M ental I llness C oncerns A ll	Draft Darren Rogers was seen by the family doctor, together with his parents, because of his experience with helplessness and depression during the previous month, during a difficult time in relationships with his current partner, with long hours at work often away, culminating in an irritable row there, after which the girl friend departed, and Rogers took 16 distalgesic tablets and phoned his mother. He was seen at the local Accident & Emergency Department, kept overnight, and a letter of notification went to the local A & E self harm team. Rogers discharged himself before being seen by them, but the team may have telephoned the parents. The family knew he did have times of depression and anger in the past. At the age of seventeen he had attended a local A&E Department having then taken an overdose on two occasions when disappointed in a relationship. The family doctor referred him to the local community mental health team, and prescribed Prozac. Rogers now aged twenty-four, was given one assessment contact with a community mental health team member Community Psychiatric Nurse ( CPN ), who had since left that employment, and who declined to attend the Inquiry Panel. Her supervisor at the time had also left his appointment, and similarly declined to attend. The assessment nurse was acompanied by a colleague, because, in checking prior to making a visit at home - as Rogers would not leave there at the time, the assessment nurse had received a warning from a deliberate self harm team, who were the first call at an A&E service, and although not having seen Rogers, at the time of two o.d and self harm attendances earlier that month, it seems had some knowledge about Rogers. The assesment by the visiting CPN, and a holding plan, was discussed at the team meeting the next day in terms of :- re-contact , crisis intervention, Citizen Advice Bureau re housing; and referral to a voluntary Organisation again about housing, and for support. The colleague companion at the time described Rogers as controlled and polite. It is not reported whether Rogers expressed satisfaction and agreement with the advice offered. The Team meeting - which had social workers in the team, but were without for that meeting their consultant clinical lead, requested a Social Services referral, but was told he did not meet their eligibility criteria. Instead the Social srvices manager gave advice to the community nurse. The father of Rogers rang to the team to complain angrily about the outcome of Rogers being seen at the voluntary organisation. The community nurse closed the contact. A month after that episode, Rogers attended the same A&E department having made a cut on his hand with a Stanley knife He again did not see th self harm team. Six weeks later he stabbed and killed his woman partner. The Panel were invited to hear from Rogers after his sentence. He said he would liked to have had a 'diplomatic sort of counselling talk at the time he made the contact rather than be given advice and been sent away. His experience of that was negative. He thought the family doctor should have been aware of the possible side-effects of Prozac on impulse and anger. He felt resentment at being classed as needing a mental health service - and his reaction was .. not me i'm not mental - bye bye... close the door. The Inquiry found the Internal Inquiry not rigorous and rather inclined to criticise other services than learn benefit for it's own. comment E-mail reaction is welcome mica@didgy.freeserve.co.uk