Teen found unresponsive in room 'shouldn't have been alone', Essex mental health trust tells inquest

ITV News

29-04-2025

An NHS trust has admitted a teenage girl found dead in her hospital room should not have been allowed to return there unsupervised.
Elise Sebastian was just 16 when she took her own life while being treated at a mental health unit in Essex in 2021.
At the start of the inquest into her death, the trust that runs the St Aubyn Centre in Colchester told the jury that Elise had been able to return to her room unaccompanied on 17 April 2021, despite being on observation at the time.
The teenager was later found unresponsive, was resuscitated and taken to Colchester Hospital, where she died two days later.
Pravin Fernando, representing Essex Partnership University NHS Trust, admitted Elise's room should have been locked to prevent her entering alone, adding: "The trust accepts that these failings were causative of her death."
Elise had a history of mental ill health which dated back to 2016 when she was 12 and included anxiety and depression.
She was diagnosed with high-functioning autistic spectrum disorder in March 2020 and, while an inpatient at mental health units, including St Aubyn, had previously self-harmed and absconded.
But in statements read to Essex Coroner's Court, Elise's parents described her as a "happy, outgoing, funny little girl" who loved music, reading and art.
Her mum, Victoria Sebastian, said she had visited her daughter - who was the youngest of four siblings - the same day she was found unresponsive and Elise had been "so excited to see me".
As a photograph of the teenager was passed around court, Mrs Sebastian talked about her daughter's love of One Direction and her plans to work with animals.
"She was my beautiful baby, my best friend," she told the jury. "It was very hard as a mother to watch her struggle."
Her dad, Glen Sebastian added: "My world has been completely destroyed. My family has been shattered. I've hardly left the house in the past couple of years."
The court was told the inquest, which is due to last around a month, was likely to look at a range of issues including the appropriateness of care plans and risk assessments, staffing levels, training and the management of Elise's self-harming.
On the opening day, the hearing also heard from a paramedic with the East of England Ambulance Service who described the call-out to the St Aubyn Centre as "frustrating", having had to wait for a member of staff to unlock each door he passed through.
Lisa Cunningham, an Essex and Herts Air Ambulance doctor who arrived at the centre around 7.30pm, said staff seemed stressed and it was difficult to get information from them.
Essex Partnership University Trust is currently the subject of a statutory inquiry which is looking into the deaths of more than 2,000 patients - including Elise - in its care between January 2000 and December 2023.
The Lampard Inquiry will include those who died within three months of discharge, and those who died as inpatients receiving NHS-funded care in the independent sector.
At a hearing last year the chairwoman of the inquiry, Baroness Kate Lampard, said 'we may never know' the true number of people who died.