Ella Louise Murray should have been celebrating her 16th birthday this year, sitting her GCSEs in the summer and starting to plan out her future with her friends and family.
But instead, they can only imagine the life she could have had if she had received the mental health support she was desperately crying out for, her mum Natalie James told senior reporter Alex Langridge.
Ella Murray, from Sheerness, died on November 15, 2023. Picture: Natalie James
Ella died on November 15, 2023, at King’s College Hospital in London from suicide, after struggling with her mental health.
A four-day inquest was held into her death in December 2024, where area coroner Catherine Wood heard the 13-year-old was admitted to A&E two days before she died after telling her teachers “she wanted to kill herself”.
The Year 9 student at Highsted Grammar School in Sittingbourne was first seen by a paediatric nurse at Medway Maritime Hospital, who she told that she would end her life if she went home.
Ella was referred to the Child and Adolescent Mental Health Services (CAMHS) and then seen by a mental health nurse who deemed her a “medium risk”.
She was discharged with an agreed home treatment plan, and seen by another mental health nurse the following day at her home in Alexandra Road, Sheerness.
Ella was seen by three medical professionals in the days before her death. Picture: Natalie James
According to the assessment notes, the rugby player for Aylesford RFC told the practitioner she would “hurt herself or others” if she stayed at home, was feeling suicidal and wanted to go to the hospital.
It was deemed that she did not meet the criteria to be admitted.
After the nurse left, Ella attempted to end her life and was airlifted to King’s College Hospital, where she died the following day (November 15).
In her findings, Ms Wood said she found it “incredible” that a 13-year-old could tell a nurse she was going to harm herself and then a risk assessment was not completed.
She added: “I simply cannot accept it is reasonable to leave her at home even with a plan to see her the following day. There was a clear failure here to keep Ella safe.
Ella with her mum, Natalie, when she was younger. Picture: Natalie James
“This was a child crying out for help, and I find she should have been risk-assessed. Had she been, she would have been high risk.”
She declared that Ella should have been taken to a mental health ward and admitted to the hospital, or an urgent discussion should have been held with partner organisations to ensure Ella was in a safe place.
Speaking to KentOnline two years after the inquest’s conclusion, her mum, Natalie, still cannot understand how Ella was seen by three different professionals but wasn’t admitted to the hospital.
She added: “Losing a child is something I will never get over. There are so many questions I will never have the answer to, so many ‘what ifs’, and I cannot ask Ella.
An inquest has found that there had been failings in Ella’s care. Picture: Natalie James
“I look back and think she could still be here. If she felt like someone was helping her, maybe she would not have given up hope.
“One of the hardest things I hear is ‘she would have done it anyway’. We do not know that.
“What we do know is that if she were risk-assessed, she would have been rated as high risk, and she might not have done it then.”
Ella’s friend, Daisy Sunley, has now launched a government petition calling for mandatory suicide risk assessments when a child in hospital care expresses intent to harm themselves. You can view it here.
Natalie, who now lives in Sittingbourne, said: “If they have gone to the hospital, they should not be leaving without having an assessment, and they should not have to jump through so many hoops and red tape for it.
Ella with her mum, Natalie, who is calling for a change in the system. Picture: Natalie James
“Anyone expressing a desire to harm themselves at a young age should be taken more seriously.
“We have had these reviews, plans and still nothing has changed. If someone comes in and is dismissed, then it does not matter.
“How many more Ellas does there need to be?”
Daisy, who not only lost Ella, but also their other friend, Eivie, to suicide, added: “Losing one friend so young was heartbreaking, but losing two was something I struggled to understand at that age, especially to suicide.
“As I have gotten older and learned more about Ella’s case, I began researching what a suicide risk assessment was and why it mattered.
Ella was said to be “crying out for help”. Picture: Natalie James
“Now, as an almost 18-year-old, I cannot understand how something that could determine whether a vulnerable young person receives life-saving support can still be treated as optional.
“What affected me most was learning the details of Ella’s case. She had told professionals she wanted to end her life, she was hearing voices, and she was clearly crying out for help, yet a suicide risk assessment was not completed.
“I do not want any other child, friend, or family to go through what so many people around Ella and Eivie had to go through.
“If mandatory suicide risk assessments can save even one life, then that change is worth fighting for.
“No child asking for help should be turned away without proper assessment and support, and no family should ever be left wondering whether more could have been done.
Mum Natalie believes more needs to be done for other children. Picture: Natalie James
“For me, this petition is about turning something so negative into positive and making sure Ella and Eivie’s names stand for something that could protect others in the future. I hope I am doing them proud.”
Natalie, who has completed several training courses in mental health and suicide awareness, understands that sometimes not every person who says they intend to harm themselves will do so.
But she explained that it should still be taken seriously: “It is not worth the risk. They are big words for a small person, and are warning signs that should not be ignored.
“A 13-year-old should not know how to end their life, and it should not be a consideration.
“I know it will require resources, and the NHS is already under a lot of pressure, but at the cost of young people’s lives, it is just not acceptable.”
Ella with her mum, Natalie, and step-dad, Oliver. Picture: Natalie James
Peter Scutts, founder of The Elliott Holmes Memorial Fund, which helps young people access mental health counselling in Gravesham, said the current system is “under immense pressure”.
He added: “It is heartbreaking to hear stories of children being sent home without adequate support.
“While hospitals do their best to triage and assess risk, the inevitable delays in getting specialist CAMHS input, often requiring medical clearance, mean that critical windows for intervention are being missed.
“We need to urgently address the red tape and funding gaps that prevent young people from accessing the help they need, precisely when they need it most.
“Investing in early intervention and community-based services is not just compassionate, it is essential to help prevent further tragedies.”
Ella should have been celebrating her 16th birthday this year. Ella is pictured with her mum, Natalie, when she was younger. Picture: Natalie James
Following Ella’s death, a Prevention of Future Deaths (PFD) report was submitted to the Secretary of State for Health and Social Care, the chief executive of NHS England and the Kent and Medway Integrated Care Board (ICB).
The coroner outlined her concerns, including that if the teenager had been removed from her home, she “may still be alive today”.
In response, the organisations said multiple meetings and reviews had taken place, and steps were being taken to strengthen information sharing between agencies and escalation plans for professionals.
Mental health problems can affect any of us at any time in our lives.
When life gets tough, talking can help.
Call the Samaritans 24/7 on 116 123, or chat in confidence to a trained Release the Pressure adviser, anytime, just text the word SHOUT to 85258 or call 0800 107 0160.
For details about other mental health support in Kent and Medway, including Amparo, which provides support to anyone bereaved by suicide, please visit kent.gov.uk/mentalhealth