THE FAMILY of an 18-year-old girl who died by suicide say they feel ‘utterly let down’ by the care and support offered by her school and the NHS prior to her death.

This comes despite a coroner concluding there were no failings in the care Zoe Lyalle, aged 18, received from her local mental health team and her specialist school.

Ms Lyalle died in her bedroom at her Earley home on May 26, 2020, and an inquest into her death found she had poisoned herself.

The 18-year-old had ‘very complex psychological conditions including autism’, a coroner noted, and she had self-harmed and attempted suicide from 2014 onwards.

She was treated by Berkshire Healthcare NHS Foundation Trust (BHFT) and the organisation ‘missed opportunities’ to assess Zoe’s suitability for ‘effective’ mental health treatment over their period of care.

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But coroner Ian Wade QC claimed these factors did not cause or contribute to her death.

Mr Wade also said access to health services and education was ‘severely disrupted’ by the coronavirus pandemic in March 2020, just months after Zoe was admitted to Prospect Park Hospital having suffered ‘increasing crises.’

Speaking after the inquest, Zoe’s family said: “We are completely devastated by the loss of Zoe and feel utterly let down by the care and support offered to her by Berkshire Healthcare NHS Foundation Trust and Catch 22 [Zoe’s college in Bracknell].

“Neither seemed to understand or take into account her communication needs caused by her autism.

 

Zoe Lyalle.

Zoe Lyalle.

“They treated Zoe as if she chose not to engage, when in reality she found it incredibly difficult to communicate, including talking on the phone or being in large classroom groups.

“Zoe was in crisis and needed support from both mental health services and her school to provide her with hope that life could be different for her in the future. Instead, she felt that things would never change and that people were against her.

“We hope that despite the coroner’s findings, the Trust will reflect on the way in which they handled Zoe’s care and better support young patients and their families in the future.”

According to the law firm representing Zoe’s family, Reading Coroner’s Court heard how Zoe had been threatening to starve and dehydrate herself to death and discussed other ways of ending her life near the end of 2019 and the start of 2020.

Zoe’s family had ‘no confidence’ the 18-year-old’s care coordinator grasped the urgency of her situation, according to law firm Leigh Day, and two days after a January 2020 meeting with the doctor, the Earley girl tried to take her life.

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It was also revealed that Zoe went five months without input from a psychiatrist after transferring to adult mental health services from children’s mental health services.

Zoe’s GP, a Dr Shaw, reportedly gave evidence at the hearing to suggest the care provided by the NHS Trust’s mental health team was ‘fragmented’.

A spokesperson from the BFHT said: “As a Trust, we recognised that Zoe’s transition into adult services was a difficult time for her.

“Our investigation following Zoe’s death found that this process needed to be improved to better support other young people in the future. We have implemented a new procedure for staff to follow when a young person moves from child and adolescent services into adult services.

“Also, in response to requests from staff, we have provided additional resources and training to help our clinicians feel more confident when working with patients with autism.”

Zoe’s family also criticised the actions of Catch 22 -- the college she attended in Bracknell.

According to Leigh Day, Zoe found larger class sizes implemented in September 2019 ‘stressful.’

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In April 2020, the school pulled Zoe out of her GCSEs due to ‘poor attendance’, a decision that was a ‘massive trigger’ for the 18-year-old in ‘losing all hope for the future.’

A spokesperson for Catch 22 said: “The death of Zoe is a tragedy and her family has our deepest sympathy.

“The ethos of Catch22 is to work with our young people to give them the best possible chance to achieve their educational goals.

“Catch 22 has significant expertise in assisting young people who have differing needs including those on the Autistic Spectrum.

“Catch 22 considers that the Coroner’s approach and findings of fact were appropriate.

“Sadly as an educational facility, we cannot provide specialist mental health services as reflected at the inquest.

“All of the staff at Catch22 were shocked and saddened to hear that Zoe had taken her own life.

“We are acutely aware of how difficult this time is for Zoe’s family and friends and we hope that the inquest process has gone some way to address the family’s concerns.”

The inquest into Zoe’s death took place at Reading Town Hall from May 16 to May 19.