However, they have considerable skill in diagnosing and treating mental illness. The public would be better protected by having a good standard of care for all patients.

Extracts from 'Keeping up to date' DSA = Dave Sheppard Associates Ltd ... www.davesheppard.co.uk monthly issues around mental health law and mental service untoward incidents.

After a Freedom of Information Act request by BBC Three Counties Radio,
it was revealed the trust had poor communication, management and training.

Obih, of Winsdon Road, Luton, denied murdering Pc Henry
but admitted killing him on the grounds of diminished responsibility.
He was found guilty of murder at Luton Crown Court in March.
He was also found guilty of attempting to murder a window cleaner.
Obih, who had been detained in the secure mental hospital in Rampton, Nottinghamshire, since his arrest
was suffering from paranoid schizophrenia at the time of the attack, his defence team said.
The court was told he was diagnosed with the condition in 2005 after suffering problems from abusing alcohol and cannabis.
Three Counties Radio has appealed against the decision by the trust to withhold key information into the case.

The Bedfordshire and Luton Mental Health Partnership Trust said it had a serious duty
to obtain a balance between public openness and patient confidentiality.
It added in a statement: "The Trust extends its deepest sympathies to people affected by the tragic events in Luton Town Centre two years ago.
The Trust is now under new interim management and many major improvements are being made to services across the organisation.
The Trust is co-operating fully with the East of England Strategic Health Authority's independent investigation of the events which took place in 2007."

" Since Zito was killed, there have been 400 official homicide inquiry reports, documenting deaths in the community associated with mental health patients.

Shocking figures from the National Patient Safety Agency made public in April ,
show there are now an average of four deaths every day of patients in psychiatric care.
This has led campaigners to stress the need for juries as a safeguard to ensure public accountability.
Detention rates of people from African Caribbean under the Mental Health Act are now at an all time high.
Figures from the government's Count Me In Census report on inpatient care show that black people are over 44% more likely to be sectioned than their white counterparts,

despite having similar rates of mental ill health as any other ethnic group.
The over representation of black people within these custodial setting has raised fears among race equality groups
that black families will be hit hardest the proposals in this Coroners Bill.

‘The increase in the number of deaths of those detained in psychiatric care to four a day
means that the process established to uncover the reason
behind this loss of life should be made more transparent, not less.
A culture of cover up has emerged during some investigations into death in custody cases in the past.
If there isn't an automatic requirement for the inquest into the death to be heard before a jury,
what this law is effectively saying is that these people do not have the same rights as others ,
just because they have been detained under the Mental Health Act,'

Family of man stabbed to death call decision to free killer with paranoid schizophrenia 'terrible mistake', Daily Mail, 2nd September 2008

The parents of a man stabbed to death by a paranoid schizophrenic said last night
that it was a 'terrible mistake' to allow the killer to live in the community.
Landscape gardener Daniel Quelch, 34, suffered 82 knife wounds during a frenzied attack
after Benjamin Frankum broke into his parents' bungalow.
Yesterday, a jury took less than an hour to find him responsible for the killing,
after Judge Zoe Smith ruled he was unfit to be tried for murder.
He was ordered to be detained in Broadmoor Hospital for an unlimited time.
A full independent inquiry was announced as it emerged Frankum
was assessed for detention under the Mental Health Act several weeks before the killing
- but not found to be a danger to the public.
Frankum, 26, broke into the house near Maidenhead, Berkshire, last August,
and stabbed Mr Quelch as he lay in bed beside his youngest son.

Reading Crown Court heard Frankum had been in and out of hospital with mental illness.
On one occasion in 2001 On one occasion in 2001, he was sectioned and diagnosed as a paranoid schizophrenic.
However, because he had no history of violence or previous convictions, he was free to leave. In early 2007,
he discharged himself from a hospital and moved into supported accommodation in Littlehampton, West Sussex,
where he was living at the time of the attack.

