Bournemouth woman: I stabbed my mum to death — (The Bournemouth Echo)

SSRI Ed note: Teen divorced parents is drugged for years with risperadone, venlafaxine, at 39 stops antidepressant, deteriorates, a month later is delirious, murders mum.

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The Bournemouth Echo

12 Jul 2011

by Harriet Marsh

A BOURNEMOUTH woman has admitted stabbing her 69-year-old mother to death in the street.

Ecila Henderson, 39, was charged with murder when her mother, retired teacher Rosemary Elaine Armstrong, was found dead outside a block of flats in Queensland Road, Pokesdown, last August.

On Friday, Henderson, formerly of Queensland Road, pleaded guilty to a lesser charge of manslaughter at Winchester Crown Court and was handed a hospital order by Judge Justice David Foskett.

This sentence was given on the grounds of diminished responsibility.

Detectives at Dorset Police described the stabbing as a “tragic incident”.

A spokesman said: “We hope that the conclusion today will help the family and friends of the victim to move on.”

The quiet area of Queensland Road was thrown into chaos just after 1pm on August 28 last year when Mrs Armstrong, from Salisbury, was found outside the Queensland Lodge block of flats.

Part of the block is owned by Knightstone Housing Association and was home to Ecila Henderson and nine other “vulnerable” people.

Neighbours told the Daily Echo at the time how they had been alerted by terrible screams.

Detectives sealed off the area, and crime scene investigators also scoured a small area at the Christchurch Road entrance to Woodland Walk in their hunt for clues.

Mum-of-three Mrs Armstrong, known as Elaine by friends, was a regular churchgoer and history society member.

One of her daughters had died aged five, and Fiona Henderson, 41, lives abroad.

She described her mother as an elegant and compassionate woman who lived for her children and for other people.


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Independent Investigation into the Care and Treatment Provided to Ms A by the Dorset Healthcare University NHS Foundation Trust Bournemouth Local Authority Social Services and Knightstone Housing Association — (NHS South West and the Bournemouth and Poole Adults Safeguarding Board)

Authored by: Mr Jonathan Allen

April, 2014

Commissioned by NHS South West and the Bournemouth and Poole Adults Safeguarding Board

Investigation Managed by: the Health and Social Care Advisory Service Report

Investigation Team Preface

The Independent Investigation into the care and treatment of Ms A was commissioned jointly by NHS South West and Bournemouth and Poole Adult Safeguarding Board. The Investigation is pursuant to HSG (94)271 and the Bournemouth and Poole Adult Safeguarding Serious Case Review Policy and Procedure. This Investigation was asked to examine the care and treatment received by Ms A in the years and months prior to the killing her mother, Ms B, on 25 of August 2010.

Ms A  received care and treatment for her mental health condition from the Dorset Healthcare University NHS Foundation Trust in partnership with Bournemouth Local Authority Social Services from October 2001 through to the death of her mother in August 2010. She was also in receipt of supported accommodation from Knightstone Housing Association from December 2009 through to the killing of her mother in August 2010.

Investigations of this sort should aim to increase public confidence in statutory mental health service providers and to promote professional competence. The purpose of this Investigation is to learn any lessons that might help to prevent any further incidents of this nature and to help to improve the reporting and investigation of similar serious events in the future.

Those who attended for interview to provide evidence were asked to give an account of their roles and provide information about clinical and managerial practice. They all did so in accordance with expectations. We are grateful to all those who gave evidence directly, and those who have supported them. We would also like to thank the Trust, the Local Authority and Knightstone Senior Management Teams who have granted access to facilities and individuals throughout this process. The Senior Management Teams of all three organisations have acted in an exceptionally professional manner during the course of this inquiry process and have engaged fully with the root cause analysis ethos of this Investigation.

Incident Description and Consequences

Background Information for Ms A  This background is predominantly drawn from a Psychiatric Court report on Ms A and a detailed history provided in an Independent Psychiatrist’s report for a Mental Health Review Tribunal in 2007.

Ms A was born in Salisbury, Wiltshire, on 10 August 1971. Her mother and father separated when she was nine-years old. This was a few years after her younger sister had died from a brain tumour. She did well at school and went to University and gained a degree in art and ceramics. She first showed signs of mental health problems in 1995, when she was living in London. This led her to move back to her mother’s home, where over the next few years her mental health problems started to materialise as a serious mental health disorder, and she commenced treatment under the care of local secondary mental health services. Over the next 15 years she received care and treatment from teams in London and more substantially in Dorset following a move back to the area to be close to her father.   Her illness developed into a serious and frequently remitting mental illness.

Ms A did not sustain a significant period of stable mental health until 2008. This followed a two year period of receiving inpatient rehabilitation. Following this she progressed over the next 18 months. She moved into her own supported flat, regained her driving licence and found some part-time paid work. This continued through to August 2010, when her mental health relapsed with tragic consequences.

