Teenager with anorexia chose to leave hospital to go to university, inquest told

Averil Hart, 19, was discharged from the eating disorder clinic at Addenbrooke’s Hospital in Cambridge in August 2012 and started her creative writing course at the University of East Anglia (UEA) in Norwich the following month.

The teenager, of Newton in Suffolk, lost weight during her first term and was found collapsed in her room on December 7.

She died in hospital in Cambridge on December 15 2012.

Averil’s inquest is one of five separate inquests into the deaths of five women who died from eating disorders while under the care of Cambridgeshire and Peterborough NHS Foundation Trust.

MORE: Inquest told of ‘fun-loving’ teenage student’s struggle with anorexia

Dr Jane Shapleske, a consultant psychiatrist for Cambridgeshire and Peterborough NHS Foundation Trust, said Miss Hart weighed around 45.2kg (7 stone 1lb) when she left hospital in August – less than her target weight of 50kg (7 stone 12lb).

“There was no pressure for her that she needed to go at the beginning of August,” Dr Shapleske told Tuesday’s hearing in Peterborough.

She said Miss Hart was deemed to be at high risk of relapse but that she had spoken of her wish to go to UEA, where she had an unconditional offer.

Dr Shapleske described the offer as a “massive motivation for her”.

“She thought, ‘I really want to go to UEA’,” she said. “She set herself a really ambitious target.”

Dr Shapleske said Miss Hart was gaining a kilo (2lbs 3oz) per week from February to May 2012.

Miss Hart “worked best when she came forward with her own plan”, she said.

Dr Shapleske ruled out detaining Miss Hart under the Mental Health Act.

She said “we would have talked about the pros and cons and risks attached” of each of her options.

Dr Shapleske said that remaining in hospital to regain more weight with increasing periods of home leave would have meant Miss Hart would not have gone to university.

If she was discharged home to work with health services in the community then “boredom and lack of structure was a risk factor”, Dr Shapleske said.

Referring to Miss Hart’s decision to leave hospital and go to university, Dr Shapleske said: “We were in a very difficult position because she decided on a course of events that was risky.

“What we did at the time was do our best to provide a solution so she had a point of contact that she had a really good relationship with and she had medical monitoring at the GP surgery.”

She added: “I understand the rationale that she had.

“There was about seven weeks between discharge and her arriving in Norwich.”

Miss Hart had been admitted to the eating disorder clinic in September 2011 and was there for 10 months.

“Weight can come off really rapidly and there was some suggestion that may have happened before she was admitted in September 2011, then before she was admitted to the Norfolk and Norwich University Hospital (on December 7 2012 after her collapse),” Dr Shapleske said.

The inquest, which is listed to last for four weeks, continues.