No concerns in run-up to St Annes teen Marshall Metcalfe taking own life, says medic
A senior psychiatrist at a residential care unit said there was no alarm bells when he released a young patient from St Annes back into the care of his mother, months before they took their own lives.
Just one month after his death his mother Jane Ireland, of the same address, died at her home on June 7, 2020, after taking a quantity of methadone, which contributed to her death.
The pair, who had been struggling with serious mental health issues, had both been under the care of the Lancashire and South Cumbria NHS Foundation Trust mental health services in Blackpool.
An inquest into their deaths heard that Marshall had been admitted to Heysham-based The Cove, a specialist unit for teenagers with mental illnesses, on two separate occasions, culminating in his eventual release in February 2020.
Marshall, who had been treated with a series of antipsychotic drugs before being moved onto Clozapine, had expressed unhappiness at being at The Cove and often did not engage with staff or fellow residents, making it clear he wanted to go back home.
But Marshall's sister Holly had raised concerns about the declining mental health of their mum.
During the second day of the inquiry Dr Amith Paramel, a child and adolescent psychiatrist at The Cove, was asked about the "discharge plan" drawn up to prepare Marshall for release from the unit back into the care of his mum and community-based treatment.
Claire Watson, counsel for the inquest asked him if there were concerns about the care Marshall's mum could give him.
He replied: "I never had concerns because I had lengthy discussions with her about the strict regime of (his anti-psychotic drug) Clozapine
"She always collected him, asked about his weight, always supervised his Clozapine treatment and his blood tests and she knew the benefits of them."
Ciara Bartlam, a legal representative for the family, asked Dr Paramel, asked if there were any concerns about her mental state in early 2020, he said: "Absolutely not.
"I was aware of her mental health concerns because she was always open and honest about her own health needs.
"Unlike a lot of mental health cases, where there is high emotion from parents, she was always loving, a real positive, one of the few Marshal had."
Marshall had previously spoken in 2018 about wanting to harm himself and thoughts of suicide, but asked about such concerns at The Cove, Dr Paramel said: "Risk to self was never a feature, it was not a driver in managing his condition.
"I was shocked when I heard the sad news, I could not see that happening to Marshall, it was not something we saw at The Cove."
Ms Bartlam said: "Was any attempt made to speak to the psychiatrist to whom me made the disclosure?"
Dr Paramel said it had not been necessary.
He was asked if he was aware that no community care was in place at the time of Marshall's impending discharge from The Cove, which might necessitate a delay in his leaving at that point.
He said: "That would be unethical just because social care had not done what was expected of them.
"Marshall had done everything he needed for him to be discharged."
The inquiry, scheduled until Friday under the guidance of coroner Andrew Wilson, aims to establish if any opportunities were missed in the professional care given to the both Marshall and his mother, who at various points were under social services, care coordinators, and the mental health services.