A dad-of-three took his own life a day after rejecting further help from mental health services, a coroner has concluded. Liam Ratcliffe, 29, was found unresponsive at his home in on April 13 after police received a concern for welfare call.
He was tragically found hanged. Liam had been suffering depression following the death of his father two years earlier, Bolton Coroners' Court heard.
In the months leading up to his death, he had also broken up with the mother of one of his children and suffered an injury that forced him to stop playing rugby.
Coroner Peter Sigee read out a statement prepared by Liam’s mum Gaynor Ratcliffe, in which she said her son was brought up in Leigh, but was living in Newton-le-Willows, Merseyside, at the time of his death. She described Mr Ratcliffe as a 'massive rugby league fan' and said he had played competitively since the age of five.
In the statement, Mrs Ratcliffe also said her son loved boxing, football and golf, and that he often went fishing and played darts.
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Speaking to Mrs Ratcliffe about the statement, Mr Sigee said: “You tell me about the loss of Liam’s father in April 2020 and how much that had upset Liam, as well as everyone else who had known him. You told me you believe that from that point on, Liam suffered with his mental health.”
On April 5 of this year, Liam was rushed to hospital after attempting to overdose on paracetamol. He was seen at Warrington Hospital by mental health nurse Tracey Woods. Ms Woods told the hearing that during the consultation, Liam was 'initially quite short', but eventually 'warmed up'.
She said: “He spoke at length about his relationship with his dad and how he’d had some social stressors such as his rugby career ending prematurely due to injury, about a breakdown of his relationship and how he felt he’d lost his home and his family.
“I asked him if he’d be willing to engage with the community mental health services and he was agreeable to do so.”
Liam was given a safety management plan with emergency phone numbers, but Ms Woods said that it did not 'feel' as if they could detain him under the Mental Health Act. She added: “I didn’t feel as if Liam was detainable and he provided assurances that he would be safe in the community.”
Liam’s case was allocated to senior nurse practitioner Jacqueline Darby. She made two appointments to see him on April 7 but he did not attend either due to ‘other commitments’, the hearing was told.
When Ms Darby eventually saw Liam at his mum’s home, she said that he 'engaged well' and 'discussed the problems he was having'.
“We discussed risk and he said he’d keep himself safe and that he was with mum and would speak to her if there were any problems”, she added.
On April 12, Liam attended an appointment with Ms Darby at Atherleigh Park mental health unit. “There appeared to be a change in Liam’s mood. He was quite low and tearful,” Ms Darby told the hearing.
“Liam discussed that he would go through with [suicide]. He said ‘well the overdose didn’t work, so I’ll have to try something else’. We discussed inpatient admission, we discussed medication, but Liam was just declining everything.
“At that point I became very worried because of the change in his presentation. I did offer Liam another appointment to see if he’d engage but again he declined.”
Ms Darby raised her concerns to her manager, who told her to tell consultant psychiatrist Dr Vadhani. “She recommended giving him a phone call the next day and keeping her informed,” Ms Darby said.
Mental health services attempted to call Liam on the evening of April 13 but there was no answer. They then called Mrs Ratcliffe, who confirmed that he had left her home that morning and had stopped replying to text messages.
At that point, a concern for welfare was made to the police. Liam was found later that night and following post mortem, pathologist Dr Barker recorded 'suspension by ligature' as the cause of Liam's death.
Mr Sigee concluded: “I find that Mr Ratcliffe died by suicide at his home.”
Operational manager at Atherleigh Park, Janine Steele, wrote a report into the care that Liam received and raised concerns about a lack of 'effective risk formulation'. However, Mr Sigee ruled that the care he received was not a causative factor in his death.
He said: “On the evidence I have heard, I cannot find that Mr Ratcliffe would have voluntarily accepted additional care if it had been offered to him or that he would have satisfied the criteria for such care to be provided to him on a compulsory basis. Further, I cannot find that if additional care had been offered or provided to Mr Ratcliffe, that it would have enabled a different outcome to be achieved.
“On that basis, I conclude that the mental health care that Liam received was not causative of his death and will therefore not include any findings about that mental healthcare within the decision.”
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