Health Investigations

NHS England East of England Region and Midlands Region, commissioned Niche Health and Social Care Consulting Ltd (Niche) to carry out an independent investigation into the care and treatment of mental health service user, Sam. Documents:

This summary reviews the findings of an independent assurance review conducted to evaluate the care and treatment provided to PS by mental health services. The review was initiated after a tragic incident involving PS, which highlighted significant failures in care coordination, clinical management, and service pathways. Documents

Paranoid Schizophrenic fatally batters with an axe after leaving Sheffield Psych Unit and Greenwich hospital. Long MH history, not taking meds

Paranoid schizophrenic beats wife to death with crowbar. Long MH history. Prev. threats to kill wife. (Ind Inq 2012 Dineen)

Mentally ill man with history of violence fatally punches stranger. Investigation finds death was preventable

MH patient fatally stabs father then hangs himself

MH homicide. Ind Inq 1999 – failure to evaluate and assess properly

Paranoid Schizophrenic hospital patient with collection of knives fatally and repeatedly stabbed another patient. Ind Inq 2001, wrong risk assessment, avoidable

Mentally ill man killed girlfriend (PD). Ind Inq 2000

MH patient fatally and repeatedly stabs victim (affair). Ind Inq 2004

Mentally ill man fatally stabs friend. Dem Resp – hospital order MSU

Mentally disordered man fatally batters and stamps on man. Convicted of Murder

Paranoid and deluded former patient repeatedly and fatally stabs stranger on release from prison. History of violence, drug abuse, & psychosis – convicted of murder

Mental health patient beats man to death. MH history.Ind inq 2013 HASCAS

Schizophrenic repeatedly and fatally stabbed parents. Previous inpatient

Mentally ill man fatally stabs elderly relative

Mentally disordered prisoner with history of violence fatally stabs fellow prisoner

Mentally disordered man drowns grandson. Long MH history – Recently released from inpatient unit

Sectioned MH patient on day release kills girlfriend. Ind Rev 2004 – originally unpubl. Not in public interest

Paranoid schizophrenic fatally stabs mother. Off meds – long history of serious mental illness

Mentally disordered man repeatedly and fatally stabbed his grandmother. Convicted of Murder – Life – minimum 18 years

Mentally ill man kills hostel worker with hockey stick and knife. Long MH history – AOT had warned about dangers

Depressed and anxious woman jumped in front of a high speed train holding her young son. Family said there had been ‘shortfalls’ in her mental health treatment

Psychotic MH patient sets fire to flat killing occupant. Ind Inq (2004/282) 2006. Warnings unheeded