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The treatment care of his schizophrenia illness spreads over six years - since he was twenty one years of age . At the time it began he had just served a prison sentence for grievous bodily harm to a girl friend . His illness had broken up the life of his family before that . Since seventeen years of age his family had to bear with him.
" Martin shared a bedroom with his younger brother , and was regularly leaving death threats on his bed , such as "I am going to kill you". The relationship deteriorated to such an extent that the younger brother asked the grandfather - a bricklayer - to build a wall to partition off his part."
His brother left the family home because of the behaviour of MM .
MM would stay out all night and sleep all day. He told his mother 'he would stay up all night thinking of killing both his mother and her husband whilst they were asleep'.
MM had never reached steady independent living in the metropolis . He comes into the psychiatric care of five different Consultant Psychiatrists, all of whom except the last used Sections of the Mental Health Act to admit and detain him on five occasions when he broke down out of hospital.
The admission wards for his catchment area are usually over 100% occupied. The Inquiry reports some in-patients saying they were reluctant ot go home on leave in case their bed was no longer available to them for return.
During his last care he agrees to informal admission, but declines a depot regime, and is hardly compliant or cooperative, or cleared from his illness, but was never deatined.
Early in the illness he claimed, was eventually given, his own accomodation , but was never up to looking after it or himself, or realising a settled life. His tenancy was withdrawn after his accomodation was vandalised whilst he was in hospital.
He used cannabis from time to time. After his conviction he said he had used heroin over the previous six years.
Visits from the Mental Health Act Commission to the hospital service in the area result in adverse criticism of after-care arrangements for the catchment area, and especially the working together of social service and health.
He was never reliable with maintenance medication but responsive to it when taken regularly , and when in hospital. He rejects injection depot regimes. His mother remained his last port of resort when things go out of his control. He hit her badly on occasion. At one stage the Social Service worker suggested that the mother initiate Mental Health Act Section proceedings . His mother is strongly critical of the later social service work, especially their tardy reaction to his loss of abodes, and to her reports that he was actively ill. She went on believing a professional service could and should be able to do something. He never settles to accommodation. None is found which suits him or enables steady support to be found for him, and a weekly routine.
In the last year he is in a bed and breakfast social service system , out of contact with any professional service.
His mother sees him in the street and invites him to stay and have a meal. She checks with the social services that this is alright, and is told to call the police if worried.
The home visit develops badly.
The mother is stabbed, and her male companion killed .
Three days before the tragedy, a prospective tenancy becomes available for him. At the time he is not on medication and is ill.
The Inquiry comments .... ' loose structures of inadequate integration of separate services and meagre distribution of professional expertise appeared to have been sanctioned by Government in carrying out a new policy without adequate preparation and resourcing .'
Review Chapman; Mursell
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