But after failing to take his medication for a number of weeks,
he killed landscape gardener Mr Quelch..
In a statement, the Sussex Partnership NHS Foundation Trust, which was responsible for Frankum's care, said:
'Mr Frankum was seen regularly by professional staff
and was assessed for detention under the Mental Health Act several weeks before the incident,
because of family concerns about his condition and his lifestyle.'
It added: 'However there was not sufficient evidence of a risk to himself or others to detain him against his will.
' He told police he had been sent by MI5 to kill Mr Quelch.
A jury was asked to decide whether he was responsible for killing Mr Quelch following a trial at Reading Crown Court.
It took them just over an hour to convict him.
Judge Smith said the killing was ‘truly horrific’ and sentenced Frankum to a hospital order under the Mental Health Act
with an additional restriction order without limit of time.

Mr Quelch’s family described the murder as ‘the beginning of a nightmare that will never end’
and said after the case that they are now awaiting an independent inquiry
which will look into the events that led to the tragedy.

Following the verdict, harrowing statements from Mr Quelch’s parents, Ernest and Barbara, were read to the court
in which they described how their son’s death had devastated their lives.
Mr Quelch, a builder from Maidenhead, Berkshire, said he had been unable to work and suffered severe depression since Frankum killed his son.
He said: ‘Somebody let him out of hospital and he was free to walk the streets.
I would like to be sure he will never again be free to do to anyone else what he has done to us.’
His wife’s statement, read to the judge, added:
‘A terrible mistake was made when Benjamin Frankum was released from care.
‘He is clearly a danger to the public. I beg you to make sure he will never be released.’ The jury had He ‘Daniel Quelch was asleep in bed with his two-year-old son. Benjamin Frankum, a paranoid schizophrenic, came into his house.
They did not know each other.
And Mr Frankum stabbed Mr Quelch 82 times. ‘The motive? There isn’t one. There is no evidence he knew Mr Quelch.
It was a totally motiveless crime.’
Early on August 23 last year, he broke into a house owned by the Quelch family.

He then stabbed Mr Quelch to death,
giving his children cola and yoghurt when they were woken up by the attack, the court heard.
Frankum was seen in his boxer shorts covered in blood by Mrs Quelch,
as she drove back from walking her dogs at around 7am, the jury heard.
He banged on her car door saying he was from the police but she did not believe him and called 999.
After being seen crouching down with a pile of his bloodied clothes, he threw a knife into a nearby hedge.
Frankum told paramedics and police at the scene: ‘You don’t want to go in there, there’s stuff you don’t want to see. T
here’s a bloke in there, I’ve stabbed him about 10 times. He wouldn’t die.
There are three children in there; they”re all OK.’

He told police that ‘MI5 sent him down to kill Danny’, adding:
‘Can you get me a can of Coke - there are some in the fridge?’

The court heard that forensic evidence showed the attack began in a bedroom
and Mr Quelch managed to move while heavily bleeding, into the kitchen.
His body was found in a pool of blood on the kitchen floor with his throat cut.
An ambulance was called to the scene by Frankum, who reported cutting his fingers but made no mention of Mr Quelch

Frankum later admitted in police interview that he had stabbed Mr Quelch
and tests later showed he had not been taking his medication.
Before killing Mr Quelch, Frankum had crashed his mother Diane King’s Range Rover into a wall at her house near Maidenhead.
He then walked over to Mrs Quelch’s house with the family dog, who was found at the scene of the crime, the court heard.
He later blamed the murder on a group of gangsters he claimed were following him around.

Mr Quelch, from Spencers Wood, Reading, was a keen fisherman and a season ticket holder at Reading FC, often taking his children along to matches.

After the case his mother read a statement outside court in which she said
the family had also lost their home of 26 years
because they could not bring themselves to return following the murder.
The statement read: ‘It has been a terrible year - just the beginning of a nightmare that will never end.
Everything in our lives has been changed forever by this one brutal crime.
‘The material losses are nothing compared to the misery of the loss of Danny himself and we would give all we have to have him back. ‘
Whilst we are pleased to see the end of the trial, for us it is only one step forward.
'Now we have an agonising wait for an independent inquiry
which will be set up to look into the events which led to the terrible tragedy that took place on August 23 last year.
‘We pray that it will ensure no other families will lose a loved one in this way.’

