Who was in Charge?

 

 

 

 

 

 

 

 

 

 

 M

I

C

A

 

DW. had an unsettled childhood. Aged five his parents separated. He had one sister and there were stepbrothers and stepsisters.The Report says little about them or the stepfather. The mother is the important figure.

Aged 9 he is referred for headaches. He was noted to be glue sniffing. He leaves school without qualifications, entering a youth training scheme and then to short term manual work. From aged fifteen he is known to be using street drugs - amphetamine, cannabis, and later ecstacy and heroin.

Aged seventeen, he sees his family dictor for 'lethargy' and 'head banging' is noted . He is referred to a psychiatric out-patient but does not go.

Aged eighteen he is found a Council flat - oddly - because nobody thinks he will manage to be independent, or be able to look after his money. The family help him move in. At the same time his mother moves elsewhere locally - and does not tell him where. He finds out where and attends thrice daily for meals. He fails to manage himself.

He stands out in bizarre dress - German and Canadian soldier clothes, sometimes wearing satin shorts over his shell trousers.

A year later he is before the Court - for trespassing with an offensive weapon - not described; and again a year later is before the Court - for carrying an offensive weapon in public, and for trespassing, as above. He is given a conditional discharge and then an eighty hour community service. His family doctor notes at this time he is over-sensitive, panics, and is unhappy. He is referred to the community mental health nurse Service but cannot be found.

Later that year his mother contacts the Service directly. She is frightened about the behaviour and attitude of her son - he is wild sometimes , will kill himself or her. The family doctor notes ... paranoid, hearing voices, and has a distorted feeling of self. In a domiciliary second opinion the psychiatrist sees him as an abnormal personality , anti-social with drug misuse. An anti-psychotic medication is prescribed, and a follow-up appointment sent which is not taken. There is no community follow up.

Two years later his mother reports to the family doctor - he is grimacing, and talking to himself, has mood swings, is obsessively clean, talks of bizarre idas, leaves gas and pans unattended, and believes his mother can read his thoughts.
The psychiatrist calls twice, a CPN several times - but he is never there.

Later in the year he is in police custody for altering prescriptions to obtain anabolic drugs and for striking his mother, is assessed there and diverted to hospital mental health services.

The first hospital admission.

On the way the police call at his house and remove weapons - large pieces of wood, an ice pick and a large metal hook. A urine sample is weakly +ve for cannabis - nothing else.The consultant diagnoses schizophrenia.

The Probation Officer to the Court calls a 'Potentially Dangerous Offender' meeting attended by the police , probation , and social services. Health does not attend.

The meeting concludes ... a manipulative fantasy of killing people, a threat to mother and to staff especialy women - advised mother has a 'panic alarm'. He is to stay on the Potentially Dangerous Offender Register. The Consultant psychiatrist, family doctor, and ward manager are informed. Police and mother to be informed if he is off ward.

He is placed on the Supervision Register - the ASW to lead - and a month later he is discharged.

He did not accept that he was ill. He would not medicate.

Three months later he is re-admitted on a Mental Health Act Section 2 - an observation Order covering twenty-eight days detention.That ends, and he discharges himself against advice

Another ' Potentially Dangerous Offender' meeting takes place and it is decided that DW will be 'charged' if he ever offends again - ( a Court Mental Health Act Order would then be an option ] - and he will not again be diverted again before that.

top

 

Two months later he admits himself to the hospital -to step back from a fight altercation. He is in a German uniform ..' it is german that should be spoken'. He discharges himself the next day. A Community Mental Health nurse and Social Worker are attached to his case and he continues on the Supervision Register.

Because the 'community' rejects him he is found a place in a Local Authority Social Services Hostel for severe mental illness.

He does not accept the diagnosis of schizophrenia. He has a rental debt of 650£ to repay. Three bicycles soon go missing.

He acknowledges he has a heroin habit perhaps smoking 1Gm. daily.
He is still seeing the Consultant at out-patients.

He sometimes leaves the Hostel impulsively without any realistic preparation.

One year later his Consultant notes that he has not been taking his medication for six months.

He expresses a wish to live independently - despite increased arrears from before and from his sojourn in Warren Court. He is accepted by a housing association, but before any place is found he is readmitted - this time on a Section 3 MHAct Treatment Order allowing a year detention for treatment.

He is soon granted leave to and from the Local Authority Hostel - Warren Court - who maintain he is too ill for them. The ward opinon disagrees and he is discharged without any prior warning to Warren Court, although they had asked for a prior meeting.

The CPA coordinator is not made aware of the move.

The first CPA review meeting finds many difficulties at Warren Court. He then readmits himself to a different ward - frightened and paranoid, drinking alcohol.
In three weeks is discharged back to Warren Court to be seen by the team social worker fortnightly. Many incidents of uncertainty continue. He says on one occasion he has injected air into his veins. He is angry towards his consultant. He does not accept medication. He accepts, then refuses, a depot regime. He is carrying a knife.

In August 1998 Warren Court have had enough. They are frightened of assaults and want him out ...

The consultant admits him under a social admission heading - mainly an accomodation problem. He has arrears of 1,200£. He tests positive for amphetamine.

With no alternative available, he is returned to Warren Court. His mother is advised not to enter his room to clean - too many needles. He purchases and keeps in his room a set of chef kitchen knives. Warren Court staff are warned to approach in pairs. Warren Court want him out and tell the consultant so. The social worker says he will not survive. Night staff are told not to see him on their own, not to approach and not to hold conversation. DW asks whether it is appropriate to carry a knife . Later kitchen knives are missing from the kitchen. Eight residents sign a letter wanting an immediate end. The consultant records 'not ill'. Some days later a CPA review is called - he has been told to quit Warren Court - attended by everybody except his team social worker - the care coordinator. Senior staff from the LA Social Services are present. DW is accompanied by a Richmond Fellowship advocate. Attitudes are polarised - it is Warren Court against Health .

He is admitted as a problem of suitable accomodation. The ward doctor records abnormalities. He may have his knife. Police hand over the knife. to Priory Unit staff.

A fortnight later someone in the ward objects to his wearing a Nazi uniform, and argues with DW.

A fellow patient - the eventual victim - takes the side of DW.
He is the one later that day stabbed by DW twenty times. He had gone to the room of DW.

mica@didgy.freeserve.co.uk

Back to Inquiry List

Review

Home Page

M ental I llness C oncerns A ll