Care in the community patient killed partner and daughter in front of boy, four — (The Daily Mail)

SSRI Ed note: Man in antidepressant withdrawal stabs ex-lover and her daughter to death in "frenzied attack", is then diagnosed with paranoid schizophrenia, locked up.

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SSRI Stories Summary – Rekawt Salih, 26, has been prescribed antidepressants but repeatedly expresses concerns to the NHS team about their sexual side effects.  His concerns are ignored so he stops taking the meds.  Nobody warns him to wean off slowly to avoid potentially dangerous side effects.  In withdrawal, he starts to become paranoid, thinking his phone is bugged and “behaving strangely”.   He appears to suffer either a fit of uncontrollable rage or some sort of break, and murders his former partner and her daughter.  An independent review is ordered, which finds that: “[he] spent the afternoon in the company of persons close to the deceased and nothing untoward in his behaviour was noted”.  Nobody thought he was seriously mentally ill before the tragedy which is why no diagnosis appears in the review report summary.  Once he has been incarcerated at Rampton Hospital following the incident he is diagnosed as schizophrenic, and news articles refer to him as a “paranoid schizophrenic”.  Nobody appears to be aware of the potential hazards of antidepressant withdrawal.  The inquiry report summary does not even name the medication; its only relevance seems to be to note that “assertive attempts” should have been made to “re-medicate” Rekawt.

The Daily Mail

By Jessica Satherley

Updated: 02:09 GMT, 2 November 2011

Rekawt Salih, 26, inflicted more than 100 stab wounds to the women

A paranoid schizophrenic stabbed a mother and daughter to death in a frenzied attack, a court heard today.

Rekawt Salih, 26, inflicted more than 100 stab wounds on his ex-partner Tracy Donnelly, 43, and her daughter Louise, 23, at Mrs Donnelly’s home in Sheffield, as her other four-year-old son slept on the couch.

Sheffield Crown Court heard that Mr Salih, of Gleadless, had been admitted for a brief period for assessment under the Mental Health Act a year previously but was released back into the community.

A post mortem showed more than 30 stab wounds to Tracy’s body. She died from severe blood loss and collapsed lungs.

Louise had 70 injuries to her body and the tip of a knife which had broken off was embedded in her skull.

Salih was said to have used “extreme” force and both women put up a fight, with Tracy apparently trying to help her daughter as she was attacked.

Salih drove off in his BMW X5 but was later arrested by armed police with a taser after a chase during which he collided with a group of students, leaving four of them injured.

Salih told officers he could not remember anything about what had happened.

On the way to hospital he kept repeating he was ‘the son of God’ and ‘look out there he is coming’.

Fatal attack: Tracy Donnelly (left) , 43, and her daughter Louise, 23 (right), at Mrs Donnelly’s home in Sheffield

In hospital he said the killings were nothing to do with him and blamed a ‘magician from Pitsmoor in Sheffield’.

Salih admitted the manslaughter of the two women on the grounds of diminished responsibility.

He was sent to Rampton Hospital under a hospital order with restrictions.

In court Mr Justice Treacy told him: ‘It may well be hard to envisage a time when you do not pose a risk to the public. You may never be released.’

Alistair MacDonald, prosecuting, said Tracy’s son Ashley found the bodies in the living room in the morning.

Tracy’s other son, four, was asleep on the sofa in the room where the killings took place.

Mr MacDonald said Tracy and Salih, a takeaway worker, met in a Sheffield bar and he had ‘floated in and out of her life’ according to a woman friend.

They lived together and were brought closer after their son was born but the relationship fell apart after Salih cheated on her with another woman.

Hospitalised: Rekawt Salih was sent to Rampton Hospital (pictured) under a hospital order with restrictions

Mr MacDonald said they had a ‘looser’ relationship from then on and Salih would vanish for months on end.

Salih used to beat up Tracy and insult her and her friends thought she was frightened of him.

She moved away from him but he managed to track her down to her new three-bedroom home in Gleadless.

The day before the deaths, Tracy texted a friend asking her if Salih could park his BMW X5 at the house for a week. She texted: ‘Am back with Rick.’

It appeared the couple had been back together for about a week and Salhi had a key to Mrs Donnelly’s home.

Mr MacDonald said he ‘hated’ her daughter Louise after she reported him to the police for assaulting her during an argument and he was convicted of battery in April, 2008.

Salih clashed with Louise a week before the tragedy after she had left his car and got a taxi home.

