MAJOR concerns were raised that an open ward at Cherry Knowle hospital would be unable to cope with the behaviour of a troubled woman later found hanged, an inquest has heard.
Paige Bell, 20, had been discharged from the psychiatric hospital just hours after she was dramatically pulled to safety by a policewoman from the wrong side of the railings of Wearmouth Bridge on August 6.
She was locked in a communal area on the East Willows ward when she gained access to a room and was later discovered hanging by a member of staff. She died eight days later from oxygen starvation to the brain.
An inquest into her death at Sunderland Coroner’s Court heard she repeatedly tried to harm herself after being transported to Cherry Knowle at 12.50am.
She attempted to break her own arm and was also seen hitting her head against the wall in the police’s 136 suite – so named after Section 136 of the Mental Health Act.
The inquest heard she was distressed and agitated and unmanageable without physical restraint.
She was seen by on-call consultant psychiatrist Dr Chrys Perira at 3am along with mental health social worker Liz Parry for an assessment. Dr Perira recommended she be admitted under Section 2 of the Mental Health Act.
Giving evidence on Monday Pc William Kemp had said an unnamed doctor assessing Paige at about 2.57am had insisted police remove her handcuffs and said that “if she wants to hurt herself she is an adult so she can”.
“Pc Kemp also told the inquest jury how he had pleaded with the doctor to give Paige medication to help her.
When asked about this by the Bell family’s barrister, Michael Graham, Dr Perira said: “Oh no.
“I would never have said that. There was a junior doctor who assessed her also.
“I can’t remember any sort of conversation like that with a police officer.”
He also said that he has no legal power to administer treatment until a patient has been formally assessed by two doctors.
That second doctor was fellow consultant physiatrist, Dr Thomas Fischer, who saw Paige at 8am.
“After assessing her, he provided the second recommendation required that Paige should be sectioned.
“I think she was hitting her head against the wall when I arrived,” Dr Fischer said.
“She was crying, she looked very lonely and she was very distressed. She refused to talk to me and all she said was ‘I want to go’.
“My fear at the time was that if she left the 136 suite there was a risk she would harm herself.
“My concrete fear was that she would go back to that bridge.”
Both doctors had said in their evidence that sectioning someone with a emotionally unstable personality order, which Paige had been diagnosed with, would only be done as a last resort, for their own protection or the protection of others.
Dr Dr Fischer said a bed had already been arranged for Paige on East Willows, although he had no input into that.
Entries on the Northumberland Tyne and Wear NHS Trust’s computer system showed staff had raised questions about the reasoning behind admitting Paige to an open ward rather than the psychiatric intensive care unit (PICU).
One nurse said there was a risk of her going ‘AWOL’ – she had once before climbed onto the roof of East Willows – and that Paige would be “unmanageable” in that environment.
The PICU would offer more staff and “more doors to get through to access the outside”.
Despite these concerns, Paige was escorted onto the ward in handcuffs.
Liz Parry, in her evidence, said in the hours she had been at the hospital that morning she had not once seen Paige without handcuffs and she asked a nurse if they were going to be able to manage Paige on East Willows.
“She told me they will usually try somebody there and if they feel it’s not appropriate they will then be transferred to a more secure ward,” Ms Parry said.
Ms Parry said that when she last saw Paige at about 10am, she was drifting off to sleep and there was a male nurse watching her through an open door. At 4pm she was found hanging.
The inquest, scheduled to last up to two weeks, continues today.