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Home Brighton

Mental healthcare failings contributed to death of trans teenager, coroner says

by Felice Southwell
Thursday 12 Oct, 2023 at 1:14PM
A A
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Mental healthcare failings contributed to death of trans teenager, coroner says

Failings by social and mental health services contributed to the death of a trans teenager in Brighton, a coroner has ruled.

Axel Matters, 18, died by hanging in a flat on Surrey Street in April 2021, shortly after his eighteenth birthday.

The coroner criticised the neglect and lack of action by Child and Adolescent Mental Health Services (CAMHS), and social services who gave him an unsuitable accommodation placement on his own for two months.

The coroner noted a “lack of consideration by all agencies involved with Axel as to whether the accommodation provided to him was suitable for a young person.”

Angela and Melvill Price, Axel’s mother and step-father – who refer to Axel by his name at birth, Yasmin Price – said: “We trusted professionals to provide our daughter with the right care and support but were catastrophically let down.

“We completely agree with the coroner’s conclusions, but this should never have happened in the first place.

“We hope that no other family has to go through what we have been through.

“We would like to thank our legal team Hayley Chapman and Jim Robottom for their tireless work in getting accountability for Yasmin.

“Nothing will bring our daughter back, but we will continue to be her voice.”

Being known as vulnerable because of his mental health, Axel lived in 24-hour supported accommodation between June 2019 and January 2021, but was sectioned in September 2020 following a crisis.

He was discharged in October to the care of his local Child and Adolescent Mental Health Services (CAMHS), but CAMHS discharged him after three weeks without providing any input or transitioning him to adult services.

The coroner criticised this response and found that there should have been a plan of care and risk management as a follow up.

Following another crisis after he turned 18 in January 2021, Axel was sectioned again and taken to Langley Green Hospital where he showed signs of deterioration on the ward.

On 22 February 2021, there was an unplanned discharge of Axel from Langley Green to police custody, after which social services placed him in emergency unsupported accommodation.

He was left for two months before his death – a placement which was meant to last for only seven days – despite never having lived alone, with only two visits by social workers.

At the visits, he showed visible signs of self-harm, alcohol abuse of alcohol and self-neglect, but staff did not take action such as arranging a risk assessment or mental health review.

Hayley Chapman, solicitor at Hodge, Jones and Allen, said: “Axel was an exceptionally vulnerable young person who clearly needed living support and mental health care in the community.

“Instead, he was left alone in a flat for two months.

“On the two occasions where Axel was visited by social services, obvious signs of deterioration were observed but no one took steps to address these.

“The coroner’s finding that his death was contributed to by neglect rightly reflects how badly Axel was let down.

“We hope that lessons can be learned from his tragic death.”

If you have been affected by any of the issues in this article the Samaritans can be contacted on 116 123 or https://www.samaritans.org/how-we-can-help/contact-samaritan/

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Comments 13

  1. John Walker says:
    2 years ago

    Sadly, even after death the parents are dead-naming their child, which may go some way to explaining the vulnerability of Axel.

    Reply
    • Benjamin says:
      2 years ago

      We still have a long way to go as a society around understanding transgenderism and body dysmorphia. It’s telling we have a PM who makes really ignorant comments that we do.

      Reply
    • Sarah+the+Starfish says:
      2 years ago

      Without knowing the full story you have no right to judge the no doubt grieving parents who knew thwir child better than anyone. It is now an established fact that affirming a non-biological gender to a teenager is not a positive action. It just grooms them into a path which they later find harder to get off. Read the research.

      Reply
      • John Walker says:
        2 years ago

        Sarah, I don’t need to read “the full story” to know what the child preferred to be called. Again you’ve jumped in and assumed my comment is about gender.

        Many people prefer to be called by different names to that assigned by their parents at birth – most of us will know a Bill or Bob, or someone choosing to be called by their middle name instead of their first. My brother decided at the age of 10 that he hated his name and wanted to be called “ George” instead of “Douglas”, and he’s been George ever since except on legal documents.

        It’s basic respect for a person to be called what they choose to be called.

        Reply
      • tl says:
        2 years ago

        “It is now an established fact that affirming a non-biological gender to a teenager is not a positive action.”

        No it isn’t, it’s proven that supporting transgender people reduces the risk of suicide and mental health issues. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027312/

        You commented this same garbage on the article about Alice’s death and I gave you the same response and the same link. Stop weaponising trans people’s deaths to push completely false narratives that are not backed up by any actual scientific facts or studies.

        You should be banned from commenting on these articles, you’re just using people’s deaths as a soapbox for your bigotry. Shameful behaviour and completely disrespectful to the dead teenager in question.

        Reply
        • KL says:
          2 years ago

          Is that the best research available to justify your repeated point? A narrative review highlighting that more research is needed and the current quality of research is at risk of producing false results/misinterpretation. It is far from ‘proven’ affirming gender dysmorphia is the right thing to do at all, especially long term, or that it reduces suicide risk, when there are significant mental health issues. There is a significant risk more harm than good is happening due to default gender affirmation.

          Reply
          • tl says:
            2 years ago

            this study is the most conclusive and comprehensive on the subject, as time goes past more studies prove what trans people have known for years: support dramatically improves quality of life and significantly reduces the risk of suicide.

