M ental I llness C oncerns A ll	This is a second marriage for Smart. There are two children. His wife has a son from before mostly living with her parents, nearby. She has two inpatient episodes of manic-depressive illness. During the last one - under a compulsory Treatment Order following her omission of medication it resulted in her leaping out if a window and damaging her ankle - Smart is the home carer for two months. She continues contact with community mental health nurses. He has convictions for drink driving. He is able to maintain work as a driver on private sites, and often works long hours. Both he and his partner are believed to have drink as a problem and two years before the final event both were invited to consider referral to the specialist alcohol abuse service, and both declined. Smart also disliked the thought of being seen attending the mental health centre. He has also been involved with assault and there have been many 'domestics' in this 'off and on' marriage - the police notifying the Local Authority family Social Service section on several occasions because there are children likely to be affected. He finally comes to court for a drink/driving offence, loses his licence, and as a consequnce is under a Probation Order and has to attend a Drink/Drive information course which the Probation people run. His wife reports him to the police as drunk and that this is likely to follow with domestic upsets, and then invites the family doctor to call. Her reaction leads a fortnight later to a family Social service worker calling again, and noting the wife to be 'joking and laughing quite a lot',pehaps a pointer to Hypomanic return? It leads also to 'a declaration of stress and a referral from the family doctor' to the local catchment mental health team. The referral is accepted by the community mental health nurse who then sees him and altogether sees him three times in the final month before the event. In a first letter the nurse refers the family doctor to information from Smart of a hanging attempt by Smart, days earlier, at his father's farm which failed because a structure broke. ( To the Inquiry the farm family knew nothing of it and thought it unlikely ) There is no reference to the community nurse discussing the matter with anybody else in the team. A community nurse, in adifferent team, who is seeing the wife separately, does note the referral of Smart to her team consultant psychiatrist - but that Consultant does not get the note - the records are somewhere else. It is not made clear who would have been the clinical supervisor for Smart. In the final fortnight both Smart and the wife miss appointments - the wife with her Consultant psychiatrist, Smart with his community nurse. The Consultant will not have heard anything recent about Smart. There is no 'check out' home visit This Inquiry Section ends - quotes:- 'On 17th April ( the nurse) writes to the family doctor " I have now seen Richard on three occasions on a weekly basis. The emotional crisis seems to have blown over, and accordingly Richard failed to turn up for the fourth session. I have offered another appointment on 3 may and will let you know how things are then." On 18 April the police are called to the house at about 9.30pm, following which Smart was arrested for the murder of Donna.   Comment Home Page         E-mail reaction is welcome mica@didgy.freeserve.co.uk