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The event behind this report is a road stabbing of a stranger, in March 2000 , in Leicester just an hour before an eclipse of the sun was expected. Kevin Hewett ( KH ), born 17/3/68, was the only black boy in his school to achieve the top set and get three CES's. - the basic standard . He was subject to some racial abuse and after he retaliated on one occasion the police were called to intervene.When seventeen there was an incident in a shopping mall when he reacted by slapping someone with whom, unsuccesfully, he had tried to talk. There are two elder sisters now with their own families. Aged eighteen the family brought about his referral to the psychiatric service, and he was subsequently detained for Observation, and treated at discharge with chlorpromazine to proceed to Out Patient attendance. His behaviour at home was 'over the top' and he confessed to daily use of 'ganja'.The hospital discharge diagnosis was between drug induced psychosis or an affective illness - hypomania. He soon stopped his medication and then discontiued his Out-patient contact six months after discharge. KW lived with his mother after his father died in 1992 Following school years there was a three year period of relative stability. He obtained a City & Guild qualification in motor vehicle engineering,and worked in garages , and then casual jobs. From 1994 , from aged twenty-six onwards there was continual disturbance and contiuous contact with Leicestershire Health Trust provision. He later explained that he had felt persecuted since 1991 - aged twenty-three. He took an overdose in january 1993 of GP non-specific anti-depressant medication the depression being put down to his father having died in temporary accomodation rather than at home, and to difficulties at an engineering Course at a local college. He felt forced to leave the area and travel to Nottingham and Manchester to escape the feelings. He thus escaped police proceedings. In 1994 ( aged twenty-six ) he visited someone intending to stab them but they being not there things developed so that he stabbed the girl friend, taken into custody, then was assessed at a local Medium Secure Unit, diagnosed as suffering from schizophrenia, but eventually sentenced to two years probation supervision with condition of psychiatric care. He continued under the psychiatric after care of the Unit. He relapsed once or twice so that a final Court appearance was delayed and eventually the charge reduced. He may not take oral medication. Finally a depot injection regime was established and he was discharged to a Local authority Hostel which took in people who had mental illness. There was no pre-discharge Care programme approach type preparation, although the victim had been seen and reassured of his continuous supervision. The Inquiry is critical of the disposal. A Hospital Order with Restriction would have suited this serious offence. But the probation period was completed without any trouble. Soon after its end he began to ask for the medication to be stopped, pleading excessive weight gain at one stage. The Consultant eventually agreed - he would not accept depot any longer and we could not insist - and substituted a small dosage of a phenothiazine. This was further reduced by a new Gp who did not consult with the Consultant. |
The uncertain lability continues and a Section admission is contemplated but the nearest relative - his mother - refuses. She is displaced as nearest relative and a Treatment Section is applied. Subsequent months sees an irritable weakening of the relationship between KH and his health helpers and between them and the family members. The working diagnosis is now hypomania. He is noticed to have restless movements on the depot regime and later develops the uncommon side-effect of breast enlargement sufficient to think about surgery. He remains under supervision and stays that way for three years, having frequent leave and eventually reinstating himself in a flat locally. Sometimes the family doctor has to wait weeks for a letter of release - a comment recalling a similar comment at a previous Leicestershire Inquiry ( Paul Hundleby ). In the final years there are comments about his sensitivity and suspicion. On one occasion clear paranoia is noted by the housing assessor, but he tells her not to reveal it to the team , and she accepts that - being bound by the department rules on confidentiality.At the same time the Social worker is asked by KH about moving out of the District. KW misses two depot appointments with the family doctor but this is not registered with all the team. Four months later - two months before the final tragedy - at a routine appointment with the Consultant KH says he has not had depot injections for six months. He seems alright at interview. The Consultant speaks to his Defence Society for advice about his position. The Consultant writes to the family doctor a letter pointing up the problem of keeping in touch with KH if he relapses slowly as was the previous presentation. He suggests that the family doctor is better placed to keep some contact as the Consultant is likely to be rejected by KH. The Social worker assumes that all this means that the family doctor is the case coordinator now, but the family doctor decides he will have to approach KW about that first of all and sends an appointment letter which receives no response. The month before the event sees a number of incidents of unusual request from KH - he asked DSS Benefits that his money be stopped because he was well and not entitled - this was relayed to the socuial worker who felt he would be becoming unwell again - he went the hospital adminstration asking to see his medical records, his demeanour frightening the staff there but without them informing the team - and calling at the Police station to complain that hospital staff were following him about - which was also not brought to the attention of the team or family doctor. His demeanour also disturbed his married sister, but again that did not get to the team. A last monthly team meeting discussed the problems - advice was sought from the Medical Records Department about any advantageous powers from the section 117 supervision Order but the Consultant was informed there were no significant powers. There was a proposal to put the name of KW forward on a Public protection register the next month.The social worker would see the sister, the Consultant be in touch again to the family doctor. KH does see the family doctor twice on the basis of a physical complaint without there being any significant dsiplay of signsof mental illness, and this is agreed on discussion with the Consultant. Two days later the offence occurs. His sister has noted a wild demeanour the night before but the address the Social worker has is not the one where she is living. KWHturns up at a general hospital complaining of sleeplessness and overactivity, but does not remain to be seen again. Later that morning KH stabs the people in the street without any warning or provocation. His explanation will be that with the end of the world at hand he was defending himself.
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