A deranged mental patient was freed to kill a stranger
in a frenzied stabbing after being admitted to various psychiatric wards on seven different occasions.
Paul Cusack, 32, was a paranoid schizophrenic who told carers he abused illegal drugs and had voices in his head.
He had also twice been arrested with a knife - at one time while prowling the grounds of a hospital.
He had also flown to the US to get a gun.
But a consultant psychiatrist did not consider him a risk
and last April, Cusack was released into the community and allowed to live in flats in Withington, Manchester.

Three months later on July 28 semi-retired joiner Sidney Waller, 67,
was installing a kitchen in the block of flats on Mauldeth Road West,
when Cusak emerged from his apartment and plunged a blade into his neck.
The killer then called police to the building, saying that he had just killed someone.
Mr Waller - a grandfather described as a devoted and hard working family man -
was found in the flat with numerous stab wounds.
He was taken by ambulance to Manchester Royal Infirmary but
staff were not able to save his life and he died from his injuries.
During his interviews Cusack said that he had heard voices in his head willing him to confront Sidney.

On Monday an investigation into the role played by Manchester Mental Health and Social Care Trust (MMHSCT)
was underway after Cusack admitted manslaughter on the grounds of diminished responsibility.
His not guilty plea to murder was accepted by the prosecution.
Health bosses said Cusak had been receiving support in Manchester for mental health issues for a number of years.
Reports claimed he had twice appealed to carers for help
in the run up to the killing and was arrested in February after being caught with a knife in Wythenshawe Hospital.
It is believed he claimed he told carers he had taken illegal drugs
which were preventing his medication from working
and later said he had a knife and intended to kill himself.

Carers made 25 attempts to visit Cusack but only saw him seven times.
His care plan and risk assessment were not updated.
Three appointments were made for Cusack to see a consultant psychiatrist
but he failed to turn up and he was not raised as a particular concern.

Following the killing of Mr Waller, a review was carried out by MMHSCT and Manchester Primary Care Trust
held a safety review of the care provided to Cusack.
It emerged his social worker was not registered with the General Social Care Council and he was sacked.
Last week the trust transferred the interim management of mental health service
to another provider who will deal with people with severe and enduring mental health needs.

A report found the care of Cusack under social and care workers and doctors at the Assertive Outreach Team
run by the charity Health Advocacy & Resource Project (HARP)
was described as "below the standard expected.” At Manchester Crown Court, Mr Thomas Cross QC, prosecuting said, "This is a defendant who has had a longstanding mental condition.
"He has in the most recent decade been admitted to various psychiatric hospitals as an in-patient on seven occasions.
He was this year admitted to hospital and discharged in April.
This terrible event was brought to the attention of the authorities by the defendant himself
when he telephoned emergency services telling them that which he had done.
After his remand into custody three psychiatric assessments have been made on him. Each and every report concludes that he suffer from a form of paranoid schizophrenia.”

Cusack is due to be sentenced on March 13 following the preparation of psychiatric reports.
He was remanded in custody awaiting transfer to Ashworth high security hospital for further assessment.

Mr Waller's widow, Pauline, and two adult children, Gill and Mark, paid tribute to him:
"We are absolutely devastated by Sid's death and are struggling to come to terms with everything that has happened.
Sid was a devoted, hard-working family man.
He was a loving husband, father and grandfather.
Sid brought fun and laughter into so many people's lives.
Aside from spending time with his family,
he loved nothing more than enjoying a pint and watching his beloved Manchester United on television."

Cusak had been receiving support in Manchester for mental health issues for a number of years.
On April 3, he was transferred from a Community Mental Health Team with MMHSCT
and into the Assertive Outreach Service which is managed on a day-to-day basis by HARP
but delivered as a partnership between HARP and MMHSCT. J
ackie Daniel, chief executive of MMHSCT,said: "When Mr Waller was killed, I was new in post
and immediately asked colleagues to carry out a review of the circumstances that led up to his death.
The result of that caused me serious concern about the safety of the Assertive Outreach Service.
There were clearly some serious failures in the care of Paul Cusak
and I would like to offer my condolences and most sincere apologies to Mr Waller's family and friends.”
The MMHSCT was ranked as having the third worst hospital care in the country - in 2007 it received the same poor ranking for community care

