M ental I llness C oncerns A ll	The victim was a police officer , called to the house . There was no trial because the illness prevented McF taking part . This limited the extent of the Inquiry , because a trial could resume when McF is fit to appear . This Inquiry, in Scotland where the administration is different, was able to take advantage of reading the Ritchie-Clunis and Cooper-Robinson Reports when preparing their own . McF was managed comprehensibly by the adolescent hospital service from the age of fourteen through till eighteen. A firm diagnosis of schizophrenia was made and a depot medication procedure instigated and maintained by the adolescent service community nurse , rather than by the family doctor practice . It is not clear from the Report how much the General Medical Practitioner ( GP ) Service was involved directly in those years . A Practice consultant nurse working at the General Practitioner surgery practice was active in support, and saw the family when he was managed by the Child psychiatry services . McF. was not under any compulsion , other than that felt by a boy of that age range. Schooling was disrupted, by his illness management, and by his attitude, and by family obligation in Ireland. He was taken up with peer group late teen behaviour and was able to use street drugs . His father was away often, and eventually split from the marriage. When McF was 16, one of the two elder brothers was killed in an accident, leaving one elder brother and two sisters . At the age of eighteen a psychiatric service is taken on by Adult services . He did not agree to a direct transfer to the adult service at eighteen , and refused introduction to that service, ending it when the Community Mental health nurse of the adolescent mental health service, and the Practice consultant nurse, could not persuade the boy to continue depot treatment . Neither the mother, nor the family practice, made any contact with the adult mental health services to get them involved. The carer was not visited or supported in her own right , even though someone with untreated schizophrenia was living at home. It is not clear that she had any early warning advice. Nor is there any sign that the family doctor service were much involved with the family before his final breakdown. D McF attended the surgery for sick notice renewals and saw a locum family doctor and the practitioner nurse who knew him during his illlness at the surgery. He seemed well enough. There were two incidents with the police one of which resulted in a charge to come to Court, which , because his sister informed the police at the time that her brother had been mentally ill, usually would have led to psychiatric examination and report, but this was not pursued. McF attended the family doctor surgery twice, and met a locum doctor; was thought to be alright, renewed his medical certificates, and talked with the Practitioner nurse. Three weeks before the incident a fire in their house - unexplained - obliged the family to move house and district, and be temporarily rehoused at a new address in the Gorbals . There were premonitory signs of illness over two months , but no contact for support until the day of the incident, when the family were frightened by the behaviour of McF, who had a kitchen knife , and was threatening to use it on his remaining brother. His mother tried to contact the surgery in mid-morning, but neither the family doctor on duty there , nor the consultant nurse who was seeing clients, were made aware of the call by the Receptionists . The story the mother told Receptionists was not persuasive. She had asked to speak to the family doctor and then the practitioner nurse, but without, it seems, making clear the emergency behind her plea. She was not told the Practitioner nurse ( the one who knew the illness history of McF and the family ) was in the surgery . She turned to her old contact with the Adolescent Service consultant, spoke to a substitute doctor , who rang the Surgery with the information he had been given, but did not speak directly with a doctor. The practice manager , early afternoon , then spoke to the police , who expected a doctor to be available. The manager then spoke to a different partner in the family practice, who said he expected the police to intervene first, and deal with the dangerous situation, so that the doctor could then examine, and decide what could be done . In mid-afternoon, a policeman who went to the house, was the victim . Because the potential for a trial remains, the Inquiry could not ask for police evidence . Social services were involved with the family, at the time of school attendance , but only because of absenteeism. Between the discharge from the Adolescence Mental Health Services and the final event, there is no indication that there was any contact with the Adult Mental Health Service, other than on the day of the tragedy. Review McFadden Home Page	E-mail reaction is welcome mica@didgy.freeserve.co.uk