On 23 August Ms A’s Housing Support Worker from Knightstone Housing called the Community Mental Health Team (CMHT) Duty Service to inform them that Ms A appeared unwell, and requested an assessment. The CMHT Team Leader, who took the duty call, asked the Housing Support Worker if Ms A was showing signs of relapse. The Housing Support Worker said she had not seen her unwell before so could not be sure, but advised that she had never seen Ms A like this before. The CMHT Team Leader stated the team was about to go off duty, and advised he would discuss the concerns with a member of staff who knew Ms A, and arrange for her to be seen if necessary the next day…

On 25 August a further call was made by the Knightstone Housing staff who continued to express concerns about Ms A’s mental state. It was agreed that a CPN would go and assess Ms A later in the afternoon.   Later that afternoon a call was received by the CMHT from Ms A’s mother expressing concerns about her daughter. When the Duty Worker tried to call Ms B back there was no reply. By this time Ms A had already killed Ms B.    It is reported by a colleague and friend of Ms A (who was an eye witness to the homicide) that Ms B had arrived at Ms A’s flat in the early afternoon. She had not heard from her daughter for a couple of days as Ms A was not answering her telephone. Ms A’s friend told Ms B that she could see Ms A in the flat and that she was pacing up and down, but would not answer the door. Ms B is reported to have knocked on the door in an insistent manner. When she did not get an answer she went downstairs and outside of the block of flats to telephone the Community Mental Health Team. Ms A came out of her flat with a knife and attacked her mother, stabbing her over 22 times. Following the attack she proceeded to walk through the streets of Boscombe, until she was apprehended by the Police.

Ms A was arrested and placed into medium secure psychiatric care under the powers of recall of her Section 17a Community Treatment Order.  At her trial she was found guilty of manslaughter on the grounds of diminished responsibility, and placed on Section 37 of the Mental Health Act (1983 & 2007) with Section 41 Home Office Restrictions…

Between July 2002 and June 2003 Ms A continued to live at Irving Road, and was regularly seen by her new CPN/Care Coordinator (Care Coordinator 2). Ms A worked as a volunteer in a charity shop and attended a pottery workshop. She was seen every three months in her new Consultant Psychiatrist’s (Consultant 4) Outpatient Clinic by his junior doctors. During these clinic appointments she was noted as being free from psychotic symptoms, but as remaining low in mood. Her lowered mood appeared to be related to adjusting to the impact her mental illness had made on her life. As a result she was started on Venlafaxine an antidepressant medication, which was titrated to a therapeutic dose over the course of the year.  She was also referred to a Clinical Psychologist to see if she could benefit from psychological work around managing the impact her illness had made on her life. Following the assessment the Clinical Psychologist (Psychologist 1) thought that there would be no obvious benefit to Ms A from psychological intervention at that time…

31 August 2005. Ms A’s father found her on Weymouth Beach and reported that her mental health appeared to have deteriorated again. Ms A’s mother called the ward to state how unhappy she was with the situation.

During a ward round on 2 October [2005] the team decided to change Ms A’s medication to Risperidone to enable a transfer to Risperdal Consta depot injection. Following her change in medication her behaviour appeared to deteriorate further and the Risperidone was increased to the maximum dose and Sulpiride, another antipsychotic medication, was added…

July 2010. Ms A attended her Outpatient appointment with Associate Specialist 1 and appeared to be progressing well. Associate Specialist 1 agreed to stop her antidepressant and discussed a change in anticholinergic medication for side effects…

August 2010. Ms A did not attend the appointment with her Care Coordinator for her depot injection.91

August 2010. It was recorded that Ms A’s depot had been given to her by Care Coordinator 5 as a relief visit, following a missed depot on 13 August (notes later indicate that this was the date that it was entered on RiO, the electronic patient record system. The actual date the depot was administered was 16 August.

23 August 2010 16.15 hours. A Housing Support Worker reported that she had gone to Ms A’s flat, with a new Housing Support Worker to whom she was handing over Ms A’s care. When she knocked on Ms A’s door Ms A would not answer. The Housing Support Worker then tried to telephone Ms A and went into the car park to see if her car was there. Ms A then came to the door, but was unable to maintain eye contact and spoke monosyllabically. The Housing Support Worker reported that Ms A appeared very

agitated. She asked Ms A if she felt unwell and whether she wanted her CMHT to be contacted. Ms A responded that she did, she was asked how long she had felt like this and Ms A responded “today”. She was also asked if she had slept the previous night and Ms A responded that she had not.

