Finding into death of Deborah Leona Smith

64y · Female·complications following a fractured neck of femur and mandible from a fall

Deborah Smith, a 64-year-old woman with dissociative identity disorder (DID) and multiple psychiatric comorbidities, died from complications of a fractured femur and mandible sustained in a fall from a fence at Quest Apartments on 14 August 2022. She had been missing for five days after leaving her residence on 9 August. The coroner found she was receiving reasonable and appropriate support services prior to death, though she was reluctant to fully engage. Her DID was a significant contributing factor to the fall. Clinical lessons include the challenges of managing patients with severe DID who have limited insight into their actions, difficulty with medical compliance, and the complexities of balancing autonomy with appropriate safeguarding in community settings. The coroner did not identify any failures in care provision.