A specialist epilepsy nurse who treated the Dorset teenager Gaia Pope has told her inquest the service was under-resourced and admitted that better communication with mental health teams could prevent deaths in the future.
Pope died of hypothermia after either burrowing into undergrowth on a clifftop or falling into the bushes and may have been experiencing an epileptic seizure or mental health episode at the time.
Giving evidence on the third day of the inquest in Bournemouth, Michelle Knight, who treated Pope for two years, told the jury that her condition was complex. She once suffered 15 seizures in two days and her epilepsy became so severe that she could not take a bath or shower unsupervised.
But Knight said Pope, 19, was one of 10,000 patients in Dorset under the care of just two specialist nurses. Asked if the team had sufficient resources, she answered: “No.”
The jury has been told that Pope was diagnosed with post-traumatic stress disorder after reporting being raped at the age of 16. Shortly before she vanished, a man had sent her indecent images, which caused flashbacks and anxiety.
Knight, who works for the University Hospitals Dorset NHS foundation trust, knew something of Pope’s mental health issues and said deteriorating mental health could exacerbate epilepsy.
But under questioning from the senior coroner for Dorset, Rachael Griffin, Knight admitted there had been no process for her to communicate with the mental health teams that treated Pope at a separate trust, Dorset HealthCare – and even now there was no system in place for this. The nurse agreed with the coroner that a system of communication would be of “great benefit” and could prevent future deaths.
Knight said she was not informed when Pope was admitted to hospital shortly before she died. The coroner asked if this was a missed opportunity for her to have contact with Pope. She replied: “Yes.”
Jurors were told that Pope was diagnosed with epilepsy in 2013 but the year before her death, the way she experienced seizures changed. While before she had felt them coming on and could sit down, by the autumn of 2016 they incapacitated her and filled her with fear.
Earlier in the day the inquest heard from Dr Russell Delaney, a Home Office pathologist, who told jurors that on the afternoon of Pope’s disappearance, 7 November 2017, she began behaving “irrationally” at a friend’s house in her home town of Swanage and revealed she thought she was pregnant, though a test the day before had proved negative.
She also said she had split up with her boyfriend, started acting in a “highly sexualised manner” and undressed. Someone persuaded her to put her clothes back on and she dashed out into “rotten weather” without her coat.
The pathologist said she may have burrowed into the “deep undergrowth” where her naked body was eventually discovered on 18 November or fallen in. An internal examination picked up indications that she had died of hypothermia, the court was told.
Delaney said Pope may have suffered a mental health episode and taken her clothes off on the clifftop. It was also possible a phenomenon called “paradoxical undressing” occurred, in which a person suffering from hypothermia begins to remove clothes because the brain mistakes the feeling of coldness for warmth.
Delaney said it was not possible to say if she had a seizure just before she died. Asked on the balance of probabilities if epilepsy had played a part, he replied: “I don’t think it’s possible to say either way. It may have done, it may not have done.”
The pathologist said he had been told by police that Pope was due to see her GP at 5pm on the day she disappeared and said a relative had called the police at 6.18pm.
Caoilfhionn Gallagher QC, who is representing members of Pope’s family, highlighted that the court had been told the police were called by a member of the teenager’s family at 3.42pm. Delaney said police had not told him that.
Neither was he told that Pope had been due to meet police about the indecent images she had been sent or that her family were worried she had vanished without her medication.
The inquest continues.
In the UK and Ireland, Samaritans can be contacted on 116 123 or email firstname.lastname@example.org or email@example.com. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at www.befrienders.org.