Finding into death of Casey Evan Cahill

19y · Male·Multiple injuries sustained on a train impact (pedestrian)

Casey Evan Cahill, aged 19, died by suicide on 10 October 2019 when he placed himself in front of a train near Berwick Railway Station. He had a significant history of mental ill health including depression, psychotic symptoms, and suicidal ideation, alongside substance misuse involving methamphetamine, cannabis, cocaine, and alcohol. He was enrolled in the Headspace Youth Early Psychosis Program and was receiving treatment with antipsychotic medication (aripiprazole depot). Key clinical lessons include: the importance of early identification and treatment of emerging mental health problems in adolescents; the challenge of medication compliance in early psychosis; recognition that concurrent substance misuse significantly complicates psychiatric management; the critical need for family engagement and support from initial service contact; and the service gap in youth homelessness support. Clinical opportunities to prevent this death may have included more intensive engagement around missed appointments, better coordination between mental health and substance misuse services, and earlier consideration of involuntary treatment.