THE family of a Bridgwater man who took his own life felt that their son was not given adequate care in the lead up to his death.

Bridgwater’s Reece Baker took his own life on October 9, 2016 at the age of 23.

His inquest was held over two days at Taunton Coroner’s Court with evidence heard on Tuesday, May 14 and Senior Coroner Tony Williams giving his conclusion the following day.

The inquest heard a statement from Reece’s mother Shelley Baker about the tragic circumstances that led up to his suicide.

Reece was admitted to hospital on a number of occasions for overdoses related to alcohol and tablets between December 2015 and September 2016. On each occasion he was assessed by psychiatric staff, who concluded his issues stemmed from alcohol and drug problems more than mental health issues, and believed until his substance abuse was more under control he would not be able to engage with psychiatric treatment effectively.

The family contend that had the Somerset Partnership installed its dual diagnosis policy which is now in place, allowing more flexibility for treating people with both mental health problems and substance addictions, Reece’s treatment could have been more effective and there is a chance his death could have been avoided.

The family also argue there could have been significantly better communication between the respective organisations who dealt with Reece during his treatment.

In her statement Mrs Baker said that Reece was a loving father, son, brother and best friend to many.

She said Reece had a tough upbringing in that he had seen his father stabbed and missed out on his dream career due to injury.

In December 2015 Reece’s long-term relationship was strained, and he also felt under pressure from his employer, the inquest heard.

He had turned to drink to cope with the stress but this combined with other factors led to the end of his relationship with his fiancé and it was then the Reece took the first attempt on his life through an overdose of paracetamol.

He survived but caused serious damage to his liver and spent a significant stretch of time in hospital.

Although he recovered enough to return to work for a time, his health declined and he continued to drink, and he was subsequently dismissed by his employers.

He went from earning £37,000 to signing on for Universal Credit and continued to struggle, drinking heavily and taking cocaine, before again overdosing on alcohol and tablets and ending up in hospital on successive occasions in June.

However he seemed to make some improvements in September and October, and was looking after his parents’ house while they were away on holiday and was messaging the family positively, the inquest heard.

But sadly Reece took his own life while the family were away, hanging himself. His post-mortem found he had 132mg of alcohol in his blood for every 100 ml – around one and a half times the drink/drive limit, and there was no evidence of drugs in his system.

Chuck Honeywell, a psychiatric nurse who saw Reece on a three occasions when he was discharged from hospital explained that he and fellow staff initially encouraged Reece to engage with the Somerset Drug and Alcohol Service and meet his GP to be prescribed anti-depressants and undertake Talking Therapy.

However Talking Therapy typically has a waiting time of 12-14 weeks, and Reece did not get an appointment after referral in January until June – which he did not attend because he was in A&E following an overdose.

Witnesses from the Home Treatment Team, and the Somerset CCG medical director for adult mental health services testified that Reece was repeatedly offered treatment for alcohol and substance abuse but consistently refused to engage with treatment.

Dr Sarah Oake confirmed that a serious incident requiring investigation (SIRI) report had been created following Reece’s death and a number of recommendations implemented improving care such as a dual diagnosis leader being employed, and that further investment had gone into strengthening the Home Treatment Team. The report also concluded that one of the organisations involved should have been responsible for an overview of Reece’s treatment.

Senior coroner, Tony Williams, reviewed the evidence which had been submitted and recorded a conclusion of suicide.

He said: "On October 9 in 18 York Road in Bridgwater Reece Baker deliberately suspended himself by the neck with intention of ending his life."

If you have been affected by this article, there is support available.

The Samaritans can be contacted on the free national number 116123, or e-mail jo@samaritans.org or alternatively contact Somerset CRUSE bereavement on 01458-898211 or e-mail somerset@cruse.org.uk