Timothy Crook: Lessons must be learnt, says judge, Swindon Advertiser, 18th December 2008

The judge who gave Timothy Crook a permanent hospital order
said lessons must be learned from the case. Mr Justice Roderick Evans said:
“This family were trying to obtain help for a considerable time before this tragedy occurred
but their efforts to obtain help were largely unsuccessful.
“From what we do know from the evidence from the case and the documents,
it appears to me that the appropriate authorities should stand back,
look at this case to see whether something did go wrong
and what lessons can be learnt.
There are clearly matters here of continuing concern.”

Judge Evans said he had no choice but to order Crook to be detained under the Mental Health Act. Addressing Crook via the video link Judge Evans said:
You have not been fit to stand trial.
You will be subject to a hospital order and remain as long as there is a bed for you at Rampton.
As well as remaining there you will be subject to another order and without liberty of time.”

Crook, who has a history of mental illness dating back to 2000, moved in with his parents in 2003
after being released from a psychiatric hospital in Lincoln, where he had previously worked for the RAF.
In his increasingly paranoid and delusional state,
Crook subjected his parents to intimidation and abuse over five years.
It was perhaps an argument over the state of the bathroom w
hich tipped him over the edge in to a brutal rage.
In his increasingly paranoid state, he ripped out the bathroom and insisted on replacing it himself, causing tension.

Crook is at Rampton Secure Psychiatric Hospital and has been watching the trial
for the double murder by video link.
Three psychiatrists have assessed Crook to be unfit to plead to the offences
and Judge Evans ordered that the trial was taking place only to establish
whether it was Crook who committed the crime.

On Monday last week, Crook’s sister Janice Lawrence said: “He would be unkind to them, domineer them and control them, the language was terrible.”
The following day next door neighbour in Swindon, Nigel Collins told the court
he found two black bin bags in his garden at around the same time as Robert and Elsie disappeared.

Last Wednesday police officers described the moment they discovered the bodies of Robert and Elsie Crook in the garden of a house belonging to their son in Foxglove Way, Lincoln underneath two wheelie bins.
And on Thursday the jury heard how Wiltshire Police officers found blood-soaked clothes belonging to Robert and Elsie Crook dumped at their Swindon home.
On Monday senior forensic scientist Steven Harrington said a shirt was found in a bin liner at the couple’s home was found splattered with Elsie’s blood.
Crook’s DNA was found on a sock inside the bag and his parents blood was sprayed across a pillow case, wall and hallway.
On the final day of evidence on Tuesday, the jury was told how six different police forces involved in the case found no evidence
that pensioners Robert and Elsie Crook died anywhere other than their Swindon home.

Det Sgt Nicholas Shorton from Wiltshire Police’s major investigation team said:
“Lincoln police had to force entry into 29 Foxglove Way, Lincoln, through a window above the garage.
There was no evidence of an assault within that house, no blood left on the walls or carpets.”

I would have been next, says sister, Swindon Advertiser, 18th December 2008

Mental health services knew for years about Timothy Crook’s medical problems
but did not lift a finger to help his parents, his sister has claimed.
Janice Lawrence, 52, of Shrivenham, said that Avon and Wiltshire Mental Health Partnership Trust finally agreed to section Crook
the week before he murdered his parents, but failed to turn up on the day.
An appointment was postponed for the next week, by which time Robert and Elsie were dead.

Mrs Lawrence said that for five years Crook received no treatment at all for his delusional disorder
from either Swindon or Lincoln mental health services despite her parents’ efforts to get help for him.
“Whatever drove Timothy to do this we will never know,” said Mrs Lawrence.
“I can never forgive my brother for murdering my parents and the devastation this has caused to me and my family.
This disaster could have been so easily avoided,
as we as a family believe that we were severely let down by the mental health services.
Had Timothy received the help that we had been requesting for many years,
I know that Mum and Dad would not have had to pay the ultimate price of their lives
for loyally standing by and helping their son.
It was building up each year.
It got to the stage where his behaviour became unacceptable to us.
It wasn’t right, it wasn’t acceptable but it became the norm.
The last six months things really clammed up. All the danger signs were there.”

