M ental I llness C oncerns A ll	Wayne H, from a family of three boys and one girl, had an untroubled schooling , without getting to any useful academic qualifications. He found work as an apprentice carpenter, but left because there was no learning. He then took up labouring jobs, generally living at home with his mother. In his early twenties he became mixed in with community drug trafficking. Around the same time he developed a mental illness, the same as schizophrenia. Because of drug abuse, some professionals took it to be entirely drug maintained, and that it would disappear if cannabis was not used. It may have been that some believed that drugs could cause illness identical to schizophrenia which would then continue even if the drugs were avoided. His first contact with mental health services came after an arrest for possessing a firearm, a gun which had previously been used - not by WH - for attempted murder. On bail he became increasingly odd. His family doctor correctly saw mental illness as an explanation for odd beliefs - his buttock was turning into a vagina. Seen at the local Teaching Hospital by a doctor in training he became verbally aggressive and anxious, expressing ideas of influence during the interview. He was detained and sedated under common law of necessity, and later on following a recommendation by a senior hospital psychiatrist in training, further detained under the assessment and Observation Order (sec.2) of the 1983 Mental Health Act. The second regulatory request - whether there is risk - being ticked. He was treated with a sedative phenothiazine. Schizophrenia was established as the diagnosis. He never settled into a cooperative patienthood, and was transferred to the local catchment area mental hospital which had better security options, although they were not often available. That hospital developed no idea of his dangerousness. No risk assessment was ever formally made, nor any record of his community habits. His married sister knew of his very risky life style and history. His condition in hospital often showed no obvious illness, and he got leave at home , after one week in hospital, because of this, approved by a junior doctor - not his ward doctor - who would not have been within team authorisation. He failed to return. He was later seen with another pistol which he fired at a night club. Two days later, the local Police brought him back in handcuffs, clearly mentally ill. The Inquiry notes this as the critical point - a Treatment Order - detaining for six months - could and should have been applied. His detaining Observation Hospital Order ran out of its twenty-eight days time, and he was discharged from the hospital 'books', without a collective team response to further review. Very little was done to make contact. Contact was then lost for six weeks. He was never at any one address,and was not reported in. That had not been allowed for. Over the Xmas period he attacked and injured two people, and killed two others. After transfer to a special hospital, it was observed that cannabis provoked active schizophrenic symptoms. Without cannabis when medication was withheld he relapsed into schizophrenia. With medication his illness was responsive and manageable. The Inquiry report took five years to come to publication. Not fully explained, but WH was slow to give consent to letting his documents be examined. Home Page Inquiry List Reviewed	E-mail reaction is welcome mica@didgy.freeserve.co.uk