Family of 17-year-old boy from Lymm hope 'lessons learned’ after death

And now his family have spoken out of hope that 'lessons have been learned’ to ensure other families of children with complex needs get the help they 'desperately need and deserve'.

Erik Marshall, from Lymm, was described by his loved ones as someone who could ‘fill a room’.

He was a talented runner from a young age, proudly bringing home the silver medal for Warrington in the under 13s Cheshire Cross Country Championships.

However, he also battled with issues relating to mental health as well as other additional needs.

An inquest into the sad death of the Lymm teen held at Cheshire Coroners Court last Tuesday heard how Erik was tragically found dead in the garden of his family home at around 9am on September 30, 2023.

Coroner Marilyn Whittle concluded the boy’s death was a ‘misadventure’, however factors contributing to this included a ‘delay in an autism diagnosis and specialist input for his sensory needs’.

The coroners court heard how Erik had suffered with his mental health from a young age and was diagnosed with ADHD age seven.

Despite showing early signs of autism, he did not receive a diagnosis for this until he was 16, when he was admitted to a Priory.

Speaking about her son during the inquest, Erik’s mum Glenda Marshall said:

“When he was born he came out fierce and full of spirit. He filled a room. He was extra lively from the word go.

“When he was young he did not play with ordinary toys, he was obsessed with spoons. It was wonderful. He had more imagination than most kids.”

She added that school was a difficult time for Erik.

“He had some learning difficulties, we were never clear about the impact of his learning difficulties on him.

“He was just a whirl wind. He was so focused on activities growing up. It would just be on one thing at the time and then he would focus on something else.”

Glenda told the coroner how Erik was ‘well liked’ but did not have close friendships, something that affected him as he got older.

“He started to get intrusive thoughts. At 10 he was fixated on his legs slowing down. That lasted over a year and then it would move on to something else.

“There was two days in a year when he was free of this anxiety, it would consume him.”

Erik had monthly visits from an ADHD nurse who had suggested that he may have autism.

He had an Autism Diagnostic Observation Schedule (ADOS) assessment with a doctor in 2019.

His mum added: “I never felt there was a good family history check taken.”

A paediatrician would see him and would describe him as ‘sparky’, his mum detailed, before stating that ‘there was an awful lot that was missed’ as it was discussed during the inquest that Erik was good at ‘masking’ the true extent of his mental health and additional needs.

The inquest was heard at Cheshire's Coroners Court on Museum Street (Image: Warrington Guardian)
Erik also had involvement with CAMHS, a mental health service, who he would see weekly. He was referred to this service after having reported experiencing suicidal thoughts.

His mum told the coroners court how Erik liked to run and ran for Cheshire, before his anxieties surrounding his legs eventually prevented him from continuing the sport.

In 2019, the Warrington Guardian reported on the successes of Erik’s running career as he secured a silver medal in the under 13’s Cheshire Cross Country Championships.

And in an interview with sports editor Mike Parsons, Erik talked about his committed training schedule in the lead up to the race, training five days a week – aged 12 at the time.

He told Mike, ‘I want to be an athlete when I’m older. I just want to proceed and do well at something that I am really good at’.

Glenda explained how her son would become fixated on things and that these fixations were linked to his mental health.

When asked if the support from CAMHS helped Erik with his mental health struggles, Glenda said: “No, I do not think anything helped. We had so many provisions, but he was tortured by his intrusive thoughts.”

“He needed help and he wanted help,” she said.

Erik was admitted into a priory when he was 16, on September 8, 2022, but due to his additional needs, he found the sensory aspect of the hospital ward overwhelming and was put into isolation for three weeks.

It was during this admission that Erik received the diagnosis of autism.

He had also developed ‘high risk behaviours’ during his time in the priory which he used to assist him with his sensory needs. These were closely monitored by his parents and a health team.

Erik received an assessment from Ancora Care, a care service delivered by Cheshire and Wirral Partnership NHS Foundation Trusts.

Verbal evidence given by Dr Mandara from Ancora spoke of how Erik seemed in CAMHS assessments to appear as functioning at a ‘higher degree’.

“He was masking and functioning at a higher level,” she explained.

Referring to the reasoning behind admitting Erik into isolation for three weeks, Dr Mandara said that he was ‘presenting as fight or flight’ and that in order to keep himself and others safe, secluded management had to be used.

Leigh Marshall, Erik’s dad, questioned Dr Mandara on the ‘long term affects’ the seclusion period may have had on his son.

She replied: “It is difficult to comment on that. Seclusion is traumatic for young people.”

The assessment concluded that Erik would be discharged and would go home on a managed plan basis.

It was heard that following his discharge there was a plan in place to obtain a sensory assessment through occupational therapy in the community to help him with the high-risk sensory behaviours he had developed.

The Child Development Centre (CDC), part of Bridgewater Community Healthcare NHS Trust, were invited to Care Programme Approach meetings and were aware of Erik.

Referrals were made to the CDC for an Autism Diagnostic Observation Schedule (ADOS) assessment and Occupational therapy input in May 2023.

The coroner heard how the CDC responded to state they did not require an ADOS assessment to provide the support needed but they did want to review the assessment undertaken at the Priory to see if this complied with NICE guidance before any referral to their nurses was made.

They also made a decision, based on the limited information that they had been provided and without speaking to any clinician or family member, that Erik’s mental health need was more prominent than the sensory need.

Evidence was provided that escalations were made for specialist input for his sensory needs because it was identified that without this it was ‘likely to deteriorate and his risk increase’.

The Occupational therapy referral was not accepted because of Erik’s age. He was signposted by Mersey Care to adult services, but these would only have assisted him when he was 18 because there was a ‘commissioning gap’.

Funding was eventually put in place for access to The Sensory Hive, an occupational therapist in Liverpool, for Erik but the initial appointment only occurred on September 22, 2023 and Erik was sadly found dead just eight days later.

On the day of his death, an ambulance attended the family home in Lymm on the morning of September 30, having received a call at around 9.08am.

A paramedic from North West Ambulance Service arrived on the scene and it was noted that 9.12am was the recorded time of Erik’s death.

The family of Erik Marshall provided a statement following the inquest, saying: “Erik was an amazing young man with a huge spirit and love for life.

“He touched the hearts of everyone who knew him and we are devastated by his loss.

"Although it's not going to bring Erik back, we hope that lessons will be learnt, so that other young people with complex needs along with their families, get the support they desperately need and deserve.”