A consultant psychiatrist at Goodmayes Hospital said Alice Figueiredo, who took own life in 2015, had been ‘showing signs of improvement’ in the days before her death, reports Sebastian Mann, Local Democracy Reporter

The decision to reduce observations of a mental health in-patient who took her own life was “rational,” and her death could not have been foreseen, a court heard.

Alice Figueiredo, 22, died during her admission to Hepworth ward, in Goodmayes Hospital, on 7th July 2015.

Benjamin Aninakwa, the ward manager at the time of her death, has pleaded not guilty to gross negligence manslaughter.

The North East London Foundation NHS Trust (NELFT) similarly denies charges of corporate manslaughter over her death.

Professor Thomas Fahy, a consultant psychiatrist at the South London and Maudsley NHS Trust, said the decision to lower her observation levels was “rational” as well as “appropriate and clinically justified”.

Speaking as an expert witness in the Old Bailey, he described her death as an “impulsive act” and one that was unpredictable. He told the jury that “no one could have seen this coming,” despite Alice’s repeated attempts to self harm.

Alice had been suffering from “deteriorating” mental health but was showing signs of improvement in the lead-up to her death, the court heard.

She had been on level-three observation – where she needed to be within eyesight at all times – in the weeks before her death, but this was reduced to general observation in late June.

At one point, she was well enough to be given night leave, which she used to attend a Fleetwood Mac concert at the O2.

She had shown physical signs of being frustrated days before her death, but Prof Fahy said there was “no reason” to increase her observation levels.

He told the jury it would have been “perceived by her as oppressive” and a “signal that things were going backward rather than forward”.

He said it was “not clinically indicated or appropriate” to increase them, though “from time to time” she shared “some despairing thoughts”.

Alice had been admitted to the Hepworth ward in early 2015. She had received a prior diagnosis of bipolar affective disorder and an eating disorder.

Alice used the same plastic items in her self harm attempts on 18 occasions, and the jury was previously told that they were not removed from the ward during her stay.

Prof Fahy was later asked by Duncan Atkinson KC, prosecuting, if Alice’s care plan “lacked detail” in managing her access to these items. He said it did.

The jury heard that removing these items from the ward would have been the “simplest solution,” though there may have been issues with infection control.

The trial continues.

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