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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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Former President Donald Trump made his first live CNN appearance since 2016 on Wednesday as he sat down with the network’s Kaitlan Collins in the early GOP primary state of New Hampshire. What transpired over the nearly 90-minute broadcast was almost nostalgia-evoking as Collins was largely unable to make fact checks of the former president stick amid a seemingly unending cascade of lies put forward by an unrepentant Mr Trump. Let’s take a look at exactly why Wednesday’s return to mainstream cable news by the former president was so significant, and why CNN was facing ridicule on all sides before the evening ended: Trump steamrolls Collins Kaitlan Collins made a serious attempt to make sure that the truth got as much airtime as Donald Trump’s falsehoods during her moderation of the event on Wednesday, but sometimes a serious attempt still falls flat. That’s what happens when a journalist is set up to fail by their network; Collins, battling a raucous crowd that appeared to be almost exclusively in the former president’s corner, was often overshadowed by cheers and jeers as she attempted to shoehorn in last-second corrections after Mr Trump’s various spiels. She also found herself with no backup from the control room or CNN’s production team in general, who left her without any way to pull up examples of factual information, statements by Trump appointees, and other useful bits of media that would have greatly aided her fact-checking endeavors. As a result, the town hall at many times resembled the first Joe Biden-Donald Trump debate of the 2020 cycle, when moderators were sharply criticised for allowing Mr Trump to constantly talk over his opponent. By the end, the CNN host had been labeled a “nasty person” by Mr Trump on her own network while his supporters roared their approval. The production was roundly criticised by other journalists and by Democrats especially as the interview continued, with Rep Alexandria Ocasio-Cortez calling the programme “irresponsible”. Trump steamrolls the truth, too There seemed to be no end to the whitewashing which Mr Trump engaged in Wednesday evening. He called the deadly January 6 attack a “beautiful day”, his supporters supposedly throwing themselves against police barricades and shields with “love” in their hearts. He repeated his long-debunked conspiracies about 2020, despite Collins’s reminder that he had failed to prove any of his claims in court (no mention by the CNN host that Mr Trump’s own lawyer had admitted to not having any evidence). He even lied about supposedly issuing an order to deploy thousands of troops on January 6, an order his own defence chief later testified never came. E Jean Carroll faces furious attacks and an accusation of racism from Trump The former president made no secret of his displeasure regarding a New York jury’s decision this week to find him liable for sexual abuse in the case brought by author E Jean Carroll. He repeatedly denounced her as someone he had supposedly never met, while accusing her of calling her own husband a word with racist connotations. Little of this was “fact-checked” by CNN; Collins instead asked him if he regretted not testifying in the trial himself. Mr Trump described Ms Carroll’s lawsuit as “election interference” — despite the election being more than a year away. The Access Hollywood tape returns In easily the most surreal moment of the night, Mr Trump gave perhaps his longest philosophical defence yet of his infamous “grab ‘em by the p****” comment. That remark, which surfaced in the fall of 2016 just weeks before voters elected him to the White House for four years, was made during a conversation on the set of an Access Hollywood taping. It would go on to haunt Mr Trump long afterwards. But on Wednesday, Mr Trump went into excruciating detail about that comment: He wasn’t talking about his own personal behaviour, he claimed, nor was he talking (supposedly) about non-consensual encounters. Instead, the former US president argued, he was merely making an observation about the power of money and how rich men use it to attract women, albeit in the crudest possible manner. Whether that explanation was believable is another story entirely, but it was nonetheless remarkable to hear out loud. Trump cheers default as debt ceiling deadline looms The ex-president gave a hefty piece of ammunition to his furthest-right allies in the US House of Representatives as he talked about the economy on Wednesday. Asked by Collins about the GOP’s debt ceiling negotiation strategy on Capitol Hill, Mr Trump responded that Republicans may need to force the US to default on its loan obligations in order to rein in spending. And he made the bizarre prediction that such a decision may not have real negative effects, calling the possible economic catastrophe nothing but “psychological” problems. "We have to start paying off debt ... I say to the Republicans out there — congressmen, senators — if they don’t give you massive cuts, you’re going to have to do a default, and I don’t believe they’re going to do a default because I think the Democrats will absolutely cave because you don’t want to have that happen, but it’s better than what we’re doing right now because we’re spending money like drunken sailors,” he told CNN. Expect Republicans to hunker down and be more willing to risk passing the 1 June deadline after which the federal government may be unable to pay obligations to its creditors with the former president’s encouragement, knowing that their party enjoys only a slim majority in the House. Read More Ivanka and Jared split over attending Trump 2024 launch – follow live Why was Donald Trump impeached twice during his first term? Four big lies Trump told during his 2024 presidential announcement Trump snaps and calls Kaitlan Collins ‘nasty’ in tense exchange at CNN town hall LOCALIZE IT: Migrants adapt to shift in border enforcement AOC blasts CNN’s Trump town hall as she brands it ‘shameful’

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