Semina Halliwell inquest; Day Two

Dr Killen said Semina was referred by her GP to CAMHS (Child and Adolescents Mental Health Services) in November 2018 but did not receive an appointment until November 2019. (It was later clarified that Semina had been assessed in December 2018 but had not started any treatment until 2019).

When asked by Miss Johnson, representing the family, why there was such a long wait Dr Killen said waiting times were a national challenge and that in the time since improvements had made and waiting times had improved. Dr Killen accepted there had been fluctuations in Semina’s mental health during that period.

Nadine Walker, an agency practitioner, took over from Mike Nugent as the CAMHS practitioner for Semina in March 2021.

Miss Johnson asked why Ms Walker’s approach had been to speak only to Semina’s mother Rachel and not Semina and whether that was appropriate. Dr Killen said there had been regular contact with the family and the offer of a face-to-face appointment. She said the practitioner was trying to engage with family.

A face-to-face meeting was organised for 11 May 2021 but was cancelled. Dr Killen conceded this was because Semina was at school on that day but said that it was difficult to offer everyone out-of-school-hours appointments.

Dr Killen agreed there had been a two-week gap in the clinical supervision (of Ms Walker) due to staff sickness. Ms Johnson asked if the time allocated for clinical supervision was infact used to support Ms Walker in the use of electronic patient records and she said on review it had been recognised that having separate supervision was essential and it had since been separated.

Dr Killen said it had been recognised that face-to-face meetings were preferential for Semina but it had also preferable to have more room spaces available to promote more timely meetings.

When asked if more focus should have been on a relationship with Semina Dr Killen said they were confident that Rachel was sharing appropriately and engaging well in the meetings Semina was not able to attend.

Dr Killen said Semina’s care plan have been reviewed multiple times and they were confident the care plan to support Semina and Rachel with their emotional health and wellbeing was in line with the family’s wishes.

Dr Killen acknowledged that it crucial to have strong relationships between different agencies but conceded they had not been told about the sexual image of Semina that had been shared around Semina’s school and they had not been made aware by the school when Semina took the prescription medication in March 2021.

When asked about the relationship with social services Dr Killen said CAMHS had no input in the social services assessment which had taken place in April/May 2021 and conceded there were communication issues between Semina’s practitioner and social worker.

She also agreed that a representative from CAMHS had not been able to attend a child services meeting on 12 May 2021 due to a meeting clash.

Under questioning from Miss Quirk (representing Stanley High School), Dr Killen, agreed there had been reference to Semina self-harming in an earlier referral (prior to going to secondary school in 2020).

Under questioning from Ms Wheeler (for Mersey Care and Alder Hey) Dr Killen said Semina did not have a diagnosable mental health condition but had challenges with her emotional health and wellbeing. When asked if it was possible to identify if there was a missed opportunity to render care that would have made a difference she said it was difficult to identity a single factor which would lead directly to self-harm and that it was multi-factoral.

She said you could not link any learning identified as a reason for the incident that took place in June (Semina’s overdose).

DETECTIVE SERGEANT CHRIS MAHER – MERSEYSIDE POLICE

DS Maher analysed Semina’s phone and videos, her social media posts on Snapchat and Instagram and her Whatsapp messages.                                               

In a number of images on the phone read to the court Semina referred to having ‘no feeling’ and ‘being numb’ and being ‘ruined as a person’ saying ‘I am in such pain.I just want to be whole again’.

In a whatsapp messages between Semina and her mum Semina refers to an individual ‘not getting away with it’ and in a conversation on March 28 2021, Semina and Rachel discussed what had happened and what Semina wants to do about it.

In the early hours of 9 June 2021 Semina posted a number of videos in which she is in her bedroom and miming to songs and crying.

MIKE NUGENT – CAMHS (CHILD AND ADOLESCENTS MENTAL HEALTH SERVICES)

Mr Nugent said he first met Semina and Rachel in November 2019 but the first session with her was not a success as Semina was a little bit evasive and there were communication issues. He said it had taken time to get know Semina and that he had met with her every two to three weeks.

He said he was made aware of Semina’s attempts to self-harm and concerns were raised that it was copycat behaviour from posts and videos she may have accessed online. He said Rachel had raised concerns about Semina accessing things online and they had discussed parental barriers and monitoring.

He said Semina remained evasive but Rachel was on board with the suggested strategies and diversionary work. He said Semina had resisted and not followed advice and he reinforced the need to keep practising.

He said at the next meeting he spoke to Rachel on the phone but did not speak to Semina as she struggled with telephone calls.

He said at a meeting on 18 December 2020 he said Semina had shown him some of her self-harming and they had discussed practical skills to manage distress. He said she had mentioned she was going to move away from self-harming.

He said during a meeting in January 2021 reference was made to the (sexual) assault on Semina and that he had indicted that the relevant authorities needed to be contacted.

He said when he had left to go on a course he had done a handover note for a colleague in which he had noted Semina’s self-harm and sensory issues and autistic diagnosis. He said the self-harm injuries Semina had had been classed as superficial and there was no suggestion of a suicide risk when he handed Semina’s case over.

When asked by Miss Johnson, representing the family, Mr Nugent agreed the pandemic had made it more difficult to support children and young people as effectively as normal.

He said when there was difficult communication between a therapist and a client it was difficult to support Rachel and Semina in identifying when she may be about to self-harm. He said it takes time to peel back a lot of information and Semina’s social and communication skills and not understanding things made it quite tricky to communicate effectively. He said it was difficult when people were not quite willing to engage and that for every individual you would have to individualise care.

He said when working with parents and children they would rely on parents to support them to implement change in the home environment.

When asked if he had been looking out for any signs of grooming involving Semina he said nothing had been disclosed to him and they would not necessarily be looking out for grooming or anything else other than what they were presented with. He said he would have asked questions if there had been any indications such as Semina getting a new mobile phone or clothes.

When it was reported in January 2021 that Semina had been inappropriately touched he agreed it was the first time he was aware of any sexual behaviour of any kind.

When asked if had issues booking rooms (for appointments) he said as he was embedded (within the organisation) he had certain space availability and always had a room and time to do his clinical work.

When he handed over to Semina’s new case worker he said it was done via email and that he couldn’t remember if he passed on his observation that Semina preferred face-to-face meetings rather than telephone calls.

NURSE DONNA BURKE (SCHOOL NURSE AT TIME OF SEMINA’S DEATH)

Nurse Burke said part of her role was to signpost and refer to other agencies and she had spoken to Semina in person.

She said it had been recognised that the Halliwell family had difficulties, that they were the subject of MARAC (multi-agency risk assessment conference) meetings and were open to support from Early Help.

She spoke to Semina on 14 October 2020 during which Semina showed her evidence of self-harming and they discussed alternatives to self-harm and the support available.

She said she also spoke to her about online safety advice in relation to the apps Semina could access including how to report inappropriate content and who to speak to. Under questioning from Miss Johnson, on behalf of the family, she said she did not ask Semina directly if she had experienced any issues and Semina did not volunteer any information of a concerning nature.

When asked if she had offered any specific support following the sexual assault allegation in March she said he had not as she was aware Semina and her family were already being supported by other organisations such as Early Help.

When asked about a meeting on 27 May 2021 Nurse Burke said she had not discussed the sexual allegation with Semina as she was led by Semina and if she had raised it she would have discussed it. She said she was aware there was an ongoing police investigation and did not feel it appropriate to bring it up with her as other agencies were already involved and discussing it with her. She said she had given Semina advice and information while waiting for her next appointment with CAMHS.

The inquest resumes tomorrow, Wednesday 15 January.