Alastair Mackenzie inquest: 'Community-minded' Yorkshire dad with severe health anxiety took his own life after being told he could not have a mental health assessment because he had Covid-19

Alastair James Porter Mackenzie, 42, died on April 3 last year following a period of severe anxiety caused by fears that he was suffering from a terminal illness.

The self-employed gardener, who ran his own business, at various points convinced himself that he had a brain aneurysm, dementia, motor neurone disease and Parkinson’s, but all tests and scans performed came back normal.

The inquest at North Yorkshire Coroner’s Court heard that Mr Mackenzie contacted his local NHS mental health crisis team on the day he died, but the clinician who took his call was ‘confused’ over guidance on seeing patients who had tested positive for Covid-19, as both Mr Mackenzie and his wife Christina had.

A home visit was scheduled for the following day because a suitably qualified member of staff was not available on April 3, and an offer of an assessment at The Orchard centre in Ripon was retracted when Mr Mackenzie said he had Covid. However, it was established by the coroner on hearing evidence from the NHS Tees, Esk and Wear Valley NHS Foundation Trust that Mr Mackenzie could have been seen at the facility and that PPE was available.

A Serious Incident Review into Mr Mackenzie’s case by the Trust is still ongoing, having been delayed by staff recruitment and retention issues.

Christina Mackenzie gave evidence that her husband suffered from some physical symptoms, including headaches, which she felt were ‘exacerbated by worry’, but was concerned mainly with seeking treatment for what he saw as a physical condition and had difficulty accepting that he was mentally ill.

In the months leading up to his death, Mr Mackenzie had become ‘consumed’ by fears he had a brain aneurysm. He had numerous consultations with his GP and a private neurologist and was also referred to A&E for a CT scan, but all the clinicians involved diagnosed him only with anxiety.

A postmortem confirmed Mr Mackenzie had Covid-19 but no other natural disease and there were no significant drug or alcohol findings in his system.

A psychiatrist who assessed him in late March said that he seemed to want a diagnosis of long Covid confirmed, and was ‘frustrated and agitated’ at being unable to get help for his physical ailments.

Area coroner Catherine Cundy questioned the Trust’s operational service manager for adult mental health services, Andrew Knox, about the decision made by the Band 6 clinician who took Mr Mackenzie’s phone call on the day he died.

Mr Knox admitted that there had been some ‘conflation’ on the day between the issues of clinician availability, as the responder could not leave her post at The Orchard, and Covid guidance, which was ‘changing’ at the time.

He said: “She became confused about the guidance, because the advice to the public and the Trust’s advice were different. She didn’t continue to offer a site appointment (after being told about the Covid test) but she could have offered it. There are also other teams we can consult with who could have covered the home visit.

"She thought she could not invite him up to The Orchard. She had been in the role for around a year and the guidance was changing over time.”

It was also clarified that it could have been possible for a Band 5 clinician to have conducted the home visit, and that if it had taken place the next day, PPE would have been worn.

Recording a conclusion of suicide, Ms Cundy called the incident a ‘missed opportunity’ but could not determine whether or not a different decision would have saved Mr Mackenzie’s life.

She said: “There is a background of poor knowledge about what the clinician could and couldn’t do. I find that Alastair was appropriately dealt with by primary care services, and appropriately referred to mental health services. He had multiple tests which came back negative and did not accept that he had chronic anxiety.

"The crisis team engaged with him daily and though he appeared to disclose he was thinking about suicide, he was not actively planning it.

"The Trust have accepted that the practitioner was plainly wrong in her assumption that he could not be seen at The Orchard, and though she could not leave her post, she had options available, including speaking to a manager and arranging for a Band 5 clinician to visit him at home.

"It made little sense to delay the assessment until April 4, when PPE could quite easily have been used on April 3. It was a missed opportunity to assess Alastair. I have not been able to conclude that he would have presented in a particular way and been detained and I can’t conclude that it contributed to his death, but it was a significant individual lapse of judgement and knowledge.”

Mr Mackenzie left a young daughter and stepson. He trained in ju-jitsu, was a member of Harrogate Chess Club and competed in local leagues. His family and friends have raised funds for mental health charities since his death.

Statement from Christina Mackenzie, Alastair’s widow

“Alastair was a positive influence in so many people's lives and put his own struggles aside to help others on many an occasion. Not just friends but anyone he saw in need, he would always take the time to offer advice or practical help. He had built up his own gardening business with some fantastic longstanding customers, who were very fond of him, as of course were all his family.

“The news of Alastair's suicide hit us all very hard as it was so unexpected. The poor availability of mental health support and services in our local area was very apparent and we wanted to raise awareness of this and launched a fundraiser appeal in his memory. We were overwhelmed by the response we received with some very generous donations from all those whose lives had been touched by Alastair. A fantastic total of £7,300.

“When we came across The Jordan Legacy through a friend's recommendation, we knew we had found the right cause to benefit and help bolster the incredible work that Steve and the team are doing both locally and nationally. But we didn't want to stop there.

“One of our friends and neighbours as a keen runner is always looking for a new challenge, so when he mentioned he was embarking on a month-long mile builder (totalling nearly 18 marathons) we jumped at the chance to spread the message again and raise more funds in support of The Jordan Legacy. With his help and over a gruelling 465 miles, over £2,700 was donated.

“Alastair was very community-minded and enjoyed training at the Gracie Barra Brazilian Ju-Jitsu academy where he made many new friends and enjoyed the camaraderie he experienced there. The club founder was also fond of Alastair and decided to hold an open day in his memory raising a further £4,000 through the support of his fellow club members.

“We have been humbled and overwhelmed by the response we've had so far and will continue to find ways to raise awareness and honour the lives of Alastair and Jordan and so many other young men and women, whose lives are tragically lost to suicide.”