            Sources (these are all separate studies):
            https://publications.aap.org/pediatrics/article-abstract/137/3/e20153223/81409/Mental-Health-of-Transgender-Children-Who-Are?redirectedFrom=fulltext

            https://publications.aap.org/pediatrics/article-abstract/134/4/696/32932/Young-Adult-Psychological-Outcome-After-Puberty?redirectedFrom=fulltext

            https://journals.sagepub.com/doi/10.1177/0044118X19855898

            https://www.jaacap.org/article/S0890-8567(13)00187-1/fulltext

            https://www.sciencedirect.com/science/article/pii/S1054139X21005681

            https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2749479

            I can keep going. empirical evidence > baseless transphobia

            It’s no surprise to anyone that the science reflects what hundreds of thousands of happy trans people have been saying for years.

  2. tl says:
    2 years ago

    Continuing to deadname and misgender their son and then blame mental health services…disgusting. There can be no doubt the parents themselves have a role to play in Axel’s death. It costed nothing, absolutely nothing to support him and now look. The irony that transphobic parents like his will blame his transition on mental health issues while refusing to accept his identity – this was sadly not uncommon many years ago, when gay and lesbian teenagers tragically took their life after being unsupported by their parents and forced into conversion therapy or forwarded on to mental health services just because their parents didn’t approve or didn’t want to accept their child was gay. Sure enough as times and attitudes towards LGB individuals shifted many of those parents responsible are now wracked with guilt. history repeats itself, and is repeating itself for trans individuals.

    After being pushed from pillar to post and being in assisted living since he was what…16? Still very much a child, he ends up in unsupported accomodation for two months; self harming, abusing alcohol, neglecting himself despite never having lived alone before. Did the parents not check up on him? Not insist he was being visited regularly by social workers? Even if I was frothing at the mouth in a straightjacket my mum would have been worried sick and showing up at my door daily. Either they didn’t want him in their house or he didn’t want to live with them, that alone rings alarm bells for me.

    i’ve known numerous trans people with equally unsupportive parents who were thankfully able to cut contact and live happily and survive as their true selves, normally due to having a support network of accepting friends they could turn to when things got difficult. what a shame Axel was left alone and did not get the same chance. Rest in peace.

    Reply
    • Goldi says:
      2 years ago

      Yes, this. It makes me feel so sick that the Axel’s parents were clearly in denial about their child’s identity. They are to blame for this, not the authorities. Even after death they continue to refer to him as “her” and “their daughter”. That says it all and maes me feel sick to the stomach. They and they alone are responsible for Axel’s death due to their inability to accept their child’s identity. Disgusting.

      Reply
  3. Sarah+the+Starfish says:
    2 years ago

    Many schools in Brighton are grooming kids with Autism and other vulnerabilities to believe that they are transgender. Social media finishes the job off. Stonewall is providing the training. Latest evidence now suggests that kids like this need mental health support to come to terms with puberty so autistic kids can deal with the natural changes in their body rather than being persuaded to believe they are the wrong sex. CAMHS will be to blame but they simply do not have the adequate resources after the schools, lockdowns and social media have now created a generation of damaged children.

    Reply
    • Benjamin says:
      2 years ago

      Schools are not grooming children. I can’t overstate how utterly nonsensical that statement is. You should be ashamed of yourself, Sarah, honestly.

      Strawmanning the need for mental health services for young people going through body dysmorphia is dangerous Sarah, and I’m glad that no-one intelligent reading your words would ever support such a position. Again, you should be embarrassed.

      CAMHS do a lot of work, and are very under resourced for the workloads they take on. To defame them in such a way not only betrays your utter ignorance, but also your bigoted contemptuous attitude.

      You have done yourself a massive disservice today.

      Reply
  4. Daniel Harris says:
    2 years ago

    Coming back to this story can i firstly just praise the journalist for highlighting this.

    This is indeed a turning point in how LGBTQ+ Homeless people are housed, Why was Axel placed in unsupported emergency accommodation? just 5 days before I was at a council committee meeting pleading with evidence for the administration then, the greens, but they were receptive to the idea as were Labour, officers intervened, they press against anything progressively in terms of policy people suggest, especially me for some reason.

    Rachel Sharpe and the then Sylvia Peckham should be really held accountable, the fact is the conditions in most unsupported Emergency Accommodation is not suitable for all. My data shows that the most resilient & people with wide support networks struggle. Those with none and the most serious health needs, well they are reporting very high percentages of suicidal thoughts and ideologies. This is evident to be a factor the housing also.

    I am shocked nothing here questions in detail, where axel was placed? what was the environment they were living? some of these places literally people go to die, look at homeless deaths Brighton. almost all are housed homeless.

    This is widespread neglect and collective failure. But I must point to the place Axel died, those circumstances, why was someone previously in Supported Accommodation “these are worse” then placed in unsupported, just see security guards and threats from landlords and others.

    I bed the parents to contact me. we must stop this cycle and together we can end this cycle of negligence, isolation, stress and suicidal intent.

    Click my name for a link to my research which confirms all this.

    Reply
    • Benjamin says:
      2 years ago

      You do a lot to support those who find themselves homeless, Daniel. It doesn’t go unnoticed!

      Reply

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