" could have prevented his death, he was concerned about the shortage of hospital beds for young people with serious mental health issues.

Sheriff Paterson said that it was a "sad truth" that young people continue to be admitted to "wholly inappropriate adult wards" and the situation has worsened since 2018.

Harris' mother, Jane, says the sheriff's findings and recommendations fall short of what she had hoped for.

But she told BBC Scotland News that Harris's case could still act as a catalyst for change.

She said: "Good will only come from the sheriff's findings if people will sit up and listen to what is being said.

"I fear that Harris' story will be forgotten within a few weeks unless people who are going through similar situations engage with their MPs , MSPs and local authorities."

Harris took his own life in the early hours of August 19, 2020 close to the family home in the Borders village of Lilliesleaf.

His family described him as being a "bright, active boy with a quirky sense of humour".

But shortly after turning 16 in 2018, he told his GP that he had begun to feel suicidal. He was prescribed medication and referred to child and adolescent mental health services (Camhs).

Within a few weeks he had climbed on to the roof his home, and fearing for his safety, a request was made for him to receive residential treatment.

Attempts to find a bed for Harris in one of Scotland's three young persons mental health units failed, and he was admitted to the adult psychiatric unit within the grounds of Borders General Hospital, near Melrose.

His family believe his nine nights within Huntlyburn scarred him mentally - as well as physically.

His mother Jane, who worked as a consultant paediatric consultant for 30 years, is convinced her son's stay in an adult unit was responsible for him failing to engage with health professionals in the final two years of his life.

She said: "The main outcome of this FAI has been about Harris' experience at the Huntlyburn unit, which is inextricably linked to what happened afterwards.

"He had a mistrust of health professionals after that, and was terrified of ever being sent back to a place like that.

"Harris was an intelligent lad and he knew about what could happen if he became ill again."

During his time at Huntlyburn Harris made several attempts to abscond.

On one occasion he was found a couple of miles away, and when being transported back to the ward he threw himself from the moving vehicle.

He required plastic surgery for facial and scalp injuries at St John's Hospital in Livingston.

A bed was found for Harris two days later at the Edinburgh young persons unit.

There are only three young people's mental health units in Scotland - Edinburgh, Glasgow and Dundee - although Lothian Health Board is currently looking to open two new six-bed units with a different pathway for admission.

Sheriff Paterson referred to evidence heard from Dr Kevin Brown, a consultant psychiatrist who treated Harris at the young person's unit in Edinburgh.

"Harris was admitted to Huntlyburn ward because of a lack of available beds in a unit suited to young persons," the sheriff said.

"It is acknowledged by all that this is highly undesirable, yet as Dr Brown so powerfully observed, the position is worse now than in 2018."

The sheriff highlighted that there had been 67 admissions involving 59 under 18s in the year 2023/24.

Figures from the Mental Welfare Commission show there has been a continuous reduction in the number of under 18s being treated in adult units - from 103 admissions in 2017/18 and 79 in 2022/23.

But Dr Brown told the FAI that adult psychiatry services were overwhelmed, and so the fall in admissions of children were due to lack of capacity not lack of demand.

He added that as a result "delay to admission is prolonged, with young people at very high risk in the meantime".

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