Trust issues apology after girl, 16, took her own life

Sixteen-year-old Jesse Carly Walker died on January 23 this year.

Her body was found by her mother Heather Walker in their family home on Langdale Road, Scarborough, at around 9pm.

An inquest held on Friday at Scarborough Town Hall heard that Jesse had been suffering from anxiety and panic attacks and had resorted to self-harm in the past.

After being referred to Scarborough, Whitby and Ryedale Child and Adolescent Mental Health Services (CAMHS) last September, Jesse was seen by mental health nurse Karen Dickinson for the first time on November 7 2018. In that meeting, Jesse revealed she had a suicide plan. Although she had no intention to act on it at the time, it was something she wanted to have in place “if it all got too much”.

During the following meetings, which she always attended on her own, Jesse spoke of feeling “like she wasn’t good enough” and was afraid of “being a disappointment”.

Despite this, Mrs Dickinson insisted that Jesse had plans for “the immediate future” and always appeared “confident” and “very independent”.

Mrs Walker told the inquest: “She always had that side to her but it was just a mask that covered everything going on and people would see that and just assume she was okay.”

According to Mrs Walker, Jesse struggled with how she looked and also felt under pressure to decide what she wanted to do in life. “I always reassured her that everything would be okay and life was a journey, and exams were not the most important thing.”

On January 22, the day before she died, Jesse went to see a doctor to request a change in anti-depressants. On that occasion, Jesse’s mood was low, however, according to the GP who prescribed her the new tablets, Jesse “presented herself very much like an adult, she knew what she wanted and she wanted to get better”.

In the early hours of January 23, police officers were called to Jesse’s home after being alerted by the National Crime Agency about a “concerning” conversation with Childline.

However, when PC Dunn attended her address, Jesse was asleep in her bedroom. The events of that night as well as the contents of Jesse’s chat with Childline were emailed to CAMHS’ crisis team who, in turn, shared them with Mrs Dickinson.

Mrs Walker said she was “desperate for help” and didn’t know what to do or say to help her daughter. Despite asking the nurse for an appointment with her later that day, Mrs Dickinson said she had other appointments and was on annual leave in the afternoon.

Although she agreed to see her on January 24, at that point it was too late.

Following Jesse’s death, Tees, Esk and Wear Valleys Foundation NHS Trust, which is responsible for the provision of mental health services, launched a review into the care received by Jesse. It highlighted how Jesse’s parents should have been notified about their daughter’s suicide plan and how an attempt should have been made, following Jesse’s conversation with Childline, to see Mrs Walker that day.

Jesse’s stepfather Simon Walker told the inquest: “We got no contact from CAHMS at all, nothing to say that Jesse was thinking about suicide. If we had known, the pair of us would have handled Jesse a lot differently and maybe she would still be here today.”

Elizabeth Moody, Director of Nursing and Governance at the trust, apologised to Jesse’s family and said steps had been taken to improve the service.

Mrs Dickinson told the inquest she had since “changed my practice”.

In a narrative verdict, coroner Jonathan Heath said “notes had been left by Miss Walker indicating an intention to take her own life”.

Paying tribute to her daughter, Mrs Walker said: “I was very gifted to have her. She was beautiful, inside and out, and so thoughtful. It’s such a tragic loss to the world because I know she would have done something really good.”

• If you are affected by any of the issues in this report, you can call the Samaritans on a free number, 116 123.