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

CHAPTER 2 – EVALUATION OF THE HEALTH CARE AND TREATMENT OF
LOUISA OVINGTON
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Addictions services
The panel was informed that addiction services were mainly provided by three teams:
ESMI (Easington Substance Misuse Initiative) which covered the Peterlee area; CAS
(Community Addictions Service) which covered the Sedgefield District Council locality
and NECA (the North East Council for Addictions). The first two services worked with
clients on a practical and medical level to address their addictions, the third was a
counselling service. Whilst there were addiction services in the area, the panel was told
that they focussed mostly on opiate use and that alcohol services were more “thin on
the ground”. Thus, alcohol treatment was largely left to the care of general mental
health services.
Louisa Ovington was apparently first seen by drug and alcohol services regarding her
drug use when she was 15 or 16, although the panel has seen no contemporaneous
records of this contact. She was referred to ESMI just prior to her first admission – but
the panel again saw no records of this contact, if it did occur.
The issue of Louisa Ovington’s substance misuse was not specifically addressed whilst
she was at the Tony White Unit or at St Nicholas’ Hospital, although its contribution to
her difficulties was noted.
When she was at St Nicholas’ hospital she was assessed by a psychologist from the
Newcastle forensic adolescent service who noted that drug use was an issue, but that
although she might respond to relapse-prevention work she had at that time little
motivation to change. It was suggested that a motivational interviewing approach
regarding drugs might be useful. Psychologist 1 (psychologist at St Nicholas’) noted
that Louisa Ovington related all her past difficulties to the abuse of illegal drugs.
Consultant 10 (Psychiatrist from Rampton who assessed her at St Nicholas’) described
Louisa Ovington as a complex and quite profoundly disturbed individual. He felt that
she required a period of treatment in a controlled setting until that was a satisfactory
understanding of her emotional insecurity and instability and until there was
adequate support to ensure that she did not take drugs. Otherwise, he felt that the
consequences could be serious or indeed grave.
When Louisa Ovington moved on to Kneesworth House, she engaged in a psychology
assessment process, but during this it was noted that although she clearly attributed
all her difficulties to her substance misuse, she was “blithely convinced” she would
have no difficulty avoiding drugs in the future. One to one psychology sessions and
a drug and alcohol group were proposed to address Louisa Ovington’s lack of relapse
prevention strategies regarding illicit substance use. An inexperienced psychologist
attempted to work with Louisa Ovington on this, but Louisa Ovington was apparently
resistant and guarded and she avoided effectively doing this work. She did, however,