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SSRI Stories summary: Mark Robinson has been prescribed citalopram. He reports to his GP that the drug is not helping and he feels anxious, conflicted, and has insomnia and panic attacks. So on October 15, 2010, his GP doubles his dose. In mid-Dec he tells a CMHT psychiatrist he needs help, explaining that he bought a baseball bat and a knife and went to the home of Albert Wright with the intention of killing him. The psychiatrist duly inform the police and for weeks officials talk about doing something. The psychiatrist reacts by changing his diagnosis and on Feb 17 increases MR’s dose of citalopram again. On Feb 25 MR murders Albert Wright. MR is sentenced and jailed for life with no chance of parole for 21 years. The news article blames a grudge but no mention is made of medication. The independent review provides details of the prescription but does not consider it a potential contributing factor.
The Ilford Recorder
16:16 20 January 2012
A delivery driver who stabbed his stepdad’s 80-year-old father to death with a steak knife in a row over his inheritance has today been jailed for at least 21 years.
Mark Robinson, 35, knifed widower Albert Wright, of Trelawney Road, Hainault, 31 times “in order to inflict suffering” on his victim’s son David.
David Wright had married Robinson’s mother Susan just three months before her death from liver disease and her son held him “at least partly responsible”, the Old Bailey heard.
Robinson was angry he inherited the bulk of her estate, including a house in Borehamwood, Hertfordshire, and lucrative pension funds.
But the court heard David had paid Robinson £22,500 from the money he had inherited, on the understanding it would be paid to Robinson’s 15-year-old daughter.
After the February 25 murder Robinson told police: ‘I wanna stick it to him and if he has to live the rest of his life without his dad then so be it.’
Robinson, of Green Court, Green Close, Luton, admitted murder at a hearing on Monday.
Judge Andrew Bright said: “It’s clear that the murder of Albert Wright has had a profound and lasting impact, not just on David Wright but on the family friends and neighbours of Albert Wright.
“They have all had to come to terms in particular with the manner of Albert Wright’s death at your hands, which was shocking and deeply distressing for all those who knew him.”
Prosecuting, Roger Smart said: “The defendant attacked the deceased almost immediately after he answered the door and did not exchange words with him.”
In a statement read to the court, David Wright said: “My father was my only living family member with whom I had a relationship.
“Dad and I were very close. I was living with him at the time he was killed and his death has left me devastated.”
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An independent investigation into the care and treatment of a mental health service user (X) in Bedfordshire by South Essex Partnership University NHS Foundation Trust
1.6 During the day of 25 February 2011 X went to the house of Mr Y in Hainault, London. At around 18.00, when Mr Y opened the door, X attacked Mr Y with a knife, causing fatal injuries. Mr Y was discovered by his son Z, at around midnight on 25 February 2011.X was arrested on suspicion of the murder of Mr Y on 28 February 2011.
1.7 X had a period of care provided by secondary mental health services between October 2010 and February 2011.
1.8 He was initially referred to primary care ‘Talking Therapies’ in August 2010, and to mental health services by his GP in September 2010, after a period of time off work with anxiety, panic attacks and depression. He was seen for assessment on 15 October 2010 by a psychiatrist from the Luton Assessment and Single Point of Access (ASPA) team.
1.9 He was assessed as having intermittent thoughts of suicide but no active plans. There is no record of an assessment of risk to others at the time. His antidepressant medication, citalopram,1 was increased, and he was given a further out patient appointment in 4 weeks’ time, when a referral to psychology would be considered.
1.10 He was seen again on 22 November 2010 and referred to psychology for assessment following disclosing psychological conflicts and anxiety.
1.11 X was next seen by a psychiatrist on 13 December 2010 and disclosed that over the weekend he had left his delivery lorry and taken the train to the house in Borehamwood where his mother used to live with his ‘stepfather’ Z. He stated he disclosed this because he wanted help.
1.12 He reported that he had bought a baseball bat (and later disclosed he had a knife) and waited outside the house from 14.00 to 23.30, with the intention of killing Z. He went again to the address on the following day but did not find Z.
1.13 The psychiatrist informed the police, and referred X to the Luton and South Beds Crisis Resolution and Home Treatment Team (CRHTT) on 13 December 2010, for more intensive input. ..
1.17 Although there were a series of daily phone calls made, some of which he answered, the CRHTT did not actually see him again until a cold call was made on 18 January 2011.
1.18 On this occasion his flat was observed through the letterbox to be in disarray and although X was present, he would not respond to staff.
