A ‘remarkable’ woman who was found dead at her home in Salford was experiencing her first episode of psychosis an inquest heard. Ella Formosa, 21, was found dead at her home in Salford on November 2, 2021.
The social media executive was found in the garage of her home by the boyfriend of her younger sister who she lived with, along with her mother in Swinton. During an inquest into her death, the court heard how Ella had been exhibiting ‘weird’ behaviour in the month prior.
Speaking at the inquest, her emotional mother, Enid, detailed how Ella had become paranoid, withdrawn and spoke of unusual things such as ‘seeing people walk in synchronicity’ friends and family disappearing and their next door neighbour with a ‘hacksaw’ threatening to harm to her.
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The inquest heard how the family had a history of mental health illness including Enid’s own and at one point when Ella confided in her mother for support she told her “this too shall pass Ella, this too shall pass.” The court also heard how during consultations she spoke of feeling like a witch, scared that her sister was infiltrating her friendship groups and that she heard a ‘derogatory male voice’ that was abusing her.
Speaking at the inquest, Ella’s mother Enid said: “She became quite delusional, she said that she could see people walking in synchronicity and that the neighbours and friends had vanished.”
The court heard how Ella had visited her local GP and during the appointment that she attended with her younger sister, and had her mother listening on the phone, she confirmed that she also heard voices in her head and complained of being in a ‘low mood’, however, she did acknowledge that she knew none of these things were happening but she was ‘afraid’ that she was having those thoughts.
Ella’s mother told the court how Ella’s personality changed during the month of October, and told the inquest how over time, Ella became ‘stressed and confused’. Enid said: “She became very quiet, lost her appetite, she didn’t want to go out and wanted to be very close to her mother.”
Ella had just started her new job having graduated in September and was described as ‘beaming and proud of herself’ during her ceremony. The question was raised as to whether her ‘recreational’ use of marijuana was a factor to her first episode of psychosis as well as ‘imposter syndrome’ caused by the stress leaving education and starting the journey of adulthood.
She developed her cannabis habit in university at the Leeds Beckett University, the court also heard how she had been prescribed a course of anti-depressants for three weeks while at university but she stopped taking them soon after.
Her mother described the last time she spoke to her on the phone on that fateful day and told the court how Ella sounded ‘different’. She said that during their exchange, Ella said she was calling to ‘check’ on her while she was at work but Enid believes she was calling to see how much time she had to take her own life.
The court heard that Ella had left a note which had an ‘expression of love and affection’ for her family and berated herself for ‘putting her mother through hell’. This was something her mother refuted and put down to Ella being ‘over critical’ of herself.
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During the inquest family and friends of Ella’s raised many question as to the handling of Ella’s case from when she was referred to the Salford Early Intervention Team (EIT) who help young people experiencing a first episode of psychosis by her GP. The court heard how throughout the consultations and phone calls Ella had with clinicians she never made mention of self harm or suicidal thoughts and at one point said she knew the ‘damage’ that would cause to her mother and family.
However, during the inquest the family said they felt as though they were left in the dark for a majority of the consultations and did not believe that Ella was processed through the system quickly enough to access the help she needed. The court heard how once Ella was recommended to the EIT, there many ‘missed opportunities’ to reach her hastily due to shortage of staff due to illness, the pandemic and rota schedules.
During the inquest multiple witnesses who handled Ella’s case spoke, her GP Maeve Hanley of the Pendlebury Health Centre who made the urgent referral to the EIT was one of them and said that in ‘hindsight’ more should have been done to speed up the care process for Ella, during the end of her questioning, the emotional doctor thanked her family for giving her the opportunity to speak and expressed condolences for her loss and hoped she gave Ella’s family the ‘answers’ they needed.
The inquest heard how both the Pendlebury Health Centre and Salford EIT have since made a review of their process and have put training and policies in place to ensure the same mistakes aren’t made.
The pathologist’s report confirmed that Ella passed away by asphyxia as suspension by ligature, a toxicology report showed that she tested positive for a ‘low concentration’ of alcohol and there were no cannabinoids in her system.
Senior Coroner Timothy Brenand reached a ‘narrative conclusion’ citing Ella’s mental health struggles as the reason why he refused the conclusion of ‘suicide’. Whilst he acknowledged there were ‘missed opportunities’ regarding care access for Ella, he said there ‘too many variables, too many ifs and buts’ regarding the case to determine whether or not Ella’s life would have been saved had she been seen too quicker.
In his closing speech, he paid tribute to Ella, her family and her neighbours who did ‘all the right things’ when they tried to resuscitate her and called the emergency services. He described the 21-year-old as a ‘bright’ and ‘remarkable woman who had her whole life ahead of her’ with ‘remarkable mother and not half bad God mother’ and highlighted her 'tragic case' as the dangers of early onset psychosis in younger people.
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