The scale of the deaths in an Essex mental health trust could be significantly higher than 2,000, the chairwoman of the public inquiry has warned.
Baroness Kate Lampard CBE said as she opened the Lampard Inquiry that we may never have a definitive number of deaths put forward within the inquirys remit.
She said she is committed to publish a number but this number is only ever likely to be approximate and I find it shocking we may never be able to say for sure how many people died in the remit of this inquiry.
However, she said the figure will be significantly in excess of 2,000.
The Lampard Inquiry will investigate the deaths of people who were receiving mental health inpatient care in Essex between 2000 and 2023 and Baroness Lampard added that it will investigate alleged failings on a scale thats deeply shocking.
The cases to be investigated will include people who died within three months of discharge, and those who died as inpatients receiving NHS-funded care in the independent sector.
Baroness Kate Lampard CBE (pictured) said as she opened the Lampard Inquiry that we may never have a definitive number of deaths put forward within the inquirys remit
Family members of those lost after receiving treatment for mental health concerns hold up pictures during a protest outside the Lampard Inquiry at Chelmsford Civic Centre before the start of the hearings into the deaths of mental health inpatients in Essex
A number of bereaved parents and families gathered outside the inquiry venue in Chelmsford on Monday, laying placards on the pavement with photos of loved ones who had died.
Among the banners on display was one saying We will not be silenced, another read We demand truth justice accountability change and a third stated: Failed by Essex mental health services.
Why is there an inquiry into Essex mental health services?
The mothers of two men aged 20 who died at the Linden Centre in Chelmsford first called for an inquiry.
One of them was Ben Morris, who was found dead in 2008 after telling his mother Lisa that he wanted to leave the facility, the BBC reports.
The second one was Melanie Leahys son Matthew, who died in 2012, just days after he reported being raped.
The Care Quality Commission also raised concerns regarding the safety of the wards and staffing from 2014 to 2018 - but its recommendations were not acted on.
This was followed by a corporate manslaughter probe over the death of 25 patients in nine mental health units launched by Essex Police in 2017.
In 2019, a report by the Parliamentary and Health Service Ombudsman into Ben Morris and Matthew Leahys deaths said there was a systemic failure to tackle repeated and criticals failings over an unacceptable period of time.
But in 2020, Melanie Leahy and the families of 24 other patients who died in the Essex mental health wards set up a petition for an independent inquiry into the deaths, resulting in a debate in Parliament, with then-health minister Nadine Dorries confirming in 2021 that an inquiry would be held.
Melanie Leahy and her son Matthew
In 2023, a Channel 4 Dispatches report showed staff sleeping on wards while they were supposed to watch over patients.
Since Ms Dorries first confirmed an inquiry would be held, it was given full legal powers to compel witnesses to give evidence.
More and more deaths were included in the inquiry due to ongoing concerns over the service in the Essex wards.
Some bereaved parents had indicated that they would protest outside the venue because they had been refused core participant status in the inquiry, a special status which grants participatory rights including being able to suggest lines of questioning via counsel to the inquiry.
The Essex Mental Health Independent Inquiry was established in 2021 without statutory status.
It was upgraded to a statutory footing last year, which means it has legal powers to compel witnesses to give evidence.
Opening the inquiry on Monday, Baroness Lampard said hearings will be investigating matters of the gravest concern and significance.
She extended her deepest sympathy to the loved ones of those who have died, and held a minutes silence as a mark of respect.
Each death represents a tragedy, she said, and praised the courage, resilience and strength the families have demonstrated in some of these most tragic circumstances, including bringing to light some of the issues.
Without their dedicated and tireless campaigning its unlikely we would be here today, Baroness Lampard said.
Nicholas Griffin KC, counsel to the inquiry, said evidence will be heard throughout 2025 and into 2026.
He said commemorative evidence from families and friends of those who died will be heard next week, with further virtual hearings for more commemorative statements from November 25 to December 5.
Mr Griffin said it was thought important that an inquiry with an Essex focus should hold its opening hearings in Essex.
But he said organisers were aware of the sensitivities of a number of locations in this county, which includes places that people took their life.
He said that, with this in mind, a neutral venue in London had been identified for hearings next year.
He said that Arundel House, near Temple underground station, also had trauma-informed space... allowing access to emotional support.
Steven Snowden KC, for law firm Hodge Jones & Allen which is representing 52 core participants in the inquiry, raised an article published in The Daily Telegraph before the inquiry on Monday.
The article includes details of leaked WhatsApp messages from Ms Dorries, including an alleged exchange with then-health secretary Matt Hancock in November 2020.
In the messages, Ms Dorries wrote that she was picking off families whose relatives had died as a way to ensure a full public inquiry into suspicious deaths was not launched, the inquiry heard.
Mr Snowden told the inquiry on Monday: What she (Nadine Dorries) did, we say, is a classic example of cover-up. Campaigners being actively undermined. A divide and conquer strategy when all those families sought was the truth.
He continued: We may make a formal request in due course that Nadine Dorries and Matt Hancock be called to give evidence but thats a matter for another day.
Family members of those lost after receiving treatment for mental health concerns hold up pictures during a protest outside the Lampard Inquiry
Lisa Morris, the mother of Ben Morris, who was found hanged in his room at the Linden Centre mental health facility in Chelmsford, outside the Lampard Inquiry at Chelmsford Civic Centre before the start of the hearings into the deaths of mental health inpatients in Essex
Melanie Leahy, whose 20-year-old son, Matthew, died in November 2012 while a patient at the Linden Centre mental health facility in Chelmsford, with a picture of him outside the Lampard Inquiry at Chelmsford Civic Centre before the start of the hearings into the deaths of mental health inpatients in Essex
Speaking on the first day of the inquiry, Mr Snowden said some patients in the care of NHS trusts in Essex were traumatised, or re-traumatised, by ill-treatment and abuse and some suffered avoidable injury, whilst on an NHS ward.
What is more, it happened time and again, he said. Every time it happened, there was an opportunity to prevent further death and ill-treatment.
But lessons were not learned, practices did not change, poor decisions were repeated, the tragedies continued, and continue to this day.
Priya Singh, a partner at Hodge Jones & Allen which represents more than 120 victims and families at the Lampard Inquiry, said: It has been shocking to hear that the inquiry is expecting to uncover many more deaths.
There is no time to wait, people are still dying, not just in Essex, but potentially, nationally.
Weve heard encouraging sounds today, but the families have fought too hard and for too long to get this inquiry and will hold the inquiry team to account every step of the way.
In turn, the inquiry team must demonstrate its trustworthiness and capability to deliver meaningful change to our clients. Nothing less will do.
Today must mark the start of the families finally being treated with the dignity and respect that was so lacking in their loved ones care.
For confidential support call the Samaritans on 116123 or visit a local Samaritans branch, see www.samaritans.org for details.