A HEALTH board has vowed to improve ways of dealing with mental illness following the death of a man at his Flintshire home.

Ian Francis Duff, who suffered from chronic health anxiety, was found dead at his home in Hawarden Way, Mancot, on June 4 last year, a resumed inquest in Ruthin was told.

An earlier hearing in Wrexham was adjourned in January after John Gittins, coroner for North Wales East and Central, said there were still questions to be answered over whether a combination of drugs including anti-depressants prescribed to Mr Duff as part of his treatment regime might have had a “catastrophic” impact.

The cause of death of the former sign language interpreter was reported as cardio-respiratory failure caused by toxic levels of anti-depressants exacerbated by fatty liver and a pancreatic abscess.

Extra investigative work was carried out by Dr Masood Malik, consultant psychiatrist/clinical director at Betsi Cadwaladr University Health Board, who revealed that as well as the health anxiety order Mr Duff, 46, had at various points in his life suffered from a dependency on alcohol and an obsessive compulsive disorder.

He was offered cognitive behavioural therapy (CBT) and at the time of his death was receiving twice daily dosages of medication, including the anti-depressants Clomipramine and Temazapam, which were being managed by a local pharmacy because Mr Duff had had a tendency to overdose himself and not been consistent in how he was taking the drugs.

Mr Duff's family had a number of concerns about whether the amount and variety of drugs prescribed to him were considered to be wise considering he was at times drinking very heavily.

At its worst Mr Duff was consuming up to 15 cans of four per cent lager on a daily basis, the reconvened hearing was told.

Dr Malik reassured the family that alcohol consumption was always considered before drugs were prescribed and that warnings were given to him that GPs would stop the drug use if consumption was not reduced.

Although Mr Duff, who was originally from Liverpool, had shown some signs of improvement in his condition in the summer of 2017, he suffered a fall outside his home in October of that year which resulted in several injuries including a cracked skull.

Just two months prior to his death his sister, Yvonne Duff, felt her brother seemed to be "over sedated" and although he had not been drinking for about eight months, his continued prescription and use of Co-codamol was a concern with Mr Duff himself admitting at the time that he was not sure why he took the painkiller, although he believed it might have helped with his anxiety.

Ms Duff said: "Medication was given to my brother, even though the risks posed by those two drugs (Clomipramine and Temazapam) could cause an irregular heartbeat and he had a history of over-dosing on drugs."

Dr Malik, in concluding his evidence, said training would be given to all Betsi consultants dealing with mental health issues, especially in relation to the risks posed from the use of medication.

An additional learning point, he said, would be improved documentation in relation to patient care.

Tests after Mr Duff died showed he had a number of drugs in his system, mostly at a therapeutic level.

However he also had 3.9mg of Clomipramine per litre of blood when a dose over 1.7mg of the drug can be fatal to some.

His blood also showed a level of 0.65mg of Temazapam, a drug which is toxic over 0.3mg.

In reaching a conclusion of accidental death Mr Gittins said the combination of Mr Duff's condition and his tendency to take more medication than was considered appropriate to him had resulted in his death.

He thanked family members for their roles in the proceedings and said: "It is very important in cases such as this that the family has interaction with the medical team to be given the opportunity to raise any personal concerns they have, which is all part of the learning process.

“I have no doubt that the end of this inquest will not be the end of this matter.

"When dealing with matters such as this one, the gravest concerns held by family members is often that… they weren't listened to, so I am pleased you could engage in the process today.

"What has been clear throughout both hearings is that you were always there for him.

“I realise you feel like you were let down but I hope there's some level of comfort you can take from this."

Mr Duff's father Francis said: "There is an over reliance on medication, rather than therapy, when dealing with issues of mental health."