A mother of a 21-year-old warned hospital staff that her daughter “had a plan to kill herself” before she was discharged from a Dublin hospital and died by suicide hours later, an inquest has heard.
Edie McGuinness from Malahide, Co Dublin, died on October 20th, 2023, after self-presenting to the Mater Hospital earlier that morning.
Ms McGuinness, who was diagnosed with emotionally unstable personality disorder and autism, had been receiving psychological support since her early teens.
Dublin District Coroner’s Court heard on Tuesday that she had a history of self-harm, suicidal ideation and had made several suicide attempts. One such attempt occurred in the hospital’s emergency department bathroom on the morning of her death.
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Her mother, Rosemary, told coroner Dr Clare Keane that her daughter left the house and attended the hospital’s emergency department shortly after midnight.
She received a call at about 5.20am from Dr Brian Armstrong, the on-call psychiatry doctor, who told her Ms McGuinness had refused voluntary admission and would be discharged.
Having then spoken to her daughter on the phone, she recalled her refusing to allow her to collect her, which was “unusual”. She rang Dr Armstrong saying she “knew she had a plan to kill herself”.
After sharing her concerns, she said she was told to stay home and she would be kept updated. She subsequently fell back to sleep and was awoken shortly after 9am to two gardaí at her door, who informed her that her daughter had died.
She said she believed her daughter was still at the Mater hospital until she learned of her death.
Dr Armstrong said after the suicide attempt in the hospital that morning, Ms McGuinness told him she “always wished she was dead” but came to the hospital because “I knew I’d be safe here”.
The doctor who carried out an hour-long face-to-face assessment told the inquest that her cognitive function was intact and she showed a willingness to engage, which suggested a “future focus”.
Upon discussing the case with consultant psychiatrist Dr Richard Duffy, it was agreed she did not meet the criteria for involuntary admission under the Mental Health Act, meaning she could only be admitted voluntarily.
The 21-year-old, who at that point denied having plans to die by suicide, ultimately refused admission, saying she did not believe there was “any point”, Dr Armstrong said.
“I had no power to detain Edie against her wishes,” he said, despite feeling that she was “in crisis.”
He did not believe a follow-up third phone call to her mother was necessary, saying he had told her a taxi would be arranged to bring her home. He believed Ms McGuinness was in ongoing contact with her mother, he said.
The deceased “promised” him she would be safe and said she would arrange her own taxi home before she left the hospital at about 6am, he said. She subsequently died within two hours.
Dr Duffy said both he and Dr Armstrong were “concerned” for her safety before her discharge. He confirmed her eligibility for involuntary admission was considered, though this was not possible as she was suffering from a personality disorder which is excluded under the Mental Health Act.
“There were massive grounds to admit her, but there were no grounds to detain her involuntarily,” he said. He added that the “magnitude of the risk” does not influence their ability to admit someone who does not want to be admitted.
Returning an inquest verdict of suicide, Dr Keane said the 21-year-old had “heartbreaking struggles in what was a very short life”.
Samaritans Ireland provides support at all times to those in distress and can be contacted on 116 123.
