I llness

C oncerns

A ll

RV. had an established diagnosis of schizophrenia . He and his mother lived together for twenty years . Educated to degree status , his illness prevented his qualification . All subsequent employment foundered .

The diagnosis took some time to become confidently established but for the final two years RV was stabilised on a depot injection regime.
Earlier attempts at depot injections were implemented after a fortnight admission to the mental hospital which served the catchment area in which RV and his mother were living. The initial response to depot medication was lost when RV refused the injections. Five months later he was readmitted . Subsequent medication was by oral tablets, mixed in category, with a basis of medication for schizophrenia but with other preparations he juggled with himself. Response was variable but the unchallenging home situation allowed him to get by with residual symptoms, with a lack of personal initiative and a lack of personal care continuing.
He drank alcohol a lot and there were often angry exchanges with his mother.

The Inquiry notes. He got the benefits, she got the obligations.

Two years before the tragedy, he was re-established on regular monthly depot injections, with a more stable level of conduct. The dosage was increased later after a temporary return of illnes, unexplained, and some stability or regularity , resumed.
During the five final years RV was encouraged, pressed, to seek alternative accommodation, and tried hard himself to get on different waiting lists for housing, without success in gaining priority, and without any assistance from social work or the psychiatric professional support .

He was visited by professional staff, social workers, and at one time an occupational therapist, who could not follow up with access to any programme of outside activity that would givethm both a beak away from each other. He was always reluctant to be anywhere if he was to be liable to be kept waiting. In fact he was dependent upon the tolerance and conscientious attention to house and meal maintenance that his mother kept up with until the last year.

His mother tried to join a self-help National Schizophrenia Fellowship ( NSF ) carer support group, but gave this up when RV angrily cross-questioned her on her return home.
There was no independent support for the mother, except for visits from her married daughter , which RV resented . His mother eventually felt the strain too wearing, and added her wish that he leave home. A plan to achieve this was set u. RV would be invited to admit himself to the hospital to review his medication and he would then be resettled in other accommodation . His last injection was given on the day before the admission was to take place and the tragedy occurred that day.

Review H; RV