Death of ‘brilliant’ trans teenager prompts call for mental health referral review

A coroner says she will call for a review into how mental health referrals are made by schools after the tragic death of a trans teenager in 2022.

Alex Dews, from Barnsley, South Yorkshire, was found seriously injured in a park and died in hospital four days later on 18 July 2022. His family explained that the teen had been “crying out for help” from his school. He was just 13 years old.

Coroner Abigail Combes found that while there were “individual failings” in the way support processes at the school Alex attended were followed, there was no evidence of a “systemic failure”, the BBC reported.

At an inquest into the teenager’s death earlier this year, it was found that Dews told staff at Outwood Academy Shafton in Barnsley that he felt suicidal in the months before he died. The school remembers Dews as a “brilliant student”.

His family explained that Dews had told them he wanted to change his name after coming out as a transgender boy, with his school then putting his name on its vulnerable register. 

Later that month, the 13-year-old had reportedly self-harmed while at school, however the incident was not properly logged, despite it warranting a risk assessment. 

Dews was reportedly placed on the waiting list for mental health support iSpace, beginning six weeks of counselling in March 2022 after expressing thoughts of suicide to a teacher earlier that month. 

The iSpace sessions reportedly ended in May 2022, and although a handover suggested further mental health support, it was reportedly not followed up. 

The inquest heard that Outwood Academy did not make a referral for Alex to NHS Child and Adolescent Mental Health Services (CAMHS) due to concerns he would be removed from the waiting list because he was already receiving support from iSpace. 

Combes explained at the resumed inquest at Sheffield Coroner’s Court on Thursday (7 September) that the school had later made a referral to CAMHS in June 2022 in order to put support in place for Alex for the next school year, and that the school could not have assumed “there was a real or immediate threat to Alex’s life” as he had no further instances of self-harming.

She said that she did not have enough evidence to conclude that Alex had died as a result of suicide. 

“I’m satisfied that there are processes in place,” Combes said in a narrative conclusion.

“There are absolutely identifiable individual failures of following these processes … these are not sufficient to amount to systemic failure.”

Combes said she was “slightly horrified” that vital decisions about which services to refer Dews to were left to his school, and that she would write a prevention of future deaths report to organisations, including the Department of Health and Social Care, about concerns regarding the way referrals are made to CAMHS.

She also voiced concerns around information sharing between schools and counselling services.

Alex Dews’ grandmother, Susan Dews, said at an inquest June: “What has happened to us has ripped us all apart and no amount of words will ever explain the emptiness and amount of pain we feel.

“He was not just some troubled teen, not a number lost in a system, but a scared child, struggling to come to terms with his own gender and how he could fit into society, how he was crying out for help and was disregarded.

“How he was let down and how we are now left trying to pick up the pieces of our shattered life.”

The Outwood Academy told PinkNews: “As a school community we were devastated by the loss of one of our students; our thoughts and condolences continue to be with Alex’s family and friends during this difficult time.

“Alex was a brilliant student who received regular praise for amazing and consistent effort. He will be missed by friends and our wider academy community.”

Suicide is preventable. Readers who are affected by the issues raised in this story are encouraged to contact Samaritans on 116 123 (www.samaritans.org), or Mind on 0300 123 3393 (www.mind.org.uk). ​Readers in the US are encouraged to contact the National Suicide Prevention Line on 1-800-273-8255.