She added: “We were telling everybody
but no-one was prepared to do anything about it.
I’m just appalled. This never should have happened. It could so easily have been averted.
We just wanted someone to take responsibility, to see he was in the community and needed medication.
My parents were struggling.
They were elderly people, intimidated for five years by him.
Swindon Crisis Team kept saying unless my parents were prepared to ask for my brother to be sectioned they couldn’t section him.
And even if they did they could probably only keep him for 24 hours and release him.
My parents couldn’t do that because after 24 hours he would know,
then he would come home and they knew they would be harmed.”

Mrs Lawrence said she was finally told 10 or 11 mental health staff would visit her parents home
two weeks before they died and detain Crook, but they never arrived.
Another appointment was set up for Robert and Elsie to speak to Swindon crisis team, by which time they were dead.
“I spoke to Mum on the Friday,” she said. “She said he wanted to rip the bathroom floors up.
They were telling him he couldn’t do it.
I said just let him do whatever he wants.
I said after Thursday we’ll sort it out, just let him do what he wants now.
They would go to their tea-dances and on holiday a couple of days a year.
That was their only escape.
We were concerned he would hurt them, but never thought he was capable of this.
I feel the Swindon health services are more to blame than the Lincoln ones,
because they actually had his records since 2003 without us knowing.
Had they turned up on the morning they promised I would have my parents.
It should never be allowed to happen again.
When someone is in your care you should know what is wrong with them
and be able to get medical help and the back up needed.

“My mother and father were wonderful people, amazingly supportive parents a
nd a devoted couple who adored their grandchildren and were loved by the whole family.
We are all desperately missing them, and to have been murdered in such a brutal and callous way
by their own son is beyond everyone’s comprehension.
We love them and miss them terribly, but they will live in our hearts forever.
I would now like the strategic health authority to commission without further delay a full and independent inquiry into Timothy’s care.”
During the years Crook lived with his parents in Thames Avenue, he would visit his sister on Saturdays to give Robert and Elsie a break.
But as his condition deteriorated, the family’s young children became disturbed by his behaviour.
They would have been 11 and 13,” said Mrs Lawrence. “He was just acting strange, getting aggressive.
They would look after him and he was an uncle they loved, then he started becoming aggressive.
They didn’t like it.
It was instinctive, children pick up on these things.
Because he wouldn’t talk to me and my husband it became difficult having him at our house.”

A violinist stabbed to death near his home in broad daylight
was allegedly killed by a man who had recently been discharged from a mental hospital, it emerged today.
Michael Kahan, 39, had gone to buy bagels for Sunday breakfast for himself and his wife at the weekend when he was attacked.
Neighbours of the man accused of murdering the father-of-three
said he had recently been treated in hospital for schizophrenia,
and an investigation has been launched into his care.
Mr Kahan, who was due to celebrate his 40th birthday later this week,
played violin in a duo performing a traditional Jewish form of music called klezmer.
On Sunday morning, he walked from his home in Crumpsall, Manchester, to visit a bakery to buy breakfast for himself and his wife, Eva, when he was attacked.
An off-duty doctor and nurse were among the first people on the scene after the attack
and tried desperately to revive him.
He was rushed to hospital but died soon afterwards.

When he failed to return, Mrs Kahan went to check on him and discovered the police cordon.

Mr Kahan had been stabbed twice, once in the chest and once in the abdomen.
The attack happened opposite a synagogue but is not believed to have been motivated by religion or race.
The building's CCTV cameras are thought to have captured what happened.
His distraught widow later paid tribute to her husband.
"Michael was a very kind, gentle and gifted man - he was just going to buy Sunday breakfast but he never came home,"
Mrs Kahan said. "He had a great sense of humour, was very chatty and instantly likeable.
He was simply a nice guy and we are devastated at what has happened."

Police said there was no clear motive for the attack,
and a 31-year-old man arrested soon afterwards is thought to have mental health problems.

Neighbours said he had suffered from schizophrenia for many years
and had completed a spell at a mental hospital within the last few weeks.
But they added that he had a supportive, loving family and was well-liked in the area.

