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The death of a mentally ill teenager after he drank excessive amounts of water may have been prevented if his care and treatment had been delivered differently, an investigation has found. The 18-year-old was admitted out of hours to an adult mental health service inpatient unit in a health board neighbouring his own on 5 December 2018 as there were no local beds available – a move described in the report as a “high-risk action”. On the evening of 7 December, he suffered a seizure after drinking too much water and was transferred to intensive care. He died three days later from the consequences of water intoxication. The teenager, referred to as Mr D, had previous contact with Child and Adolescent Mental Health Services (CAMHS), where he had been treated after drinking an excessive quantity of water. He was diagnosed with early onset psychosis and received two years of community-based CAMHS care. An anonymised investigation by the Mental Welfare Commission for Scotland concluded there were “aspects of the care and treatment delivered by each health board which had it been conducted differently, might have prevented Mr D’s death”. The report, which made 10 recommendations, also said: “A more assertive approach to the treatment of Mr D’s psychotic illness in the two years before his death was warranted.” Mr D’s death came almost two years after he was first admitted as an emergency to an acute general hospital in January 2017 following a seizure due to water intoxication, aged 16. The seizure was induced by drinking large quantities of water, which he believed would remove toxins from his system. This affected his sodium metabolism (blood salts) with near fatal consequences. He later spent more time as an inpatient and turned 18 while still under the care of the CAMHS specialist psychosis service. The transfer of a very unwell young man with a complex clinical history to another health board area during the night was a high-risk action Suzanne McGuinness, Mental Welfare Commission The service was moving away from a treatment model that supported young people with first onset psychosis for at least three years from the point of diagnosis, towards one in which transition to adult mental health services began around the age of 18. He was admitted to a hospital in Scotland in December 2018 while detained under the Mental Health Act. The investigation also found that during the 70 hours after that admission to hospital, Mr D’s case records from his years of contact with the CAMHS community team were unavailable. The report said: “The failure to impart key clinical details to the treating ward staff during his final admission, both in the provision of all relevant case files and the creation of an informed and updated risk assessment and care plan, meant Mr D was able to engage in risky and ultimately fatal psychosis-driven behaviour without mitigations having been put in place.” The report makes recommendations for change to bodies including the health boards involved, the Royal College of Psychiatrists, NHS Education Scotland and the Scottish Government. They include that the Government should set standards within the next six months for the safe transfer to, or management of patients who present from other health boards. Suzanne McGuinness, executive director for social work at the Mental Welfare Commission, said: “This was a tragic death of a young man while he was being cared for in hospital. “Our report details the actions and decisions taken by teams at the two health boards involved in the lead-up to his death.” She said the risks associated with psychotic illness were “not coherently managed”. She added: “We also found that there were problems in Mr D’s transition from child and adolescent mental health services to adult mental health services. Existing guidance was not adhered to. “We found that although the service had no other viable option, the transfer of a very unwell young man with a complex clinical history to another health board area during the night was a high-risk action. “Mr D’s family told us they felt that they had not been listened to. They felt their concerns were not given due credence.” She urged mental health services across Scotland to read the report and take action where they believe they can make improvements. A Scottish Government spokesperson said: “The death of any person in care is not acceptable. “It is vital that people using our mental health services feel safe and know they will receive the right help, in the right place when they need it. “The relevant health boards and health and social care partnerships in this case have been issued with specific recommendations and learning points alongside general recommendations for all health boards and HSCPs. We expect the commission’s recommendations to be fully implemented. “The Mental Welfare Commission recommended that the Scottish Government set standards for the safe transfer of patients between health boards. “We will publish core mental health standards in the coming weeks to set clear expectations for transitions between and within mental health services.” Read More More parents letting children skip school and take term-time holidays post-Covid Student accused of fatally shooting UNC professor may be mentally unfit for trial Family of man who died while being admitted to psychiatric hospital agrees to $8.5M settlement Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live

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Joshua Buatsi and Dan Azeez will go head to head in London this weekend, putting their friendship aside in an all-British main event. Each man will enter London’s O2 Arena with an unbeaten record to his name, with both boxers looking to move closer to a world-title shot at light-heavyweight. Last time out, 30-year-old Buatsi (17-0, 13 knockouts) outpointed Pawel Stepien in May to remain undefeated. Then, in July, 34-year-old Azeez (20-0, 13 KOs) was a decision victor against Khalid Graidia. Now, the friends will come face to face in the ring as they headline in a highly-anticipated bout. “What’s at stake allows me to put [our friendship] aside,” Buatsi said in August. Azeez added: “I’m at war with a friend who’s in front of my dreams and aspirations. “I see an entertaining, brutal fight, ultimately with my hand being raised.” Here’s all you need to know. We may earn commission from some of the links in this article, but we never allow this to influence our content. This revenue helps to fund journalism across The Independent. When is the fight? Buatsi vs Azeez will take place at London’s O2 Arena on Saturday 21 October. The main card is scheduled to begin at 8pm BST (12pm PT, 2pm CT, 3pm ET), with ring walks for the main event expected at around 10pm BST (2pm PT, 4pm CT, 5pm ET). How can I watch it? In the UK, the event will air live on Sky Sports for subscribers. It will also be available to stream on the broadcaster’s website and Sky Go app. No US broadcaster has yet been announced. If you’re travelling abroad and want to watch the event, you might need a VPN to unblock your streaming app. Our VPN round-up is here to help and includes deals on VPNs in the market. Viewers using a VPN need to make sure that they comply with any local regulations where they are and also with the terms of their service provider. Odds Buatsi – 30/100 Azeez – 13/5 Draw – 18/1 Full odds via Betway. • Get all the latest boxing betting sites’ offers Fight card (subject to change) Joshua Buatsi vs Dan Azeez (light-heavyweight) Louis Greene (C) vs Sam Gilley (Commonwealth super-welterweight title) Mikael Lawal (C) vs Isaac Chamberlain (British cruiserweight title) Karriss Artingstall vs Vanessa Bradford (women’s featherweight) Michael Hennessy Jr vs Joe Laws (super-welterweight) Read More Fury vs Ngannou pay-per-view price revealed ahead of controversial fight KSI vs Tommy Fury result changed after judging error Dillon Danis reveals next move after loss to Logan Paul Who is fighting on the Buatsi vs Azeez undercard this weekend? KSI vs Tommy Fury result changed after judging error Dillon Danis explains why he will appeal defeat by Logan Paul

