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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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England captain Harry Kane is hoping to win his first trophy within hours of joining Bayern Munich after completing his £100million move from Tottenham on Saturday. Kane trained with his new team-mates this morning and could make his debut for the Bavarian giants in their German Super Cup game against RB Leipzig at the Allianz Arena tonight. Victory over the German Cup winners would mean a first piece of silverware for Kane, who will wear the number nine shirt for Bayern after putting pen to paper on a deal until June 2027. “First run out. Feeling good. Looking forward to the game later,” Kane wrote on Twitter. The striker had earlier taken to social media to announce his departure from Spurs, which chairman Daniel Levy said the club “reluctantly” agreed to as Kane, who had entered into the last 12 months of his contract in north London, had made it clear he was seeking a fresh challenge. Kane said: “It’s not a goodbye because you never know how things pan out in the future, but it’s a thank you and I’ll see you soon.” He told his new club’s website: “I’m very happy to be a part of FC Bayern now. “Bayern is one of the biggest clubs in the world and I’ve always said that I want to compete and prove myself at the highest level during my career. This club is defined by its winning mentality – it feels very good to be here. “I feel like it was the right step in my career to really push myself and test myself on the highest level so that’s why I’m here and I look forward to that challenge.” Shortly before the deal was officially confirmed, Kane posted a message on social media in which he thanked the fans and said he had not wanted to start the season with his future unresolved. “From the moment I’ve been playing I’ve been one of your own and I’ve given everything that I possibly could to make you proud and give you as many special moments and memories to hopefully last forever,” Kane said. “This is a message to all you fans around the world, every single Tottenham fan that’s supported me and been with me throughout my journey. “Me and my family will cherish it forever, we’ll never forget all the moments we’ve had together so thank you. “I felt like it was the time to leave. I didn’t want to go into the season with a lot of unresolved future talk. “I think it’s important for the new manager and the players to concentrate on trying to get Tottenham back to around the top of the table and fighting for trophies, so I wish Ange (Postecoglou) and all the boys all the very best of luck. “I’ll be watching from a fan point of view now and really hope the team can be successful.” Postecoglou had revealed on Friday that Kane’s move was “imminent” after a breakthrough in negotiations between the clubs was reached on Wednesday night. It left the ball in Kane’s court and he decided on Thursday to leave his boyhood club for Bayern, who will pay an initial £100m, with add-ons potentially taking the deal up to an overall fee of £120m, the PA news agency understands. Kane leaves Tottenham as club’s all-time leading scorer with 280 goals but without a trophy. Bayern had seen their previous bids for Kane turned down, but refused to give up their pursuit of the 30-year-old, who remains 47 goals shy of equalling Alan Shearer’s Premier League record of 260. Levy told the club’s website: “We sought over a long period of time to engage Harry and his representatives in several forms of contract extension, both short and long term. “Harry was clear, however, that he wanted a fresh challenge and would not be signing a new contract this summer. We have reluctantly, therefore, agreed to his transfer. “We have seen a product of our academy system become one of the best players to ever pull on a Spurs shirt and become one of world football’s elite strikers. It has been a truly remarkable journey.” Kane’s strike partner at Spurs, Son Heung-min, paid tribute to his departing colleague in a post on Instagram. Son, who holds the Premier League record for goal combinations with Kane, wrote: “Leader, brother, legend. “Since day one it has been a joy to play by your side. So many memories, amazing games and incredible goals together. “Harry, thank you for everything you have given to me, to our club, and to our fans. Wish you nothing but the best in your new chapter. Good luck brother.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Departing Fred calls Man Utd spell ‘a true dream’ ahead of Fenerbahce switch Bukayo Saka nets stunner before Arsenal forced to cling on to beat Forest Alessia Russo ‘buzzing’ after firing England into World Cup semi-finals

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