A mentally ill man who left his home before an ambulance arrived, more than six hours after being called, was found dead just hours later, an inquest has heard.
Ciarán O’Rourke (41) left his home near Courtown, Co Wexford sometime after his wife, Éadaoin Keenan, made a 999 call for an ambulance at about 6.30pm on June 12th, 2023 when her husband told her he believed he was a risk to himself.
Due to mounting concern about Mr O’Rourke’s mental condition deteriorating over the previous week, Ms Keenan made unsuccessful attempts over the weekend of June 10th and 11th to have him admitted to St Patrick’s psychiatric hospital in Dublin, Wexford county coroner Dr Sean Nixon heard.
Damien Tansey SC, solicitor for Ms Keenan and the family, said it “haunts” Ms Keenan that neither she nor her husband were informed on June 12th of a consultant’s decision, made that afternoon, to email the hospital’s admissions committee stating that Mr O’Rourke should be admitted. Ms Keenan, who had slept very little over several days due to her husband’s deteriorating condition, said she went for a nap because Mr O’Rourke appeared calm once the ambulance was called and assured her he was all right.
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She fell into a deep sleep and only realised he was missing when woken by ambulance personnel banging on her bedroom window at around 1am on June 13th. She reported Mr O’Rourke missing and he was found dead some hours later.
The inquest heard Mr O’Rourke had a diagnosis of bipolar affective disorder from the age of 17 and received treatment at St Patrick’s hospital over some 20 years. After being discharged in September 2017, he secured employment, married Ms Keenan and appeared to be doing well until she noted a deterioration in early June 2023.
Ms Keenan, then in the final stage of her four-year training as a psychiatric nurse, said this caused her to become very concerned and to seek his admission to the hospital. She was “deeply shocked” that the hospital had decided against holding any investigation into its admission procedures following her husband’s death.
After the day-long inquest at Gorey courthouse on Monday, Dr Nixon said he was satisfied, on the balance of probabilities, to return a verdict of death by suicide.
He said he was satisfied Mr O’Rourke intended to take his own life and that severe psychotic paranoid illness will contribute to that intention. A lot of people with severe mental health issues may, he said, take that decision and it may be outside their control.
The coroner was satisfied the hospital’s advice to go to the nearest hospital emergency department when there is concern about self-harm was “reasonably acceptable” and “standard” advice.
There was some delay in expediting the request for Mr O’Rourke’s admission to the hospital and he would write to the hospital seeking a “perhaps more detailed” assessment of when it is sought to expedite admissions. He said that because St Patrick’s is a private hospital, it may not have the admission resources of other hospitals.
Dr Nixon was satisfied the National Ambulance Service appropriately categorised Mr O’Rourke in the second category – “non-serious, non life-threatening but urgent” – in order of priority in its system of call priority levels. The coroner said that because a psychiatric illness can be as serious as some physical pains, he would write to the service requesting that the category might be reviewed.
He was told the delay of six hours and 35 minutes in the ambulance arriving was due to pressure on the ambulance services at that time and resource and staffing issues.
A High Court personal injuries action has separately been initiated by Ms Keenan against St Patrick’s Mental Health Services, St Patrick’s University Hospital, James Street, Dublin, arising from Mr O’Rourke’s death.
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