'Inadequate' information given over mentally ill man, inquest hears

 

Prison staff were given "inadequate" information about a mentally ill young man who was found dead within hours of being transferred from the healthcare wing of Brixton Prison, an inquest was told.

Cesar Augusto Granja Lara was found apparently hanged in a cell in September 2007; he was 22 years old. He had suffered from acute episodes of psychosis which included hearing derogatory voices, seeing monsters and paranoid delusional thoughts that at times made him feel suicidal, the court heard.

But there was a suspicion by some healthcare staff that in the days before his death he was embellishing his symptoms in order to try and avoid a long prison sentence by being transferred to hospital.

Dr Andrew Forrester, the consultant psychiatrist in charge of mental health at Brixton prison at the time, said he thought Granja Lara's underlying schizophrenia was stable and he had not expressed any suicidal thoughts during their last meeting - five days before he was found dead.

Dr Forrester told the inquest that there was a "disconnect" between the distressing symptoms reported such as voices telling him that he would be raped in the prison wing, and his behaviour, making him suspect that Granja Lara was exaggerating his symptoms for secondary gain.

The court heard that two days after Dr Forrester decided that he was suitable for transfer to the prison wing, Granja Lara told a nurse that he was hearing voices that his girlfriend had been raped and voices telling him to kill himself. The court heard that there was no record of this information or any discussion taking place in the medical records.  

Dr Forrester admitted that the information on the transfer form completed by the healthcare nursing staff to the prison wing was "limited". But he said that there was consensus among the multi-disciplinary team that it was in Granja Lara's "best interest" to transfer him to the prison wing where there was greater access to the library and occupational therapy, and the healthcare wing in 2007 was "not fit for purpose".

Dr Forrester referred him to the mental health outreach team, which looked after between 50 and 60 mentally ill inmates in the prison wing, but Granja Lara died before he could be seen.

Dr Gregor McEwan, a GP providing primary care to prisoners, was called to the cell at 10.15 on 5 September 2007 where he found nurses trying to resuscitate Granja Lara. "There was no sign of a heartbeat, no sign of life...  he had been dead for some time; the body was very cold, cyanotic and very stiff."

The court was told that there may have been a delay in opening his cell that morning due to an "acute staffing shortage" as there was only two prison staff when there should have been five.

The expert medical witness, Dr Jonathan Shapero, who is a forensic psychiatrist with 29 years experience, said that the transfer to the prison wing was reasonable but that he would have expected the prison staff to "keep an eye" on Granja Lara due to his mental illness and the fact he'd been considered a suicide risk only days earlier. He said that the information on the transfer form was "inadequate".

Dr Shapero told the court that it was "a matter of some anxiety" that it was not at all unusual for a mentally ill man like Granja Lara to be held in prison wings.

The inquest continues

Start your day with The Independent, sign up for daily news emails
Sport
England's women celebrate after their 3rd place play-off win against Germany
Women's World CupFara Williams converts penalty to secure victory and bronze medals
Arts and Entertainment
Ricardo by Edward Sutcliffe, 2014
artPortraits of LA cricketers from notorious suburb go on display
News
newsHillary Clinton comments on viral Humans of New York photo of gay teenager
Arts and Entertainment
The gang rape scene in the Royal Opera’s production of Gioachino Rossini’s Guillaume Tell has caused huge controversy
music
ebooks
ebooksAn introduction to the ground rules of British democracy
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

Day In a Page

The Greek referendum exposes a gaping hole at the heart of the European Union – its distinct lack of any genuine popular legitimacy

Gaping hole at the heart of the European Union

Treatment of Greece has shown up a lack of genuine legitimacy
Number of young homeless in Britain 'more than three times the official figures'

'Everything changed when I went to the hostel'

Number of young homeless people in Britain is 'more than three times the official figures'
Compton Cricket Club

Compton Cricket Club

Portraits of LA cricketers from notorious suburb to be displayed in London
London now the global money-laundering centre for the drug trade, says crime expert

Wlecome to London, drug money-laundering centre for the world

'Mexico is its heart and London is its head'
The Buddhist temple minutes from Centre Court that helps a winner keep on winning

The Buddhist temple minutes from Centre Court

It helps a winner keep on winning
Is this the future of flying: battery-powered planes made of plastic, and without flight decks?

Is this the future of flying?

Battery-powered planes made of plastic, and without flight decks
Isis are barbarians – but the Caliphate is a dream at the heart of all Muslim traditions

Isis are barbarians

but the Caliphate is an ancient Muslim ideal
The Brink's-Mat curse strikes again: three tons of stolen gold that brought only grief

Curse of Brink's Mat strikes again

Death of John 'Goldfinger' Palmer the latest killing related to 1983 heist
Greece debt crisis: 'The ministers talk to us about miracles' – why Greeks are cynical ahead of the bailout referendum

'The ministers talk to us about miracles'

Why Greeks are cynical ahead of the bailout referendum
Call of the wild: How science is learning to decode the way animals communicate

Call of the wild

How science is learning to decode the way animals communicate
Greece debt crisis: What happened to democracy when it’s a case of 'Vote Yes or else'?

'The economic collapse has happened. What is at risk now is democracy...'

If it doesn’t work in Europe, how is it supposed to work in India or the Middle East, asks Robert Fisk
The science of swearing: What lies behind the use of four-letter words?

The science of swearing

What lies behind the use of four-letter words?
The Real Stories of Migrant Britain: Clive fled from Zimbabwe - now it won't have him back

The Real Stories of Migrant Britain

Clive fled from Zimbabwe - now it won’t have him back
Africa on the menu: Three foodie friends want to popularise dishes from the continent

Africa on the menu

Three foodie friends want to popularise dishes from the hot new continent
Donna Karan is stepping down after 30 years - so who will fill the DKNY creator's boots?

Who will fill Donna Karan's boots?

The designer is stepping down as Chief Designer of DKNY after 30 years. Alexander Fury looks back at the career of 'America's Chanel'