Court hears how mentally ill man's death in prison could have been avoided

A young mentally ill man who died in Brixton prison had repeatedly asked to be transferred to hospital for treatment, a coroner's court was told yesterday.

Cesar Augusto Granja Lara was found dead in a cell in September 2007 while on remand; he was 22 years old. He suffered from acute episodes of psychosis which included hearing derogatory voices and paranoid thoughts, that at times made him feel suicidal, the court heard.

His mother told the Southwark's Coroner's court that her son's death could have been avoided if he'd been given the help he kept asking for, and that his dishevelled appearance meant it should have been obvious that he was ill. Mr Granja Lara stopped looking after his personal hygiene in the last few months of his life which included growing his finger nails to "protect himself", the inquest was told.

The court heard how Granja Lara had fallen into a bad crowd after to moving to London with his family from Ecuador in 1999. Top of his class in Ecuador, in London he got involved in cannabis and repeated trouble with the police from his mid teens. He suffered his first episode of acute psychoses while in Feltham Young Offenders Institute in August 2005, which led to his transfer to a locked ward in Lambeth Hospital for treatment.

His illness was characterised by distressing voices who blamed him for things such as the London bombings and a still birth in the family. At times he believed there were prostitutes in his cell talking to him, and that he would be better in heaven with God, the court was told.

His community psychiatrist, Dr Paddy Power, told the court that he was a seriously ill young man whose condition would be made worse by smoking cannabis and inconsistent compliance with his medication - both fairly common among young people suffering from psychoses. But those symptoms would "wax and wane" and that he was not acutely disturbed all the time.

The court heard evidence that Mr Granja Lara had reported "suicidal ideation" in the weeks leading up to his death. He repeatedly asked healthcare staff at Feltham, Brixton, and his family to transfer him to hospital because he wasn't well and felt scared of being in the prison wing. A week before Granja Lara's death, Dr Power and the Brixton Prison psychiatrist had agreed to work towards a possible hospital transfer but that this could take several weeks, the court was told.

His mother, Fanni Lara Ortega, said through an interpreter: "I am not an expert, I am not a psychiatrist, but his appearance had changed so much in prison that any person would realise that he was ill. He did not need a prison, he needed a hospital, but because of the language I felt so incapable of helping my son. I'm not justifying my son, but I know that if he had had some help, he would not have died."

The inquest continues.