Lousia Ovington independent investigation report ... - NHS North East

On 10 July 2001 Louisa Ovington attended a CPA meeting at which Consultant 5 was
present and following this Consultant 5 referred her to Psychotherapist 1, consultant
psychotherapist at the regional department of psychotherapy. However, the initial
assessment form was sent to the wrong address, so was not completed by Louisa
Ovington. A new form was sent out in January 2002 and Louisa Ovington was
finally seen by Psychotherapist 1, in May 2002. During the intervening period, Louisa
Ovington was referred to an anxiety management course.
Following his assessment of Louisa Ovington, Psychotherapist 1 wrote to Consultant
5 noting that there were major gaps in the history that he had gained and that he
could only give a provisional view. However, he thought that there was “evidence
of some residual personality disturbance”. He also noted that “the assessment of
patients who are subject to probation orders is never easy, as there are other agendas
going on other than the wish for treatment”. Given Louisa Ovington’s expectations
of symptom relief rather than in-depth exploration, he did not think that the sort of
intensive therapy he offered would be appropriate. He suggested “basic psychological
treatment on a symptomatic level”.
Over the course of May 2002 to January 2006, Louisa Ovington was followed up in
the community by several different care coordinators. She was not offered formal
psychological treatment again. It was suggested to her GP, by a member of staff
from the CRT that she might benefit from anger management. Some work on this
was intended to be done at a later stage as part of a CRO, but there is no evidence
from the records that it was. Social Worker 7 suggested to Staff Grade Psychiatrist
1 in October 2004 that Louisa Ovington would benefit from Dialectic Behaviour
Therapy (DBT) given her diagnosis of severe personality disorder. This was in fact at a
meeting in which Staff Grade Psychiatrist 1 had apparently expressed the opinion that
having defaulted from two appointments, Louisa Ovington should be discharged from
services. There is no evidence that he referred Louisa Ovington for DBT and thereafter
there is no evidence of further consideration of psychological therapies.
COMMENT
CHAPTER 2 – EVALUATION OF THE HEALTH CARE AND TREATMENT OF
LOUISA OVINGTON
Whilst the Kneesworth psychology department final report could be criticised in some
respects, it was remarkably prophetic in its comments about the likelihood of Louisa
Ovington engaging in psychotherapeutic work in the community. Her unwillingness
to engage with in depth exploration of her difficulties would have made it extremely
difficult, if not impossible, to work with her using a psychodynamic approach.
However, she might have found dialectic behaviour therapy more acceptable and it is
regrettable that this suggestion was not followed through.
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