This Inquiry report was 'tried out' by a MIND representative - as the perpetrator - D.Ph. - had felt the consequences of learning difficulties all his life.His parents separated when D.Ph. was aged nine and he had no further contact with his father. After he left school with no academic qualifications, he secured regular employment as a lifeguard but, after failing to requalify, was then continued as a cleaner. He took up an interest in self defense.
He met a fellow student at a College for Further Education.
She later became a live in carer for the eventual victim who suffered from arthritis, and was doing that when she and D.Ph married, D.Ph. moving in to the house.
After his feeling of 'demotion' at work D.Ph. developed thoughts of people trying to harm him and that his wife might be poisoning him.
The eventual victim reported to the police that D.Ph. had Flash videos and a fetish with knives.
A policeman called, thought it a mental illness problem and made it a health matter for the family doctor.
The family doctor prescribed anti-depressant medication but also called in a Consultant Psychiatrist the next day. By coincidence a different policeman, who had been involved with D.Ph.and his car mismanagement the previous day, also called. The interview went on with the wife giving most of the observations of illness behaviour. D.Ph. said little but looked agitated.
He was persuaded to go into hospital - as an informal patient , pressed by the others to do so.
The eventual victim did not take part.
Initial resistance to the notion of illness and accepting being a patient meant there was no cooperation or compliance with medication, and the informal staus was changed to a MHAct Observation Order which ran for it's full month detention.
The illness subsided and D.Ph. became cooperative and attentive. He accepted medication as being helpful. His Observation Order lapsed and he was discharged .
Ward meetings did not see any reason for community follow-up. He returned to work, and to out-patient review by the Consultant Psychiatrist. Some weeks later he behaved erratically and stopped from confiding with his wife or the care victim.
Seen by a substitute oncall 'out of hours' service, that General practitioner saw no immediacy and left a note for the family doctor.
Reviewed by him, the oral medication - an effective phenothiazine - was increased but there was none of the expected recovery, no return to his ordinary and predictable normal behaviour at home, and further grounds for concern that his illness was a continuing and disturbing influence. On both interviews with the General Practitioners D.Ph. had not shown enough illness to cause them alarm or point to a more urgent response.
An out-patient appointment was due, but had to be postponed for a week at the last moment.
Before that time D.Ph had manhandled the care victim 'Dad' and sat across him till he lost consciousness, and he later died in hospital.
Review
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