To view original article click here
Darren Gregson, a young man with a history of alcohol abuse and epileptic seizures, is taken to the GP by his mum. The GP does not think he is depressed but prescribes paroxetine anyway; he has taken it before. The young man’s mood and behaviour deteriorate, and in February, 2005, the dose is increased. He becomes suicidal, suffers mood swings and seems “disoriented” to his mother. In May he has become paranoid and is not sleeping. On June 3 he stabs his step-father to death. The news report does not mention the paroxetine and the subsequent inquiry report mentions it but does not consider its potential relevance to events.
The Telegraph & Argus
15 Nov 2005
A man who stabbed to death his step-father as he lay defenceless on his settee has been jailed for life after being found guilty of murder.
Mark Berry, 49, was knifed seven times in the chest by Darren Gregson, a reclusive loner who had been drinking strong cider.
Yesterday the Recorder of Leeds, Judge Norman Jones QC, sentenced Gregson to life imprisonment and ordered that he serve a minimum of 12 years.
During the trial at Leeds Crown Court the jury heard that the large kitchen knife wielded by Gregson penetrated Mr Berry’s heart in the violent attack at the family home in Spring Bank Drive, Norristhorpe, Liversedge.
Yesterday the jury unanimously convicted Gregson, 30, of murder. He claimed he had no recollection of stabbing Mr Berry, an alcoholic, who had provoked him over a number of years.
But after the murder verdict Mr Berry’s sister, Pat Philbrick, of Mirfield, said her family welcomed the jury’s verdict. “We are very happy with the result. I sat in that court and listened to the evidence objectively and I certainly would have found him guilty.”
She said that although her brother was an alcoholic he did not deserve what had happened. “I lost my dad 12 years ago when he committed suicide and now my brother is murdered”, she told the Telegraph & Argus.
Gregson told the jury he was suffering from delusions and depression at the time of the killing. He said he was hearing voices and seeing people who weren’t there.
He told how he had suffered years of verbal taunts and abuse from Mr Berry, a former Tesco manager in Cleckheaton, who married his mother Gillian in 1989.
The court heard how Gregson, who trained as a tree surgeon and landscape gardener, had given up his work because he suffered from epilepsy and depression.
Gregson told the jury his stepfather had attacked his mother and he had seen her with bruising.
But prosecutor Andrew Campbell QC said that Mr Berry had no defensive injuries. He had suffered nine chest wounds during what must have been a deliberate and sustained attack. Gregson’s mother Gillian and sister Vicky wept in court as the verdict was announced.
To view complete original report click here
REPORT OF THE INDEPENDENT INQUIRY REFERENCE SUI 2005/2100
TO BE PRESENTED TO THE NHS YORKSHIRE AND THE HUMBER BOARD 5 JUNE 2007
- On 30 September 2004 patient B attended his GP, together with his mother. He complained of symptoms suggestive of psychomotor retardation…
His mother, who did most of the talking during the consultation, described a situation where be had been increasingly reclusive, latterly spending most of his time in his bedroom. He had become increasingly apathetic, walked out of his job as a landscaper some 3 months ago after 4¾ years in the same job. He had also “packed his girlfriend in”. He still sees her, however, from time to time. His mother’s description of the situation was ‘had a lovely girlfriend but can’t be bothered”.
Increasing apathy, lack of interest in everyday things, even difficulty getting out of bed or making a cup of coffee, is the principal presentation of his problem. 11
His bedroom had become reduced to such a state that currently, the contents have been transferred to a skip by his mother and sister. He suffers with poor sleep but denies any particular suicidal ideation.
His manner was not that of someone severely depressed in my opinion. He did not avoid eye contact, he did not show evidence of psychomotor retardation in his speech or body posture. His descriptions of recent life events were, if anything, rather matter of fact. He does not appear to have been weepy or guilty about recent events.
I was not sure about the extent of depression here but felt it more appropriate to seek a second opinion. In the interim, I have started him on the drug he was on previously, Paroxetine at 20 mgs daily and I am due to review him in some 3 weeks. I enquired regarding his current alcohol consumption and it would appear, mainly due to financial constraint, he has cut down on his alcohol consumption. Last week, for instance, he drank 8 cans of lager on a Saturday night which I estimate is approximately 14-16 units of alcohol but otherwise, did not drink…
- Patient B was sent an outpatient appointment for 19 October. He cancelled his appointment at outpatients for 19 October and subsequently one for 23 November 2004.
