Inquest finds failures by multiple services in the self-inflicted death of Sharon Kelly

Coroners Courtssource: INQUEST
published: 12 November 2020

The inquest into the death of Sharon Kelly concluded yesterday, finding that failings by Essex Partnership University Foundation Trust (EPUT), East of England Ambulance Service and Essex Police contributed to her death. The jury concluded that the timing of the Mental Health Act assessment was inadequate, the ambulance service failed to initiate a risk assessment when arriving at the scene and that there was wide spread miscommunication between all services. Sharon’s death was found to be suicide.

Sharon was 44 years old when she died on 27 June 2019 after she was found hanging by Essex Police and paramedics at her home in Colchester. It took nearly three and a half hours from an initial call for paramedics to enter Sharon’s home. Sharon had a history of mental ill health and was under the care of Essex Partnership University Foundation Trust (EPUT) at the time of her death.

The inquest heard evidence that two days before Sharon’s death, an EPUT psychiatrist had urgently requested a Mental Health Act assessment, following concerns raised about her welfare. This psychiatrist, who had been involved in Sharon’s care since 2016, said he had expected a Mental Health Act assessment to be carried out the same day the referral was made.

The assessment was not carried out until the next day, when it was decided that Sharon did not, at the time of that assessment, meet the statutory criteria to be detained under the Mental Health Act.

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