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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

An illegal streaming gang who offered cut-price subscriptions for Premier League matches to more than 50,000 people have been jailed. The Premier League said five men were convicted of conspiracy to defraud, money laundering and contempt of court after generating more than £7 million in five years. Mark Gould, from London, was reported to have masterminded the operation and was handed an 11-year prison sentence at Chesterfield Crown Court on Tuesday. The 36-year-old and co-defendants Steven Gordon, Peter Jolley, William Brown and Christopher Felvus offered illegal access to matches from hundreds of channels around the world, as well as tens of thousands of on-demand films and TV shows. A sixth gang member, Zak Smith, failed to appear at court for sentencing and a warrant has been issued for his arrest, the Premier League said. We are pleased that through rulings such as this, the courts continue to show that they recognise the importance of safeguarding the Premier League's rights Kevin Plumb The league added that the illegal streaming businesses had 30 employees, with one undercover at a specialist anti-piracy company. Brown, from Stoke-on-Trent, denied the offences, claiming to have been an undercover informant acting in the interests of law enforcement authorities and broadcasters But the 33-year-old was unanimously convicted by a jury after a seven-week trial as the Premier League said he used his technical skills to hack legitimate customers’ accounts to access and copy streams – intending for them to take the blame if identified by authorities. The prosecution was supported by Hammersmith & Fulham Council’s trading standards team and the intellectual property protection organisation Fact. Premier League general counsel Kevin Plumb said: “Today’s sentencing is the result of a long and complex prosecution of a highly sophisticated operation. “The sentences handed down, which are the longest sentences ever issued for piracy-related crimes, vindicate the efforts made to bring these individuals to justice and reflect the severity and extent of the crimes. “This prosecution is another concrete example of the clear links between piracy and wider criminality, a warning we repeatedly make. “While most Premier League fans enjoy watching our games in a safe way, those who were customers of these services were effectively supporting individuals involved in other sinister and dangerous organised crime. “The Premier League’s substantial financial contribution to the entire football pyramid is made possible through the ability to sell our broadcast rights. “We are pleased that through rulings such as this, the courts continue to show that they recognise the importance of safeguarding the Premier League’s rights. “We will continue to protect our rights and our fans by investigating and prosecuting illegal operators at all levels.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Umpire Sue Redfern: I’ll feel awkward and fortunate to break new ground in Blast Daniil Medvedev dumped out of French Open in first round by Thiago Seyboth Wild Dean Windass proud as Conor McGregor splashes cash – Tuesday’s sporting social

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India has said it “hopes” all G20 leaders, including Vladimir Putin, are able to attend this year’s summit in person amid increasing questions over the Russian leader’s participation. India, which walks a tightrope between placating the West and maintaining decades-old ties with Russia, is hosting this year’s G20 summit. It has sought the physical participation of leaders, with the awkward possibility emerging that if Mr Putin were to attend, he would be in the same room with Western leaders for the first time since he called for the invasion of Ukraine. India’s foreign ministry said the G20, to be held on 9-10 September, will take the form of a physical summit in Delhi. Signals to Mr Putin’s potential India visit will be closely watched as the Russian leader has continued to avoid many such meetings since the Ukraine war. His attendance would become a significant occasion, as it would be the first time since Russia’s war that he would be face to face with world leaders like Joe Biden, Rishi Sunak and others who have condemned the invasion. “The invitations have gone out to all the G20 members, invitee countries and international organizations,” foreign ministry spokesperson Arindam Bagchi told a media briefing in New Delhi on Thursday. “This is a physical summit and we would hope that all the invitees are able to participate in person.” He said there have been confirmations for the summit, but did not share specifics on any world leaders. India becoming the G20 host has given rise to speculation that Mr Putin could travel there because of Moscow’s longstanding ties with Delhi. He had skipped the summit last year when it was hosted by Indonesia. The Kremlin had earlier cleared up Mr Putin’s schedule at the same time as the G20 summit in September to allow the possibility of him flying to India by cancelling a scheduled event. In March, Mr Putin’s aides reportedly pushed the dates by a week for an annual economic forum in Vladivostok, from its earlier 9-10 September date. Russia’s deputy chief of mission Roman Babuskin had earlier told The Hindu newspaper that G20 is “one of the most important events” for Russia. The speculation comes after it emerged that Mr Putin will not attend the Brics summit in South Africa to be held in late August and will send his foreign minister Sergei Lavrov instead. The decision, however, was made because South Africa is a signatory to the International Criminal Court (ICC) and if Mr Putin steps on South African soil, there is a chance he could be arrested. The ICC had issued an arrest warrant for him in relation to the forced deportation of children from Ukraine to Russia.. Russian state media said Mr Putin will instead dial in via video link, while Mr Lavrov will fly down to Johannesburg. South African president Cyril Ramaphosa said the decision was “by mutual agreement” as any attempts to arrest Mr Putin would be a declaration of war against Russia. Meanwhile, India last month confirmed Ukraine president Volodymyr Zelensky will not attend the main G20 conference as invites for the summit this year were sent only to members. “G20 participation is for members of G20,” foreign minister S Jaishankar had said at a press conference marking nine years of the foreign policy of the Narendra Modi government. “And for countries and organisations who we have invited and that list we had declared as soon as we assumed presidency of the G20.” The G20 ministerial meetings held this year in India have revealed the country’s reluctance in referring to the Ukraine invasion. Under the Indian presidency, no clear, joint communiques for the G20 meetings have been issued as officials disagreed in calling the invasion a “war”. In the absence of a joint communique, the G20 chair has been publishing a “chair’s summary” as the main outcome document. On Thursday, India’s foreign ministry said it has “optimism” that G20 leaders would be able to agree to a joint communique at the upcoming meeting. “There have been differences in paragraphs related to Ukraine. But largely, there has been a high degree of convergence among the participants on other issues and that’s a very positive thing,” Mr Bagchi stated. Read More India’s Modi stakes reputation on bringing together a G20 beset by international crises G20 nations raked in $50bn in debt repayments from poor countries since Covid, report finds Vladimir Putin to skip South Africa summit where he faced risk of arrest The Body in the Woods | An Independent TV Original Documentary The harrowing discovery at centre of The Independent’s new documentary

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