A grieving mother has told an inquest she is disappointed and dissatisfied with the treatment given to her diabetic son.

Rhys Sanders died in July 2009, aged 21.

But his mother, Jane Sanders, of Pembroke Dock, feels his life could have been saved.

She told the inquest he had diabetes and depression. He may also have had an eating disorder. But he did not get the help he needed.

“I believe he should have been sectioned as his behaviour in relation to his diabetes was presenting a risk to his health,” she said.

“I believe better management of his two conditions and receipt of the help which I tried to get for him would have prevented his tragic premature death.”

The inquest heard that Rhys — a former student at Pembrokeshire College and winner of a Children of Courage Award — had been admitted to hospital as an emergency around eight times in the three years up to his death.

It was after one of those admissions, in February 2009, that his mother wrote to “the nurse or doctor in charge” at Withybush Hospital pleading for their help.

“I am asking for the fourth time for my son to have a complete mental health assessment,” she wrote.

“He was never admitted to hospital due to diabetes problems until he became depressed, and he has been diabetic since he was a baby.

“I want to see him become the happy person he used to be, not find him dead in his flat. Please help him.”

Giving evidence at the inquest was the county’s manager of mental health services, David Jenkins.

He said a mental health social worker had visited Rhys at his flat and he had appeared to be managing well, turning down an offer of continuing support.

Consultant psychiatrist Dr Elizabeth Richardson was also reluctant to invoke the Mental Health Act.

She said anyone on long-term medication struggled, but Rhys had a lot of family support and was monitored through outpatients appointments. He had also told her he did not want any further intervention.

But he was not managing his condition well, according to diabetic consultant Dr Paul Underwood.

“He knew he wasn’t doing what he should be doing to control his blood sugar levels, and his test results were at the top end of the scale for poor management,” he said.

After a two-day hearing, the Coroner for Pembrokeshire, Mark Layton, returned a verdict of death by natural causes.

He confirmed there had been no aggravating circumstances, either by neglect from external sources or by self-neglect.

Speaking to the Western Telegraph after the hearing, Rhys’ parents Jane and Eifion, who is also diabetic, said Rhys had managed his condition effectively from a young age.

But that had changed in his mid-teens when he started to become depressed.

“We had such high hopes for him,” said Mrs Sanders. “At school he was top in all his tests and was due to become an accountant. His death was tragic and premature.”


A helpline operated by The Insulin Dependent Diabetes Trust offers emotional support and a listening ear to diabetes sufferers and their families.

The number is 01604 622837 and the service is available from Monday to Friday, 9am to 5pm.