A 'beautiful' mother-of-two who was found hanged said she was 'better off dead' as she waited three years for an ADHD assessment, an inquest has heard.
Bethany Hewitt, 34, was found hanged in Runcorn, Cheshire, on February 22.
Her death came just 19 days after she disclosed she had experienced suicidal ideation and thoughts of hurting herself during a GP appointment on February 3.
She scored a 15/27 on a PHQ9 questionnaire, which is used as a screening tool by healthcare professionals to measure the presence and severity of depression.
Ms Hewitt's result was just one point below what healthcare guidelines say should prompt 'an urgent referral to specialist mental health services'.
She denied any active plans for suicide and the GP did not make plans for a follow-up appointment, her inquest at Cheshire Coroner's Court heard.
Additionally, it was decided Ms Hewitt would not be referred to secondary mental health services or for an urgent Mental Health Act assessment.
At the time of her death, she had not received an ADHD diagnostic assessment despite being first referred for one three years earlier.
Mother-of-two Bethany Hewitt, 34, who was found hanged said she was 'better off dead' as she waited three years for an ADHD assessment, an inquest has heard
Ms Hewitt was first referred to ADHD Service Halton, part of Mersey Care NHS Foundation Trust, by the Primary Care Mental Health Team, on February 16, 2023.
Over a year later, on October 21, 2024, Ms Hewitt spoke to a GP at Grove House Medical Practice in Runcorn, Cheshire, where she was based.
Ms Hewitt was in tears as she told how her symptoms were 'worsening' and she was 'very anxious' and struggling to complete everyday tasks.
The GP made a request for an expedited ADHD assessment on November 6.
Ms Hewitt also began a 25mg dose of the anti-depressant sertraline. She was warned side effects included an 'increased risk of suicidal ideation'.
A follow-up appointment 'was not made despite starting this medication'.
On November 19, a reply from ADHD Service Halton said Ms Hewitt's expedited assessment had been rejected due to 'insufficient evidence'.
However, this reply was not shown to the GP who made the expedited referral nor was it shown to any other GP, leaving Ms Hewitt in limbo.
Ms Hewitt's death came just 19 days after she disclosed she had experienced suicidal ideation and thoughts of hurting herself during a GP appointment on February 3
Sarah Murphy, Assistant Coroner for Cheshire, has now written a Prevention of Future Deaths report to avoid deaths in similar circumstances.
She concluded that it was 'likely' that the long wait for an ADHD assessment and a worsening in perceived symptoms led to a decline in Ms Hewitt's mental health.
The inquest found 'the question of intent' remains unclear.
Ms Murphy said: 'Bethany Hewitt had been waiting for three years for an ADHD diagnostic assessment and had not been assessed at the time of her death.
'I heard evidence that there are no national guidelines in relation to the ADHD referral process or expedited assessments.
'I am concerned that this may result in an inconsistent approach, and that waiting times may vary across the country, with patients not knowing how long they should be expected to wait for a diagnostic assessment.'
The Prevention of Future Deaths report said: 'On February 2, 2026, the Duty Practitioner at the surgery arranged a GP consultation the following day for Ms Hewitt after she had disclosed suicidal ideation on a PHQ9 questionnaire.
'In the questionnaire, Ms Hewitt had reported that for several days over the last two weeks, she had been bothered by thoughts that she would be better off dead, or hurting herself in some way.'
'At the GP consultation on the February 3 2026, Ms Hewitt reported that the reasons for her responses in the questionnaires were the wait for an ADHD assessment and a worsening in perceived ADHD symptoms.
'It was determined that it was not clinically indicated to refer Ms Hewitt to secondary mental health services or for an urgent Mental Health Act assessment. She denied any active plans for suicide.'
The inquest heard ADHD Service Halton receives around 60 expedited requests per month and has about 100 referrals per month.
Up to 1,250 patients are awaiting assessment for ADHD.
Dozens of loved ones shared tributes to Ms Hewitt on a Much Loved page.
One person wrote: 'Beth, you'll be so dearly missed. Your beautiful smile and vibrant energy could light up any room. Taken far too soon.'
Another said: 'RIP Beth, a shining star, always full of fun. Fabulous memories of parties and dance offs at her mum and dad's house. We are all heartbroken for our lovely friends. Sending all our love, sleep tight sweetheart.'
A third wrote: 'We will cherish all of our special memories from family parties, camping and villa holidays. You were the life and soul of the party, dancing all night.
'We've watched you grow from a child into a young beautiful woman.
'May your legacy shine bright forever.'
For confidential support, call Samaritans for free on 116 123, visit samaritans.org or visit https://www.thecalmzone.net/get-support