Shane Dean Hardy · Prevention of Future Deaths report

On the 16th March 2017 an inquest was opened into the death of Shane Dean Hardy. The investigation concluded at the end of the inquest on the 5th December 2017. The conclusion of the inquest was Accidental Death. The medical cause of death was hanging.

This 29 year old man (“Shane”) had a long history of involvement with mental health services, and his primary problems were linked to his abuse of alcohol and illicit drug substances. He had taken multiple overdoses, often whilst under the influence of alcohol or drugs, and would seek help shortly thereafter. He was living in supported accommodation. His last telephone contact with alcohol rehabilitation services was on the 14th February 2017. On the 24th February 2017 he was arrested and placed a ligature around his neck. He was formally assessed under the mental health act, and was found to not be suffering from a mental health illness. On the 28th February 2017 Shane was told by his accommodation provider that he was to be moved into different accommodation. On the 2nd March 2017 Shane cut himself, took an overdose and was admitted to hospital. The following day he was assessed by a mental health professional. Whilst he referred to a number of life stressors, no evidence of a mental health illness was found. He was discharged from hospital on the 3rd March. On the 4th March Shane moved into his new accommodation. He was booked into his accommodation, and a welfare check was carried out on the 4th March. On the 5th March Shane collected his script from the pharmacy. On the 8th March 2017 Shane spoke to a security guard at approximately 7 am. He enquired when the staff start, and complained about his current accommodation. He did not express any suicidal ideation. He walked from the office to a semi private area just off the main drive. He then placed a belt around his neck. At approximately 11.35 am other residents found Shane’s body hanging from a tree. Paramedics attended and pronounced him deceased at 11.47 am.

(1) Individuals who suffer with addiction and mental health difficulties can fall between the services. Mental health services consider it not to be a mental health issue, and refer to alcohol treatment services. If the individual then refuses to engage with the latter, the individual is left receiving no assistance.

(2) When multiple agencies are involved in providing support services to an individual, there can be a lack of information sharing between those agencies. No agency is identified as the lead agency for communication purposes.