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If you have a furry friend at home, it’s safe to say they are your best friend – and just as much a part of the family as anyone else. Indeed, according to home renovation and design platform, Houzz, more than three-in-five pet owners actively consider their pets when making decisions about home renovations, with designers on the platform noting a rise in pet-specific requests during home remodels. “Whether it’s considering the best materials or layouts for our furry friends, or even integrating bed nooks, built-in dog showers or clever feeding stations, pets are an important consideration when designing a home that works for all the family,” says Katie Greenhalf, director at KG Lifestyle & Interiors. “And as a result, people are keen to integrate items for them within their interior design scheme,” she enthuses. Bespoke storage is all the rage “For many people, storage is a key part of designing where they live – and considering your pet within this, is integral to a design that works for everyone in the home. Greenhalf continues: “We’ve had clients request bespoke cupboards in the kitchen for a pet’s food; easily accessible for pets but also hidden away to keep things clean and tidy, and tucked away from toddlers too; integrated dog showers into the utility room and creating dog beds in the under-stairs area.” Stylish sleep spaces are trending For proud pet owners, dedicated spaces for pets are no longer hidden away, but are now at the centre of the design. According to Houzz’s survey, a quarter of pet owners have created a built-in nook for their pet’s bed. “It isn’t as crazy as it might sound, as a dedicated nook can be positioned out of the way, rather than in the middle of the floor like standard pet beds and cushions,” explains Amanda Pollard, senior editor, Houzz. “It also allows owners to locate their pet’s bed in a kitchen or living space, rather than having them sleep in a separate space away from family life.” If you’re thinking about commissioning a bespoke piece of furniture for your living room, she suggests including an integrated sleep space for your dog – so it ties into the design of your room. “For furry friends of the smaller variety, such as cats or petite pooches, you can carve out an area in a sideboard for a little built-in bed,” suggests Pollard. A-list access is also top of the agenda And it’s not just sleep spaces being incorporated into design plans either – how pets can get in and out of your home is another important factor to consider. Especially with big swathes of glazing becoming increasingly popular, deciding where the humble old cat flap should go can be a slight hurdle. Dominic McKenzie, director at Dominic McKenzie Architects came up with an innovative idea to overcome this. “We recently designed a house with wall-to-wall glazing across the rear elevation, but the owners’ cat needed a way to get in and out. “We devised this special entrance through one of the cupboard doors in the kitchen, which leads onto a cat flap to the outside,” he explains. “We made the cat’s doorway house-shaped to give it a special character – the cat is very happy.” Homeowners are always very keen to make their pets’ lives better as part of a renovation – as well as everyone else in the family, says McKenzie. “There’s usually a dedicated area devoted to the pet – and often their ways in and out of the property are high on the list of priorities when planning the project!” But what if there isn’t any space on the ground floor for a cat flap? Leah Chisnall, interior design project manager for Absolute Project Management, shares a creative approach for cat access in these instances… “We’ve had two projects that included rear extensions with beautiful full-length glazing, and no space for a cat flap,” says Chisnall. “As a solution, we created cat flaps on the first floor (in a study and a bathroom) and included bespoke cat staircases from the first floor to the garden, for the family cats to use.” Feeding stations are increasingly fashionable And for those muddy paws and messy food bowls, innovative spaces for feeding and bathing are also high on the renovation wish list. According to Houzz’s survey, one in five homeowners have added a built-in pet area for bathing or feeding into their homes – and for Absolute Project Management, it’s a top request from recent clients. “The dog featured here is the very lovely Biscuit, belonging to one of our previous clients,” discloses Chisnall. “As part of their terrace house renovation, we converted a fairly snug ground-floor WC into a dog shower room. “We built a short tiled shower wall to enclose the space, fitted a stone (splash-proof) shelf for shampoo bottles and fur brushes, hooks for towels and dog leashes, and made sure the shower waste was large enough (with an adequate catcher) for the excess dog fur!” explains Chisnall. Cats aren’t missing out on dedicated spaces either, as Leah shares another project where her team created a beautiful cat litter room for a client. “We carved out a small space in an under-stairs cupboard with a hole in the hallway door for the cat to get in – and beautiful stone flooring for the litter box to go on,” says Chisnall. “It was a very luxe and practical solution to keep it out of sight!” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Sex Education season 4: How vintage finds help characters get their unique style Groundbreaking migraine treatment offers ‘new hope’ for patients ‘Millions of women and girls suffer severe pain’ during periods – research finds

GENEVA--(BUSINESS WIRE)--Oct 3, 2023--

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