"He loved cars, and he liked nothing better than helping me out," said retired mechanic Stuart Lomas, 69, who lives opposite the family home.
"We knew he was ill, but his parents did everything they could for him, and as far as I'm concerned he's a lovely lad.
There was never any suggestion he could be violent.
I just feel so sorry for both families."

Pennine Care NHS Trust, which runs mental health services in the area,
confirmed that it had treated the suspect.
"We're co-operating fully with police and we're going to conduct an internal investigation,
but we can't comment further at this stage," a spokeswoman said.
Mr Kahan, originally from North London, trained at the Royal Northern College of Music in Manchester and performed as the Klezmer Gourmets along with clarinettist Ros Hawley.
They had been due to play at a concert in Manchester this weekend as part of an event raising awareness about refugees,
and she plans to perform there in his memory.
"He was a lovely man, he would not have hurt anyone," she said yesterday.
"He did not have a harmful bone in his body and was a great musician."
The pair also held classes on Eastern European music and performed at weddings and religious events.
Klezmer music is thought to originate in the 19th century but underwent a revival in the 1970s and 80s.
Tributes have been posted from around the world from fans of Mr Kahan's music.
One wrote: "He made wonderful music, and had the rare gift of being able to play with both humour and passion - the world needs more like him."

Jonathan Mills, 31, from Chadderton, Greater Manchester,
appeared at Tameside magistrates court today charged with Mr Kahan's murder
and was remanded in custody.
A 48-year-old man who was arrested on suspicion of murder has been released on police bail pending further inquiries.

Calls for mental health boss to resign, Norwich Evening News, 11th June 2008

Health chiefs have apologised and pledged to implement all the recommendations of an independent investigation
into the care and treatment of a North Norfolk man who killed his wife's stepfather.
But today the family of John West, who was stabled 11 times during the frenzied attack by Richard King in August 2004,
called the inquiry “disappointing” and said the chief executive of Norfolk and Waveney Mental Health NHS Foundation Trust should resign.
Mr West was killed just days after King, who was a voluntary patient at Hellesdon Hospital, walked out of the facility.

He pleaded guilty to manslaughter at Ipswich Crown Court and was sectioned under the Mental Health Act.
The report concludes that
“no individual and no single act or remission led directly to the killing of John West”
and that the killing could not have been foreseen.

But it highlights a catalogue of procedural errors
from staffing through to the keeping of paperwork and care over drugs and discharge
that need attention.

Both Dr Hadrian Ball, medical director of the mental health trust, and Dr Paul Cosford, regional director of public health for the East of England who was representing the strategic health authority,
said the report's 22 recommendations would be fully implemented and action plans had already been drawn up and were being acted upon.

But Mr West's brother, Patrick, said that although he thought the report was “exemplary”,
as far as it went, he felt it should have gone further.
He said he wanted to see in writing that the trust chief executive Pat Holman had been interviewed.
He said “this report highlights poor managemen
t and who is ultimately responsible for that? She is at the head and I think her position is untenable.”
Mr West said he would be keeping a close check to ensure all the report's recommendations were carried out.

Lady Margaret Wall, who led the inquiry, said that Ms Holman had been spoken to before the final report had been collated
and certain changes had been made after the two hour meeting.

Dr Ball said it was more appropriate for him, as medical director, to be interviewed for the inquiry.
He pointed out that Ms Holman had presided over three years of great improvement at the trust.
The trust later added she had no intention of resigning,
as there were no corporate failings highlighted in the inquiry.
Procedures were in place, but not followed.

The inquiry is the fifth into Mr West's death and the second carried out by health services.
A 2005 internal inquiry found that established practice and protocols had not been followed
but after pressure from Mr West's family and continued questions,
a second inquiry was launched in 2006.

Yesterday's report also highlighted a number of failings with the first inquiry not talking to family members.
Dr Ball said the findings of the first inquiry had already led to many improvements in systems and services
but new lessons would also be learned and implemented so the best possible service would be provided.

... and ..... and .... 40 other tragedies per year, in community care for schizophrenia