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Expert Witness Spotlight on…Mental Health

Mental health problems can affect anyone and have a significant effect on the lives of individuals, their families, communities and wider society.

In the early 1990s changes were implemented regarding the provision of services for mental health problems. These included an emphasis to increase care in the community as opposed to institutional care and the reduction of acute psychiatric beds. A&E departments have long been utilised as a first point of contact for patients with mental health problems seeking care.

The provision and quality of mental health services have faced increased media attention and public scrutiny as waiting lists and demand for access to specialist mental health services continue to expand.

As a society, we are certainly talking about and recognising mental health conditions more. There is a growing recognition that healthcare professionals working across all fields of medicine should have an awareness of how mental health conditions can present in a patient, and when referral for specialist treatment can and should be made; however increased pressure on services continues to have a daily impact on the ability to forsee future needs and risks

It is estimated that one in six adults have had a common mental health disorder, such as anxiety, in the last week. Three quarters of mental health problems are established by the age of 24.

Recent data* indicates that there are close to 551,000 people in England with more severe mental illness (SMI) such as schizophrenia or bipolar disorder.

The Samaritans state that approximately 66,000 people take their own lives every year in the UK and Republic of Ireland.

Suicide is complex and has devastating ramifications for families, friends and colleagues. There is no single explanation of why people die by suicide.

There are many different risk factors, including:

  • previous suicide attempts, or previous self-harm. Many people who self-harm don’t want to die. However, research shows that people who self-harm are at higher risk of attempting or dying by suicide
  • being unemployed
  • having a physical health problem, including chronic pain
  • living alone
  • being dependent on alcohol or drugs having mental health problems

Why make a ‘claim’?

There are a variety of reasons why individuals or families may pursue a claim regarding substandard care or a failure in mental health services. At Bush & Co we have experience in providing independent expert liability opinions to both Claimant and Defendant firms including:

  • An accident/injury having occurred whilst a person was in the care of a medical institution causing injury or death.
  • Failures to identify and mitigate risks to a patient following assessment, resulting in inadequate care.
  • Failures and delays in referrals to mental health services for an assessment by primary healthcare practitioners.

The role of an expert witness

In some cases, we find our expertise are called upon in the traumatic circumstances of ‘failed’ suicide, where people find themselves living with injuries and complicating factors. These clients may have the need for ongoing nursing care, speech and language therapy, occupational therapy and physiotherapy intervention. In these cases Bush & Co expert witnesses have the skills and expertise to sensitively provide an independent opinion to the Court through quantum expert witness reports.

Our expert witnesses have a breadth of experience in acute psychiatry as well as ongoing mental health conditions. Their clinical experience includes emergency settings, high risk referrals and the care pathway for those suffering from depression, anxiety, schizophrenia, bipolar disorder, PTSD, perinatal metal health, dementia and psychosis.

Our extensive network of nurse expert witnesses also understand the responsibility of a range of health professionals and the complications and risk where mental health referrals and not handled correctly and patient safety is at risk. This enables them to objectively review the liability of a case where patient safety may have been compromised and breach of duty has occurred.

With a full understanding of ongoing case management and collaboration across Bush & Co services, where relevant, our expert witnesses are also able to provide their expert opinion on the need for ongoing case management where mental health plays a debilitating role within rehabilitation.

* Health matters: reducing health inequalities in mental illness