M ental I llness C oncerns A ll	X is the fourth child of his mother and first husband, in a family of six, four boys and two girls. At the time the first signs of schizophrenia were revealed, X had already been in trouble for car offences and thefts. His mother recognised early pointers to schizophrenia because two other members of the family had this diagnosis and had been in hospital, and were still receiving aftercare. An initial reaction of aggression to a feeling of being spied upon in the street had resulted in the slashing of car tyres. For this offence X was charged, but a second offence overtook any outcome from this incident. The mother was very familiar with the condition, and what was available in its management. Accordingly she made contact with the community mental health team. As a result the Social worker who already knew the family visited and agreed the seriousness of the presentation,and set up a Domiciliary visit by the Hospital consultant psychiatrist. He prescribed medication appropriate for schizophrenia Before any further mental health service contact, X was in remand in prison.' for driving and excess alcohol. Prompt communication from the Social Worker did not get the mental health problems put before the Court,and X received a custodial sentence - which he had already served,and was banned from driving. X gave his mother immediate concern that his mental illness persisted,and that he had been aggressive again in a pub , carried a knife,and there was talk that he had looked for a gun. She told the social worker who arranged a psychiatric review. At the same time the police visited his flat , realising there had been no followup to the street fracas. As a consequnce X was arrested and this time the Court received advice so that X went on to a medium Secure Forensic Unit - the original psychiatrist having stated X was too high a risk for an ordinary admission ward After three months X is moved on to the local mental hospital and there is quickly resettled with his mother,and with aftercare supervision by the Social Worker who had first seen him, and had already known his mother. There is no statutory review of or collective mental health decision in the aftercare. X then moves out of the area where he is living with his mother, into his own flat in another catchment area,and to a different mental health team. Nobody in the team has the hinterland of previous knowledge with the story or with the family. The consultant psychiatrist does not attend multi-disciplinary meetings. The continuity in care lapses,and lead staff supervision arrangements fall away. X loosens his own care and is drinking again and not taking his tablets. The key worker hopes an impending Court appearance will lead to a decisive Order but it does not do so. After drinking and an argument with his elder brother X stabs him fatally. Home Page Comment Roy; a client	E-mail reaction is welcome mica@didgy.freeserve.co.uk