M ental I llness C oncerns A ll

M ental I llness C oncerns A ll

'A' has 'previous' - that is he has hit out at previous wives, and got into other acts of aggression and violence. His current girl friend of seven years - the eventual victim observes him in depression which carries 'biological features - poor sleep, loss of weight , loss of interest, together with irritability, and anxiety. He also loses his temper. Because of this he has lost the confidnece of colleagues at work and has to give up his job as a lorry driver. He never really recovers a stable position after this. Other things go wrong and add to his worrying and expressions of anger. He consults his General medical Practitioner about this which suggests he saw himself changed and 'ill' His doctor prescribes one of the SSRI drugs, and one or other of these is prescribed subsequently. There is no consistent recovery as the pattern of recovery is expected to come from these prescriptions. When there is no satisfactory response he is referred to the local community mental health team. The initial assessment is by the 'gatekeeper. whose qualification is as an occupational therapist The Report does not say whether the care decisions were discussed at a multi-disciplinary team meeting level, or with any other supervisory mental health professional He does not see a psychiatrist, nor is his case discussed with one. He is passed on to a clinical psychologist and is seen four months later Anger management is discussed over a number of sessions which Mr'A' appreciates and things seem better for a while. It is not clear whether or not 'A' is continuing medication. Other things go wrong and two years later 'A' sees his doctor again, down in mood and wishing to see the psychologist again. SSRI medication starts again. 'A' gets no immediate response and makes several visits with the secondary mental health services - a rapid response contact where he is seen by a social worker in the team, later the same OT as before, passes him on to a counselling service which he does not attend. Soon after he takes an overdose described as a cry for help. His woman partner is very concerned and describes him as very depressed. She has been to the service with him earlier seeing him depressed. She seeks his admission. Seen by a social worker he returns home to be seen the next day by a consultant psychiatrist, who recalls that he offered 'A'admission or a safe house accomodation. 'A' declines but accepts a day hospital attendance failing to keep this first offer , but attending later ,and is seen there by the consultant psychiatrist with colleagues. Medication dosage is increased, and a follow on appointment is made for a fortnight later. It is not kept. 'A' sees his family doctor, still depressed, is thought not to be especially unwell, but to have medication side-effects. The medication dosage is reduced. Ten days later, six months from his second presentation, 'A' visits his girlfriend and strangles her. The circumstances and the trial rsult are not examined Comment back to Inquiry List back to Home Page   E-mail reaction is welcome mica@didgy.freeserve.co.uk