Friday 28 January 2011


This morning I am in the BBC's Swansea studio to comment on a report by the Ombudsman for Wales into the suicide of a man in Cardiff. A mother complained about the standard of care afforded to her late son by services before he took his life in October 2008.

The Ombudsman’s investigation (see it in full here) found that:

• The threshold for admission to hospital appeared to be at a high level and there was no clear policy guidance or definition as to what constituted a “severe case” warranting admission.

• The high threshold coloured the way in which the man was dealt with. This was particularly evident immediately following his return from a trip with his mother, when he had self harmed.

• There was no clear guidance in place as to what should happen when patients recently discharged from the Crisis Team’s care "self presented" at a hospital front desk, out of hours, requesting admission.

However, the Ombudsman did not uphold the complaint that shortage of beds had influenced the decision not to admit the man, as he was satisfied that a bed could have been sourced elsewhere. He also asserted that it could not be known whether admission to hospital would have prevented the suicide (this was, I think, a superfluous remark in an otherwise well-judged report because obviously you couldn't know that for sure in any circumstances).

The Ombudsman has to confine what he comments on to fairly specific aspects of the case and I think he’s reached the right conclusions here.

However, there are also wider implications. The mother of this gentleman has courageously posed a question for the wider public: if somebody in your family was in a very bad state mentally and tried to take their own life more than once in recent days and weeks, and if they then tried to get admission into hospital, what would you expect to happen?

I think most reasonable people would say that either the person should be admitted or there should be a flexible service available which ensured that someone is available to stay alongside the person until the crisis is over.

There is a weakness in the suicide strategy in Wales – it concentrates on early stage prevention, which is of course important, but much can and should be done at a later stage when a patient is at high risk.