A specialist mental health nurse and doctor have both defended their decision not to give a teenage Wem school pupil urgent psychiatric referral before his death.
Jeff Antwiss, 14, died in January after being struck by a train at Harlescott level crossing, and had been diagnosed with Asperger syndrome.
The Thomas Adams pupil had previously attempted to end his life on more than one occasion but an inquest into his death this week heard evidence he was seeking treatment and wanted help.
He had been referred to Dr Ini Oknna, who worked at Shropshire Child and Adolescent Mental Health Services, by locum nurse Melanie Archer, who made his initial assessment.
Giving evidence at the inquest at Shrewsbury’s Shirehall, Miss Archer told senior coroner John Ellery she didn’t feel the symptoms Jeff presented at two meetings warranted an urgent appointment with Dr Oknna.
However, Sophie Beesley, representing Jeff’s mother Lorraine Antwis, highlighted knowledge of previous suicide attempts made by the teenager and asked why an urgent appointment wasn’t made.
Miss Archer re-iterated her belief that because Jeff had spoken of wanting treatment and maintained his sense of humour throughout the assessment that she did not believe that he intended to harm himself.
However, the nurse admitted she had told Ms Antwis to write to Child and Adolescent Mental Health Services in order to press home a complaint that Jeff’s mother had regarding the next available appointment being March 17.
When asked why she did this, Miss Archer told the inquest it was because of how distressed Ms Antwis was and if it was a complaint, then it would have been a way of expressing dissatisfaction.
She added that had Jeff shown risk, such as refusing treatment and verbalising a desire to kill himself in her presence, she could have contacted an on-call psychiatrist.
But Miss Archer re-iterated the symptoms presented in her January 25 meeting by Jeff did not make her think he needed an urgent review, nor formal or informal hospital admission.
Dr Oknna told the inquest that on the evidence presented to her, she instructed her medical secretary to arrange a routine appointment, normally four to six weeks after assessment.
She re-iterated that Jeff’s symptoms did not require a more urgent review but had it done, he could have been seen within seven days if Dr Oknna had instructed her secretary.
However, Dr Nina Champaneri, a consultant child and adolescent psychiatrist brought in by Mr Ellery to provide an independent report, had some criticisms.
This included medical staff not seeking clarification to the extent of Jeff’s depression, which in her opinion, was moderate to serious.
If this had been undertaken, she felt it would have triggered further discussions of a management plan to take into consideration threats he posed himself.
Dr Champaneri also said she would have considered Jeff’s case to be urgent, not routine.
The inquest is expected to conclude tomorrow.
See full story in the Whitchurch Herald