- In October 2004 patient B was claiming incapacity benefit. In November he attended his GP having run out of his medications. He had started to have a recurrence of his fits. The GP increased his Epilim to 600 mg twice daily and continued the Paroxetine.
- Patient B then failed to attend an appointment on 11 January 2005. He was discharged and his GP informed that no further appointment would be given. That letter was sent on 31 January 2005.
- On 24 February, patient B attended his GP. He reported that he was getting good and bad days and that he had fallen over after a possible epileptic fit. His Paroxetine was increased to 30 mgms daily.
- On 16 March patient B’s mother telephoned the surgery and discussed her concerns about her son. She stated that she was very concerned that her son had three fits the week before and that he was ‘suicidal’. He had cut his wrists and had required 18 stitches. He was saying ‘give me paracetamol; put a gun to my head’. The GP spoke with him. patient B said that he was not depressed, that it was the fits that were concerning him, but that he still wanted to die.
- The GP made an immediate referral for a mental health assessment by the Crisis and Home Treatment Team. It was agreed that he would be seen in the Accident and Emergency Department that day.
- On 18 March 2005 the Crisis Team Charge Nurse wrote to the GP as follows: ‘Following referral to A&E department on 16.03.05 by yourself, for mental health assessment; I assessed [patient B] and also had the opportunity to speak to his mother.
[patient B] stated that he is upset and frustrated with having frequent fits. He said he has had 4 epileptic fits in the previous 4 days. He showed me a bite mark on his tongue which he said he sustained during a fit. [patient B] also said the injury on his arm (for which he received A&E treatment earlier that day) was also an injury sustained during an epileptic fit. He said, ‘people keep telling me I am depressed but I do not feel depressed”, [patient B] certainly presented as elated, in a nice way, and he was well focused on the account he was giving me. He maintained good eye contact and certainly did not present as depressed. He was sober, coherent and rational at the time. “I have not tried to commit suicide; don’t let anybody tell you otherwise”, he said. He denied having suicidal/self-harm ideas. [patient B] said he is drinking a lot (i.e. 8 – 12 pints of ‘strong cider/day). He said the drinking helps him get rid of the boredom. [patient B] revealed to me that neither his mother nor his G.P. is aware that he uses cocaine. He said he is on £120 per week habit. He went on to say he sees alcohol as a problem, not cocaine. I tried to gently educate him on the probable impact of cocaine on his behaviour pattern but he was having none of that. He said he has been using drugs for a few years and if cocaine ever becomes a problem, he would stop using it there and then. 13
Towards the end of the assessment I invited [patient B]’s mother to join us in the assessment room. She said she believed [patient B] was depressed and also expressed concern at [patient B]‘s changeable behaviour. He apparently can swing his behaviour from being calm and gentlemanly to being agitated and at times looking very depressed. Unbeknown to [patient B]’s mother, the behaviour/mood pattern she described is typical of that of a drug user. The cocaine will give him periods when he feels high and agitated. Then when the drug wears out of his body system, his mood drops to a low when sometimes drug users feel suicidal. It is all part and parcel of the illicit drug use package. I discussed this assessment with our Consultant Psychiatrist and he did say it is possible the impact of cocaine on the central nervous system is exacerbating the frequency of epileptic fits. There is not a lot our mental health services can offer [patient B] until such time he shows a readiness to get the drugs and alcohol problems sorted. He refused help with his drugs and alcoholic problems.
Plan: Discharge him home. Please note that [patient B] authorised me to discuss the drugs issue with you but he still does NOT want the drugs use information passed on to his mother. Charge Nurse Crisis and Home Treatment Team Cc Batley Enterprise Centre, File.’
- The charge nurse subsequently discussed the consultation with the consultant, both in a telephone conversation and in a meeting. No further action was considered necessary at that time.
- Patient B telephoned his GP on 18 March. He reported his visit to A&E and his assessment by the Crisis and Home Treatment Team. He referred to his usage of cocaine, which gave him sudden changes of mood and made him agitated, but he did not see this as a problem. He said his mother was unaware of him taking cocaine. He also reported drinking 12-14 pints of strong cider each day which he did see as a problem, although he did not seem motivated to do anything about it. He denied feeling depressed and did not give the impression to his GP that he was depressed. He denied any intentions of self harm.
