GP's distress at lack of support for drug death teen

Dr Penny Blackwell, a partner at the Hannage Brook Medical Centre in Wirksworth was giving evidence at the inquest into the death of 15-year-old Anthony Gell School student Joe Southam.

Joe died after choking on his own vomit following a heroin overdose at his house on Canterbury Terrace in Wirksworth on July 31, 2014.

The GP told the inquest she first became aware of Joe’s drug problem when she was asked to see him by another practice GP in May 2014.

The other doctor had told her that she had seen Joe’s mother, Barbara Southam, who was said to be ‘tearing her hair out’ over him.

When Dr Blackwell saw Joe in late May 2014, she said it quickly became clear that his drug use had escalated even beyond what his mother knew about.

In a 50-minute-long consultation he told her that he took the drugs to cope with feelings of anxiety and that he struggled to tell his mum the full extent of his difficulties.

He told her that he had been using cannabis to help him sleep for quite some time and had used amphetamines, prescription painkillers and alcohol but had never injected drugs.

The GP told the inquest that after the consultation she was ‘very concerned’ about Joe and referred him to CAMHS (Child and Adolescent Mental Health Services) for therapy as a result.

She also put him on anti-anxiety medication and gave him her personal mobile number in case he couldn’t see her at the clinic.

Over the course of the next few months Dr Blackwell said she ‘tried everybody I could think of’ to get help for Joe but ‘failed miserably’.

Only a few weeks later, on June 20, Joe admitted to her that he had tried heroin for the first time saying he ‘didn’t like it much’ and that he thought he had ‘done it wrong’.

“I told him I wasn’t happy with him and he said he was ashamed and wasn’t going to do it again,” said Dr Blackwell.

“I did feel, however, that I had to discuss safe use with him and told him if he was going to do it he should only smoke small amounts and should always be with someone else when he did so.”

She told the inquest her attempts to help Joe that summer had left her feeling ‘isolated’ and that she would have appreciated more support from other agencies that were aware of the problems he was having.

The inquest yesterday (Wednesday) also heard from a mental health nurse who regularly saw Joe in the months before his death, describing how his “personality disintegrated” due to his drug abuse.

Melanie Rateb said the 15-year-old was “enigmatic” and had a “wonderful personality” but ultimately did not want to engage fully with the mental health services he was referred to.

Mrs Rateb, who is employed by CAMHS, said during the times she saw the teenager he was open about his drug use. At times he seemed healthier, while on other occasions he was less engaging with her.

She said the first appointment she had with the teenager was by chance on October 17, 2013, when she was at Anthony Gell School, where Joe was a student, and was on site having seen a fellow pupil.

She said: “A member of the teaching staff asked me to see him because he was very distressed and crying a lot.

“I went to see him and he said that was because he was very anxious. He was sweating and shaking, he looked like he was spaced out, disorientated. One of the things he was most worried about was that he did not want to attend with mental health services.”

Mrs Rateb explained to the hearing how she met Joe on a number of appointments.

She said: “He said he had been using weed (cannabis) for around two years and had taken some other highs over the past six to 12 months.

“He said he would experiment and research pharmaceuticals on the internet. “He had a very high understanding of chemicals.”

His inquest at Derby and Derbyshire Coroner’s Court this week has been told how the 15-year-old had spent around £1,000 on drugs he bought on the so-called dark web – a hard to find part of the internet where illegal substances can be purchased online.

One occasion before his death, he sold a hallucinogenic ‘legal high’ called LSZ to a fellow pupil at the school who had to be taken to hospital with serious injuries.

Following an appointment in March 2014, four months before he died, Mrs Rateb said she saw Joe who told her he was feeling “fit and well” and had been going to the gym.

She said: “Joe was particularly keen to become a doctor, he made that quite clear.

“I told him off. I said ‘you are a clever boy, you will make your mum proud one day. Why are you doing this (experimenting with drugs)?’

“He had a wonderful personality, quite enigmatic. I think his personality disintegrated along the way with his use of substances.”

Dr Aristos Markantonakis, a child psychiatrist who also saw Joe, said the teen was “very clever” and had shown an interest in medicine.

He said: “I became aware he had trouble socialising, his anxiety was coming from that. He had difficulty in weighing people up and mixing.”

Coroner Dr Robert Hunter asked: “Can cannabis use cause anxiety, did it play any part (in Joe’s)?”

Dr Markantonakis replied: “Yes, but I don’t think it was a big part. I think he was self-medicating, but I think Joe was anxious anyway.”

The inquest continues.