A “popular” A-level student who was declined the support of adult mental health services and not diagnosed with a specific condition ended her own life, an inquest has been told.
Afrika Yearwood, who was 18, had received only two hours and 21 minutes of NHS support between a deliberate overdose in late February 2018 and her death on May 25 that year, her mother Beverley Yearwood told Wakefield Coroner's Court.
Miss Yearwood, a waitress at a Wakefield restaurant described by her mother as “the life and soul of the party”, later purposely injured herself on May 21 and died at Leeds General Infirmary four days later.
The inquest heard how the Rothwell teenager, who turned 18 on March 14 that year, was “impulsive” and whose mood fluctuated in her final months.
Mrs Yearwood told the court that the family became concerned in the summer 2017 when her daughter, then aged 17, was feeling upset, but by the December they realised it “was not just normal teenage behaviour”.
After an argument she locked herself in a room at home before telling her father, Claude, that she wanted to die.
She then began seeing a private cognitive behavioural therapist, Michelle Pittam, and following the overdose in the February was reviewed during a 45-minute psychiatric assessment by Child and Adult Mental Health Services (CAMHS) after being discharged from Pinderfields Hospital.
Miss Yearwood was not formally referred to a “transitional” CAMHS service to then be moved on to adult mental health services in the run-up to her 18th birthday, the court heard, but her mother said she was "deteriorating" by April.
The family received a letter from adult mental health services “refusing” support and was referred back to primary care, Mrs Yearwood told the court, a decision she challenged in a follow-up phone call.
“He said, ‘Basically Mrs Yearwood, the threshold for adult services is very high and she is not acutely ill enough'," she told the court.
She added: “When I’m sat there by her grave I hear him say ‘She is not acutely ill enough’.”
Mrs Yearwood said that between Febraury 24, when her daughter was “in crisis”, and her death, there was only two hours and 21 minutes of contact with the NHS.
She said: "All they did was ping pong her around. There was more time spent on emails between services than there was on Afrika."
Dr Gareth Howel, a higher trainee in child and adolescent psychiatry at Leeds Community Healthcare NHS Trust, assessed Miss Yearwood on March 7.
He told the inquest that Miss Yearwood "didn't fit into a depressive or psychotic diagnosis" and deemed her to be low risk - a classification which "in retrospect" he would increase to medium risk, he told the court.
Dr Howel said: "Afrika told me she didn't have any thoughts to harm herself or of suicide at that time."
Senior Coronor, Kevin McLoughlin, asked him whether a lack of support "had contributed in some way", even minimally, to her death.
Dr Howel replied: "I don't know."
On February 27, the doctor had invited Diane Browne, a senior clinical practitioner with the Leeds Transitions Service, to attend the assessment on March 7 to provide advice.
She could not attend the meeting but told Dr Howel that if he wanted her help in future, then he should let her know, the court heard, but did not hear anything from him.
Ms Browne told the court that there was an "informal referral process" between the services.
John Down, the legal representative for Leeds Community Healthcare NHS Trust, asked Ms Browne whether she emailed a relevant doctor the next day after being contacted by a GP about Miss Yearwood being at risk on April 10.
She replied that she had.
Earlier at the hearing, Dr Howel told the inquest: "What I wanted to do was email Diane after the appointment to see if there was anything we could do.
"I didn't do it, I didn't send that email, I'm sorry."
The family of a talented young woman from Leeds who took her own life broke into applause as a coroner announced that he would write to health bosses ensuring they take action to prevent future suicides.
The inquest was told that health agencies accepted that they needed to be clearer when communicating their referrals.
Mr McLoughlin said he would send a 'regulation 28' report, also known as Preventing Future Deaths report, to Leeds Community Healthcare NHS Trust and Leeds and York Partnership NHS Foundation Trust.
The extended family of Afrika in the courtroom broke out into applause at his announcement.
Mr McLoughlin concluded that Afrika died of a hypoxic brain injury and hanging at 3.16am on May 25 2018.