The Trust has paid £5,500 to the woman who, with the assistance of the Equality Commission for Northern Ireland (ECNI), took a case alleging that the Trust failed to provide her with adequate care and management in accessing mental health care.

The Trust acknowledged that an error was made, that it failed to make reasonable adjustments in the services it was providing to her and that this was a breach of its obligations under the Disability Discrimination Act 1995. The parties agreed that there was no intention on the part of the Trust to discriminate against her.

At the time, the woman was 19 years of age and had been diagnosed with a chronic social anxiety disorder and depression several years previously. She suffered from agoraphobia, which prevented her from leaving her house. She had recently been formally diagnosed with Asperger Syndrome. She had, up to January 2017, been under the care of the Child and Adolescent Mental Health Service (CAMHS) but was then to be placed under care of the Adult Mental Health Service (AMHS) team in order to access treatment for her anxiety disorder, including her agoraphobia. She also required adult autism services and the gateway to this service was through the AMHS team.

The AMHS ‘Do Not Attend’ protocol for outpatient appointments provided that, should a patient miss two consecutive appointments, they would be discharged from this service and this policy was strictly enforced. The AMHS policy has a Mental Health Addendum which states that, if a patient does not attend, there should be a review of risk factors with their GP and, if it is decided to discharge the patient, it must be fully documented and the patient and GP informed in writing. In this situation, the Addendum was not followed.

The woman experienced difficulty from December 2016 onwards when she was unable to attend two appointments at the AMHS office due to her disability and, in particular, the extreme anxiety and depression she was experiencing. She was discharged in February 2017 without assessment. It was only when her mother and her GP intervened on her behalf that she was reinstated. By that time, her condition had seriously deteriorated and she was not able to access the service until March 2017.

Dr Michael Wardlow, chief commissioner of the Equality Commission, said: “In this case the Trust has agreed that it failed in its reasonable adjustment duty. The protocol to be followed should have looked at the reasons for this woman’s failure to attend the two appointments before discharging her. It is important that people with mental health issues are not left without support when they need to access health services.

“Ensuring that incidents like this cannot happen again requires the sensible, responsive and considered application of effective policies and processes. Trusts need to provide early planning and preparation for adolescents during their transition to adult health, social care and well-being services.

“The Trust, in making this settlement, made commitments to undertake a range of measures, which will, we hope, ensure that anyone with specific care needs can experience practical, flexible support when making the transition from one service to another. As part of the settlement the Trust has agreed to implement in full the Transition Protocol in the transfer of service users within community mental health services.”