Tracy had also told a friend that Salih was behaving strangely and had claimed people were after him and his telephone was bugged.

Mr MacDonald said a neighbour of Salih’s accused him of following him in the early hours of Tuesday, March 29 this year as he parked his car.

Salih was holding a bayonet knife in his right hand and a screwdriver in his left.

Crime scene: The scene where the bodies of Louise Donnelly and her mother Tracy Donnelly were both killed by Rekawt Mahmood Salih in Sheffield

Salih said he was having problems with his girlfriend and the area was ‘very dangerous’ to him.

He pointed what the neighbour thought was a small handgun at him and told him not to move before slashing his neighbour’s tyres.

Salih drove off and apparently went to Mrs Donell’s home in Gleadless.

Neighbours heard two women screaming who sounded ‘terrified’.

It appeared Louise had been attacked by Salih followed by her mother.

A neighbour thought the attack lasted for 25 minutes.

Salih was then seen walking quickly away from the house barefoot.

The court heard he was prescribed anti-depressants by his GP in 2009 and there was evidence he used cocaine and was a heavy drinker.

While under assessment a year before the attack, Salih was diagnosed with schizophrenia and drug-induced psychosis before being released.

As his condition worsened the day before the killings he sought help from a mental health crisis team but there is no indication contact was ever made.

After his assessment February, 2010 he was supposed to have received some form of supervision in the community but had ceased to take his medication at the time of the killings.

It is not known whether the mental health services knew he was not taking his tablets but the judge said it was ‘a matter that should be looked into.’

Mr MacDonald said he had been housed at Rampton since he was arrested and had been diagnosed with paranoid schizophrenia.

Consultant forensic psychiatrist Dr Paul Hayes said he had been suffering from the condition for some years before the deaths and would continue to do so for the ‘indefinite’ future.

He said the abnormality in his mental function was a significant factor in the killings.

Tim Maloney, defending, accepted Salih posed a ‘very serious risk’ to others and the condition was likely to remain permanently

Mr Justice Treacy said Salih’s ability to understand what was happening to him was substantially impaired.

He said: ‘The condition from which you suffer is one which is likely to last indefinitely. You require hospital treatment and pose a very high risk of serious harm being caused to the public.’

The judge imposed special restrictions on the hospital order limiting the circumstances under which Salih could be released.

He was also banned from driving for ten years after admitting dangerous driving.


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An Independent Investigation into the Care and Treatment of Service User Mr L by Sheffield Health and Social Care NHS Foundation Trust  EXECUTIVE SUMMARY

October 2014

Main findings and conclusions

As a consequence of the quality assurance review undertaken, the Independent Team considers that the care and treatment of Mr L complied with the expected local and national standards in respect of the:

  • Assertive attempts by EIS to re-engage Mr L with service between 24 August 2010 and 30 November 2010.
  • Referral to a professor in sexual health medicine on 23 June 2010, following Mr L’s repeated concerns regarding the impact of his medication.
  • Care co-ordinator’s liaison with general practitioner (GP) on 2 November 2010 in relation to Mr L’s non-engagement with the early intervention service, and whether or not Mr L had been collecting his medication prescriptions.

(Page 5) Incident Predictability

With regards to the predictability of the incident, the Independent Team considers that this incident was not predictable. There was nothing known to the mental health services at the time that could have forewarned them of the risk Mr L posed to the two individuals who died as a consequence of his attack on them. Even had the initial admission assessment been conducted to optimal standards, and the contact with Mr L on 28 March have been optimal, it is very unlikely that the risk of this incident was predictable. Mr L displayed no behaviour of such magnitude to have alerted anyone to such a risk. Furthermore, the Independent Team understands that, after leaving the CMHT base, Mr L spent the afternoon in the company of persons close to the deceased and nothing untoward in his behaviour was noted; this further underlines the inability of anyone to have predicted the violence that was to occur.

With regards to preventability, this is often a grey area. The Independent Team is unified in its opinion that the assessment of Mr L and the management of the presenting situation on 28 March 2011 was suboptimal. However, even if the clinical management had been optimal, there were a range of avenues available to the assessing CPN, which, even if utilised, may not have prevented the incident.
These were:

  • To find out if a male mental health professional was available to speak with and assess Mr L.
  • To seek medical advice and/or a medical assessment of Mr L while he was at the community mental health team base.
  • To assertively try and achieve re-medication…