A vulnerable woman with mental health problems died after ‘absconding’ from a supermarket while on ‘supervised leave’ with a care worker.
Hayley Cowan, 29, who was being held under the Mental Health Act, fled as both she and her care worker went to the toilet in a nearby Tesco store in Prestwich, Bury in Greate Manchester. According to a report, she was found dead the next day after taking drugs at a friend’s house.
A coroner has highlighted a ‘lack of consistency’ in the definition of ‘supervised leave’ and ‘supervised leave’. That’s why she has written to the Department of Health and Social Care and Home Secretary James Cleverly to ‘prevent future deaths’.
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Mrs Cowan died on June 4, 2022. An inquest jury at Rochdale Coroner’s Court ruled she died as a result of misadventure, with the medical cause of death confirmed as an ‘adverse reaction arising from mixed drug use’.
Manchester North coroner Joanne Kearsley’s recently published Prevention of Future Deaths report revealed that Ms Cowan had been detained under the Mental Health Act since July 2021, following an incident in which she set fire to her flat. She had a “long history of involvement with the mental health system” and had previously been incarcerated, the MEN reported.
Diagnosed with paranoid schizophrenia and ADHD, Ms Cowan was described in the report as a risk to herself and others, and also had a ‘long history of illicit drug use’.
She was held in the Edenfield unit at Prestwich Hospital, run by the Greater Manchester Mental Health and Social Care Trust. After responding well to antipsychotic medication, the report shows Ms Cowan was placed on leave.
“There were times when her departure was supervised, but over time sometimes it happened without guidance,” Kearsley said.
‘Her leave also extended from staying on the hospital grounds to the local Tesco store across the road and sometimes to the local village. There had been at least two occasions when Hayley had absconded and run away from the staff with her. She had used drugs. and then returned to the hospital.”
“It was believed at all times that she was at risk of absconding, which was motivated by her urge to use drugs. On June 3, 2022, Hayley was placed on supported leave with a support worker to the local Tesco store. Both Hayley and the emergency worker had to go to the toilet and during this time Hayley was found deceased the next day, after taking drugs at a friend’s house she had gone to.
The inquest heard: “There were no guidelines for staff on what to do if they needed to use the bathroom. Guidelines were given on what to do if a patient needed to use the bathroom and was therefore out of sight.”
The coroner raised serious concerns at the inquest, as Ms Kearsley highlighted in her report: “The court heard evidence about the lack of consistency and clarity for mental health services in understanding and defining how section 17 leave should be implemented.”
“Guidelines on whether a patient should remain in the ‘eye-line’ or at a ‘reasonable distance’ are inconsistent. The Mental Health Act codes of practice, Ministry of Justice guidance to forensic healthcare providers and trust policies are inconsistent. This is especially true when it comes to whether a patient needs to be within ‘eyeline’ or ‘reasonable distance’ while on leave.”
“There is also no guidance on how trusts instruct staff on practical matters such as what to do if the staff member needs to use the toilet while out with a patient.”
The Department of Health and Social Care extended its condolences to Ms Cowan’s loved ones and said it takes every report to prevent future deaths seriously and aims to learn from them. The MEN has contacted Greater Manchester Mental Health and Social Care Trust for a statement.
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