William Moody
PFD Report
Historic (No Identified Response)
Ref: 2019-0312
No published response · Over 2 years old
Sent To
Response Status
Responses
0 of 3
56-Day Deadline
31 Dec 2019
Over 2 years old — no identified published response
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Coroner's Concerns
_ At Mr Moody's Inquest heard that his family (who were present throughout events as daughter and son-in-law own the Estate in which Mr and Moody had a cottage) initially called 999 and asked for the_Police to attend, The 999 call-taker_triaged the call aged Mrs his as requiring the attendance of Ambulance Service and deemed this to be a matter that the Police would not attend. This resulted in the family having to redial 999 and ask for an alternative service; during which some level of screening questions were repeated. This caused delay in the family reaching an appropriate service to attend. heard evidence from the Mental Health Lead for Hampshire Constabulary who explained that as the incident on the 1gth April 2019 was occurring in the person's home and, as such the Police have no power to intervene where a person is in their own home and in mental health crisis andlor threatening to harm themselves. The situation on the 1gth of April was distinguished from that which had happened the before, on the 18th April, as the incident on the 18th had occurred in a public place and So, in that case, the police had a duty to attend. heard further evidence that there is a Memorandum of Understanding 'MOU") between Hampshire Police and the South Central Ambulance Service as to who is the primary response agency for persons making threats of suicidal ideation. Ultimately, the family were confused as to where help would come from and the call-handler will not transfer the call to a particular routelservice unless the caller makes the decision as to which service they need. Despite there being a MOU between the agencies this does not appear t0 be something that the general public is aware of,and the task of making the general public aware of this is likely to be insurmountable and therefore it remains entirely foreseeable that future delays could occur because callers are unaware of which emergency service is the correct one to request in a situation where a person is suffering a mental health crisis episode andlor expressing suicidal ideation within the boundaries of their home heard further evidence regarding the existence of a different triage system, that operates in at least one arealjurisdiction of the country, but this only applies when a caller dials the 111 service; callers are given an option of accessing 'Mental Health" services and this allows calls to be triaged through to an appropriately trained teamlcall-handler who can ask a set of wider diagnostic questions to understand and establish which agency, on the particular facts, should be the primary response service to that individual; In the situation of Mr Moody it transpired that it was actually a mixed response that was required; both the Police and Ambulance services am concerned that the current system of dealing with 999 calls in Hampshire gives rise to the potential for opportunities to be missed to triage the emergency call quickly and effectively, and to share information between agencies without the need to repeat the screening progress, and these factors may result in further deaths in the future
Action Should Be Taken
In my opinion action should be taken to prevent future deaths and believe you andlor your organisation have the power to take such action
Report Sections
Investigation and Inquest
On 23rd April 2019 commenced an investigation into the death of William James Moody,
85. The investigation concluded at the end of the inquest on 16th September 2019. The conclusion of the inquest was that Mr Moody had died as a result of Suicide (by entering the River Itchen via the banks of his home address on the 19th April 2019). The medical cause of his death was given as drowning:
85. The investigation concluded at the end of the inquest on 16th September 2019. The conclusion of the inquest was that Mr Moody had died as a result of Suicide (by entering the River Itchen via the banks of his home address on the 19th April 2019). The medical cause of his death was given as drowning:
Circumstances of the Death
On the 18th April 2019, Mr Moody drove himself from his home in Bishopstoke to Wimbourne and, once there, called his family to express his intention to end his life_ He was intercepted by the Police who detained him under Section 136 of the Mental Health Act 1996 and took him to a place of safety (St Ann's Hospital in Poole) where he was the subject of an assessment by a consultant psychiatrist: He was not deemed to be detainable and so was released: On the following day, the 1gth April 2019, Mr Moody entered the banks of the River Itchen. The River runs through the gardenslgrounds of the Estate on which Mr Moody lived in a cottage. He intentionally entered the River to end his life_ He was taken by paramedics to Southampton General Hospital where it was not possible to revive him_
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.