GP not told of risk in prisoner suicide case

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A MAGHERA man who took his own life on Christmas Day 2010 after being released from Maghaberry “was not adequately identified” as vulnerable and “possible risks” were not communicated to his GP, according to the Prisoner Ombudsman.

Last Wednesday Prisoner Ombudsman for Northern Ireland, Pauline McCabe, published her report into the death of 49-year-old Francis Gerard McAlary.

The report found Mr McAlary had a history of mental health which indicated an increased risk of self-harm or suicide. His demeanor within prison created concern about his immediate well-being on a number of occasions and Mr McAlary spent the majority of his time in custody within the in-patient healthcare centre in Maghaberry where he was reviewed by a psychiatrist on 22 occasions.

An independent clinical review found that Mr McAlary’s standard of psychiatric care whilst in prison was comparable to that which exists in psychiatric services outside prison.

The Ombudsman stated that Mr McAlary was vulnerable on his release and this was not adequately identified or possible risks communicated to his GP. In particular, the report found that important information relating to his mental health treatment during his time in prison was insufficiently detailed within the discharge letter provided to Mr McAlary’s general practitioner. She concluded that if the full extent of his vulnerability had been known, his risks might have been managed differently by McAlary’s GP and community psychiatrist following his release on bail.

Releasing the report, Mrs McCabe said: “Overall, my investigation found that significant efforts were made, by healthcare staff in particular, to address Mr McAlary’s mental problems and to manage his medication effectively. The efforts of the Psychiatrist who cared for him were particularly conscientious and thoughtful.

“Of concern, however, was the failure of communications between prison and community health care providers at the time of Mr McAlary’s release. It is essential that appropriately detailed medical records are maintained in both the prison and community setting and that this information is effectively passed from community healthcare providers to prison healthcare when a prisoner enters into custody; and information is in turn provided by prison healthcare back to community healthcare providers upon a prisoner’s release. This is a crucial aspect of ensuring that there is continuity of care for a patient’s mental health care needs so that risk factors can be appropriately identified and addressed.”

“While it is certainly not possible to say that the final outcome would have been different if the full extent of Mr McAlary’s mental health issues had been communicated to his general practitioner, it is clear that the opportunity for his community needs to be appropriately assessed, on the basis of his full medical history and treatment whilst in prison, was not adequate.”

She added: “The issues of concern identified must be addressed by the Northern Ireland Prison Service and the South Eastern Health and Social Care Trust as part of the programme for change.”

The Northern Ireland Prison Service and South Eastern Health and Social Care Trust are currently engaged in two programmes of work with the aim of achieving significant change in Northern Ireland prisons. These are the Strategic Efficiency and Effectiveness (SEE) Programme and the Trust’s Service Improvement Boards.