Decision Report 201800170

  • Case ref:
    201800170
  • Date:
    February 2019
  • Body:
    Lothian NHS Board
  • Sector:
    Health
  • Outcome:
    Not upheld, no recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Mr C had been diagnosed with autistic spectrum disorder (a developmental disability that affects how a person communicates with, and relates to, other people) by the board's mental health service for children and young people (CAMHS). Shortly after discharge from CAMHS, Mr C attended A&E at St John's Hospital when he was in crisis. He was assessed by a psychiatrist (a medical practitioner who specialises in the diagnosis and treatment of mental illness) who discharged him with follow-up with the GP. Mr C said that the assessment of risk and follow-up arrangements were not reasonable given his symptoms and circumstances at the time. Mr C also said that he had subsequently been diagnosed with psychosis (when someone perceives or interprets reality in a very different way from people around them) and that it was unreasonable that the psychiatrist did not consider this.

We took independent advice from one of our medical advisers. We found that the standard of psychiatric care and treatment provided in relation to the assessment and follow-up arrangements were reasonable. In particular, the symptoms that Mr C presented with at the time were not consistent with a diagnosis of psychosis, and while it was possible that his presentation was an early sign or symptom prior to the development of psychotic symptoms at a later date, there was no evidence that this could have been predicted or anticipated. We did not uphold Mr C's complaint.

Updated: February 20, 2019