MM was born in Pakistan brought up in Islamic culture and tradition. A first arranged marriage breaks down, the husband taking custody of their son when he divorces her and he marries again. M says he was aggressive, unsympathetic, abusive, disparaging and critical of her. She marries again to an Englishman. He had enjoyed a long visit to Pakistan and its culture impressed him. He converted to Islam, following a Sufi style of belief. They returned to England. . She speaks Urdu; and later some English, better at understanding than expressing herself in that language; he likewise understand Urdu without speaking it comfortably. The family language is mostly Urdu. They have three children. He works as a teacher to special needs. Where they live is mostly in a Bangladeshi community. MM feels socially isolated, without significant friends. She develops a level of conviction that she must help out the poor, as part of her religious conviction, but this goes outside a normal obligation, and the commitment in detail, together with the neglect of her household and parenteral responsibilities, indicates mental illness, of a nature most like schizophrenia, with depression. It is never clearly defined, nor consistently addressed in terms of relevant medication at a degree of efficacy. MM does not accept that she is ill, and it is unlikely that she ever maintains medication effectively. She is admitted to an inpatient Unit, both informally and on a section of the Mental Health Act, and is supported after dischargeby regular contact with a care co-ordinator. She does not really engage with this. She never achieves what she could accept as a settled part of belonging, in either domestic or community living. She attends a mosque, regularly, but her husband does not. They are not clear about how the children should regard their religion. Her strong beliefs lead to her failing to look out for her children properly. She is often outside the home, and looking for and bringing home poor people before considering the needs of domesticity. Her husband struggles to compensate for what is missing in the home. But clashes and disagreements continue, and recriminations arise. The fact of her illness and what it means in ordinary living terms is not made clear to the family, nor does it seem the help given there is realistic about that. MM never achieves a continuous period of normal living. On one occasion she visits a sheik Mohammed Hanard in Switzerland. It is seemingly he who stabs the husband to death in her presence. He goes to jail; she is assessed as mentally ill, is moved to a Secure Hospital and later to a local medium secure Unit, where she continues to be unhappy, and does not recognise that she has been mentally ill, and that this has accounted for the difficulties she has faced. The mental Health system in the area is not functioning as it should. The consultant is singled out for adverse criticism. The family doctor is praised. There is no real evidence of team working, of co-ordinated effort, or of appropriate supervision within the local system. The various parts have become separated and hopelessly uncommuncable. list of Inquiries Home Page

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