- On 26 March patient B contacted the 24 hour helpline run by the Crisis and Home Treatment Team. The records state:
‘Phoned to have a chat. Felt bored generally. Says his epileptiform fits are increasing and that he had MRI and EEG which have shown normal. He has a GP appointment on Wednesday and I advised him to ask the GP if it was possible to refer him to a neurologist about which he sounded pleased and says he is making a note in his book so that he does not forget. He says he wants to get to the bottom of his problems and get back to work.’
- No further action resulted from this call.
- Patient B attended his GP on 30 March. The records state: ‘Continuing to have 1 fit/week. ‘Up and down’ re – depression. Thinks feels better with ↑ b.d. dose. Now just ‘pissed off’ with fits. Has cut down on alcohol. Says hasn’t drunk 12-14 pints for ages. Now just drinking socially 3x/week. States cocaine use was last year. →↑ Epilim to 3 bd Only taking 2 bd.’
- He re-attended the GP on 13 April, accompanied by his mother. The records state: ‘With mother: Mood swings ‘concerning’ frightened by this, can’t tell night from day. Taped self into bedroom (didn’t want anyone to come in). Other days is fine. Has 5 bad days to 2 good days. V. poor sleep. ‘Tired’ with epilim. Thinks he has been referred to psychiatrist and neurologist. →re-refer consultant psychiatrist. Long discussion, husband alcoholic – not [patient B]’s Dad.’
- At this point it was the clear impression of the GP that the referral to the consultant psychiatrist by his partner in September 2004 had yet to result in an appointment. He thought that an additional letter to the consultant would add further clarity to consideration of the current clinical situation. For that reason he wrote to the psychiatrist two days later as follows: ‘15 April 2005 This 29 year old man has recently been in contact with the Crisis team who have in turn liaised with yourself When he was seen by the Charge Nurse last month, it appeared that his problems all seemed to be related to alcohol (8-12 pints of strong cider per day) and recreational drug use (Cocaine £120 per week). Saw him 2 weeks following this contact when his main problems seemed to be his continuing epileptic fits and he was having I per week and he felt that this was having the most significant affect on his mood, which he described as being ‘up and down’. I challenged him with regard to his alcohol and cocaine use and he said that he had been drinking heavily for a long time, stating that he now only drinks socially around 3 times per week. With regard to his cocaine habit, he states that this is also in the past and he hasn’t used anything for months.
I therefore increased his Epilim and then agreed to review him in 2 weeks.
This week he has attended with his mother who remains extremely concerned about him. He continues to have fluctuating mood swings and at times she is quite frightened by him. He is often disorientated in time and doesn’t know whether it is day or night, let alone what day is. He has displayed some bizarre behaviour, including taping his door up with duck tape in order to keep people out. There are other days when she describes his behaviour as normal, but these only occur on average, 2 out of every 7.
Both he and his mother seem to think you are planning to see him again, though this was not clear in the letter we received from the Crisis Team Charge Nurse. I would, however, be grateful if you could see him in the near future.’
- On 15 April, patient B was admitted to Dewsbury District General Hospital under the care of a consultant physician. The discharge letter to the GP states: ‘Admitted 15/4/05, discharged 16/4/05 Epileptic fit Known epileptic – has been on Epilim Excess alcohol intake Depressive illness MCV raised at 106 Drinking 15 pints of cider a day but recently cut down to one and a half cans of lager. With this in mind we treated him with Chlordiazepoxide, thiamine and Pabrinex. No follow up was arranged.’ …
54. A risk assessment had been carried out at the time of the initial assessment on 27 April. The risk of self harm was assessed as high; the risk of harm to others as low…
68. On 18 May, patient B attended his GP with his mother. The entry states: ‘?due psych referral ↑ paranoid – not sleeping. Convinced friend trying to break into house. Running and in garden with knives. Given sister’s sleeping tablets → IMIs → nitrazepam 5 mgm 28 1-2 every third night 2. Bitten tongue →infected → amoxicillin 250 15.’ …
75. On 3 June 2005, patient B was arrested for the murder of his step-father at the family home.