1.19 Following a team discussion, a Mental Health Act assessment (MHA) was requested; but because of operational issues was not carried out, though police were asked to do a welfare check. The Mental Health Act 2007 made several key changes to the 1983 Mental Health Act, which laid down provision for the compulsory detention and treatment of people with mental health problems in England and Wales.http://www.legislation.gov.uk/ukpga/2007/12/contents
1.20 It was reported back to the CRHTT by the approved mental health professional (AMHP)that the police had visited and X was reported to be fine. After team discussion the CRHTT consultant asked for a formal MHA assessment, which was carried out on 21 January 2011 under Section 135 MHA.
1.21 X was assessed as not detainable under the MHA, and a plan of follow up action was proposed, including an appointment with his previous consultant at the ASPA/Community Mental Health Team (CMHT). X did not attend this follow up appointment on 27 January 2011, and it was agreed the CMHT would follow up. He was then discharged from the CRHTT with a diagnosis of Panic Disorder with Depression on 27 January 2011.
1.22 X attended an appointment with the CMHT psychiatrist on 17 February 2011, and was noted to have no evidence of psychosis or affective features, and he denied any thoughts of harm to himself or others. He was given a further appointment for four weeks later.
1.23 The homicide of Mr Y (Z’s elderly father), was carried out at Mr Y’s home address on 25 February 2011. X had travelled there with the intention of killing Z.
1.24 He had waited outside the house for Z to return, and when Mr Y returned instead, he decided to kill him, knocked on the door and fatally stabbed him.
1.25 X pleaded guilty to the murder of Mr Y and on 20 January 2012 was sentenced to life imprisonment, with a recommendation that he serve 21 years.
4.7.3 X attended his GP after the accident at work in June 2010.He reported taking time off work because of anxiety and depression, and not sleeping well…He was prescribed citalopram 20 mg daily.
4.7.4 He was reviewed in July 2010 by his GP and was still getting panic attacks and insomnia, and finding the citalopram was not helping. He was referred to a primary care counselling service ‘Talking Therapies’. X saw this counsellor for six sessions for management of anxiety symptoms, which was initially successful in getting him back to work in October 2010. However he returned to his GP after feeling ill and unsafe to drive at work.
4.7.5 The GP increased his citalopram to 40 mg daily in September 2010, and referred him to the community mental health team (CMHT) in Luton for psychiatric assessment…
4.7.10 At his next appointment on 13 December 2010, X disclosed to doctor K1 that when at work on 10 December he had parked his lorry and taken the train to Borehamwood (to the house his mother used to live in). He bought a baseball bat (and later disclosed having a knife) and planned to kill D (the man his mother had married before her death). He disclosed that he believed D had been encouraging her abuse of alcohol, and because of this she died. He reported waiting in bushes in front of the house between 14.00 and 23.30. D did not appear at all, and by 23.30 he reported being cold, and had many texts from his partner, who came to pick him up. 4.7.11 X told doctor K1 he returned to the house the following day but did not find Z. He disclosed that thoughts of killing Z had been present for a while, but deep inside he didn’t want to do it. X said he had discussed this with his partner, and he had decided to disclose his thoughts so he could get help. No thoughts of harm to himself or anyone else apart from Z were elicited.
4.7.12 Doctor K1 told X he would need to inform the police, and proceeded to report the disclosure and X’s actions over the weekend. This was logged by Bedfordshire police and Dr K1 was given a ‘URN’ (reference) number.
4.7.14 Dr K1 then referred X to the crisis resolution home treatment team (CRHTT) on the same day, because he believed X required more intensive input than the CMHT or ASPA could provide. The referral by Dr K1 describes X as “extremely volatile at the moment, and cannot control his thoughts and emotions…he appears very cold and there is high risk of him harming the person in question”.
4.7.29 X did not attend the appointment on 27 January 2011. On 14 February 2011 Dr K1 wrote to him informing him that his diagnosis had been changed to ‘Associated’ (sic) Personality Disorder ICD10 F60.2’; that the team did not think he needed a care coordinator, and he had been referred to a psychologist. He was offered a further appointment on 3 March 2011. This letter was copied to X’s GP.
4.7.30 Dr K1 wrote to X’s GP on 25 February 2011, after a review on 17 February 2011. Dr K1 reported that X attended on 17 February 2011, and that he had no thoughts of harm to himself or anyone else, was “compliant and insightful”, to continue on citalopram 60mg, and review in 3 months. It was noted by Dr K1 that the “psychology referral was already done”.