A vulnerable woman with a mental illness has died after “running away” from a supermarket on “holiday” from hospital with a support worker.
Hayley Cowan, 29, who was detained under the Mental Health Act at Prestwich Hospital, escaped when she and the support worker she was with went to the toilet at a nearby Tesco store in Prestwich, Bury. She was found dead the next day “after taking drugs at a friend’s house where she was going,” the report said.
The coroner subsequently said there was a “lack of consistency” in how “accompanied holidays” and “accompanied holidays” were defined. As a result, she wrote 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 4 June 2022. An inquest at Rochdale Coroner’s Court found that she died as a result of an accident with the medical cause of death confirmed as “adverse event arising from the use of mixed drugs”.
A now-released Prevention of Future Deaths report by Manchester North coroner Joanne Kearsley says Ms Cowan was detained under the Mental Health Act from July 2021 after setting fire to her flat. She is described as having a “long history of involvement with mental health services” and has previously been detained.
Ms. Cowan was diagnosed with paranoid schizophrenia and ADHD. She was described in the report as a risk to herself and others and also had a “long history of illegal drug use”.
She was detained at Prestwich Hospital’s Edenfield Unit, which is run by Greater Manchester Mental Health and Social Care Trust. It is the region’s biggest mental health provider and has been under scrutiny for months after a number of failings with vulnerable patients came to light.
After responding well to anti-psychotic medication, the report reveals Ms Cowan has been put on leave. “There were times when her holiday was escorted and after progress she was occasionally unaccompanied,” Ms Kearsley said.
“Her holiday also progressed from the hospital grounds to the local Tesco store opposite and occasionally to the local village. On at least two occasions Hayley ran away and ran away from the staff with her. She was taking drugs.” and then returned to the hospital.
“At all times she was considered to be a flight risk, which was driven by her compulsion to use drugs. On 3 June 2022 Hayley was granted leave with an escort to a local Tesco store. Both Hayley and the support worker needed to use the toilet and during this time Hayley was found dead the following day , because she used drugs at a friend’s house where she went.
“Staff had no instructions as to what to do when they needed to use the toilet. Instructions were provided as to what to do when the patient needed to use the toilet and was therefore out of sight.”
The coroner said evidence at the inquest “revealed matters of concern”. Ms Kearsley added in the report: “The court heard evidence of a lack of consistency and clarity on the part of mental health trusts in understanding and defining how section 17 leave should be exercised.
“Guidance on whether a patient should remain in ‘eye line’ or at a ‘reasonable distance’ is inconsistent. Mental Health Act codes of practice, Ministry of Justice guidance to forensic providers and trust policy are inconsistent. particularly when considering whether a patient needs be in “eye-line” or “reasonable distance” on holiday.
“There is also no guidance for trusts to instruct staff on practical matters such as what to do if a member of staff needs the toilet while out with a patient.”
The Department of Health and Social Care expressed its sympathies to Ms Cowan’s family and friends and said it was responding to and learning from every report to prevent future deaths. The MEN has asked Greater Manchester Mental Health and Social Care Trust for comment.