23 August 2010 16.30 hours. The Housing Support Worker called the Community Mental Health Team Duty Worker expressing concern about Ms A’s mental health. Initially she could not get through, but Duty Worker 1 called her back at 16.52 hours.  The Housing Support Worker reported her concerns to Duty Worker 1 about Ms A’s mental state. Duty Worker 1 asked if she appeared to be at risk of suicide or self-harm. The Housing Support Worker responded that she had not asked those questions, but reiterated how unusual Ms A’s presentation was and that she thought someone should come out and see her…

24 August 2010 17.19 hours. The Housing Support Worker returned the call to Duty Worker 2 sometime between 1pm and 4pm. She reported that she had last seen Ms A the previous day and reiterated her observations of her behaviour. Duty Worker 2 confirmed that he was aware of the situation and was planning to send someone out to see Ms A the following day. He stated that the CMHT was aware Ms A had been a complicated case in the past, and that she could get irritable and agitated…

25 August 2010 12.05 hours. A work colleague of Ms A attended Queensland Lodge as she had not heard from Ms A for a couple of days. When she went to Ms A’s flat she could see her pacing and observed that she was not answering the door or responding to her. Ms A’s work colleague contacted the Housing Support Worker, who in turn telephoned the Community Mental Health Team. She spoke to Duty Worker 3 and reiterated her observations from 23 August. Duty Worker 3 asked if the Housing Support Worker thought a home visit was required; she responded that she was not sure about the CMHT protocols. The Duty Worker then advised the Housing Support Worker that he wanted to discuss the situation with his colleagues, and that he would get back to her…

At 12.50 hours [Aug 25, 2010] Ms A’s mother telephoned the Housing Support Worker and advised that she was also outside Ms A’s front door.  She asked the Housing Support Worker if she had keys to let her into Ms A’s flat so she could make sure Ms A was alright. The Housing Support Worker advised that she did not keep keys to individual resident’s flats, and any forced entry would have to result as a decision between the CMHT and the Police. The Housing Support Worker advised Ms A’s mother to discuss the situation with the CMHT. Mrs A’s mother informed her that she had already been in touch with the Duty Team.

At 13.40 hours Housing Support Workers were advised by the other residents that there had been a stabbing outside the property and that there was a Police presence around the Queensland Lodge property.

At 13.45 hours a third party confirmed to the housing support team that Ms A had stabbed her mother.

At 19.25 hours Duty Worker 3 (the CMHT Team Leader) confirmed in Ms A’s clinical record that information had been provided through their involvement at the Police Station that Ms A had fatally stabbed her mother between 13.00 and 14.00 hours.

An eye witness account was given by Ms A’s work colleague who witnessed the events of 25 August 2010.

Ms A’s friend and colleague (Ms C) went to Ms A’s flat on 25 August as Ms A had not turned up at work for a couple of days. When she got to the flat she found that Ms A would not answer her door, but she could see her pacing around her flat by looking through the letter box. Ms C telephoned her work and told them that she may be than she thought. She then telephoned the Knightstone Housing Association Offices. Ms C was told that the Housing Support Office was aware of Ms A’s situation, but that no one could disclose any further information due to resident confidentiality. At this point Ms A’s mother arrived. She told Ms C that she had popped over because she had not heard from Ms A for a few days and was also concerned. Ms C told Ms B that her daughter was in her flat but would not answer the door or speak to her. Ms B proceeded to knock on the flat door demanding that Ms A let her in but to no effect.

Ms B contacted the CMHT Duty Team on her mobile telephone. Ms C then looked through the letter box again to check on Ms A and saw that she had got hold of a kitchen knife and had come to the door. Ms C stood back; she described Ms A as looking like a different person from the one she knew at this time. Ms C shouted at Ms B to ring the Police as Ms A had a knife. Whilst her mother was on the telephone, Ms A came into the back garden holding the knife. She walked towards her mother and stabbed her. Ms A then walked out of the garden into an alleyway and out on to the street.

Events Following the Homicide of Ms B Ms A walked into Boscombe and was seen by several people to be covered in blood and carrying a large kitchen knife. One person stopped a Police car. The Police approached Ms A to arrest her and had to use an incapacitant spray as Ms A would not put the knife down when requested. She was detained at Bournemouth Police Station, following which she was assessed by mental health workers and detained under Section 2 of the Mental Health Act (1983 & 2007).

On 18 July 2012 Ms A’s case was tried at Winchester Crown Court and she was found guilty of manslaughter on the grounds of diminished responsibility. She was placed on Section 37 of the Mental Health Act with Section 41 Home Office restrictions.

When interviewed by her Psychiatrist (Consultant 6) following admission to the medium secure unit, Ms A is reported as exhibiting a significant amount of psychotic experiences and cognitions. She understood she had stabbed her mother, but did not believe she was dead. She thought her mother would rise from the dead and come and see her. She believed she herself had risen from the dead after committing suicide earlier in the year. In later interviews she was able to describe that she felt very angry with her mother when she came to her flat, for knocking on the door and for insisting she came to speak to her. At this time she heard the voice of the man in London whom she had been bound over for harassing at the very beginning of her illness, telling her to get a big knife and stab her mother a lot. She felt compelled to do this.

The Psychiatrist concluded the homicide was caused by a rapid and acute deterioration to Ms A’s mental health.