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SSRI Stories Summary: Abdur Choudhury, in common with most people forced to take neuroleptic medication long-term, most recently Abilify, suffers side effects such as cognitive impairment, social withdrawal, loss of motivation, and probably many other side effects. Perhaps his hostility to his mother was related to his forced “treatment”. Evidence shows these medications cause transient altered mind states to become chronic mental illness, and cause brain atrophy and neurologic damage. The sudden outbursts of anger, and periodic assaults, are not uncommon for people who have been on these drugs a long time, and have nothing to do with inherent mental illness. Yet the news articles refer only to AC’s diagnosis and make no mention of the drug or its possible contributory role.
CPS Thames and Chiltern News
A paranoid schizophrenic who battered his own mother to death in her living room was today, Friday, 02 November 2012, sent to a secure mental health unit.
Abdur Choudhury, now 34, punched and kicked his mother Ramatunnessa Choudhury shouting: “How much more? How much more?”
He rained punches and kicks on the 70-year-old in front of small children at her home in Bishopscote Road, Luton on Friday 26 June 2010, Luton Crown Court was told.
Beverly Cripps for the Crown Prosecution Service (CPS) said at one point Choudhury lifted up his mother’s head as she lay on the floor and hit her with a clenched fist. “He continued to hit her in the face and the force of the blows caused her false teeth to fall out,” she said.
The children’s mother tried to phone for help, but Choudhury stopped her. He did allow her to take the children upstairs from where she was able to call for an ambulance.
Mrs Choudhury was taken to the Luton and Dunstable hospital where she died the following Monday, at 2pm, having suffered three cardiac arrests. She had injuries to her temple, forehead, had suffered broken ribs, injuries to her kidneys, broken bones and had acute blood loss.
Ms Cripps said the cause of death was multiple organ failure as a result of trauma.
Choudhury, previously of Napier Road, Luton pleaded guilty to manslaughter on the grounds of diminished responsibility. His case had been delayed until psychiatrics were able to say he was able to appear in court and make a plea.
He had previous convictions in 2009 when he had attacked his mother with a knife and had assaulted a doctor who was treating him.
The court was told he was the youngest of Mrs Choudhury’s seven children.
Defence barrister Andrew Jefferies QC, defending, said: “The family have not just lost a mother; they have lost a son.”
Judge Richard Foster passed a Hospital Order under the Mental Health Act with a Restriction Order, which means Mr Choudhury will be detained at Brockfield House Medium Secure Unit in Wickford, Essex indefinitely.
The judge: “This is a tragic case for everyone, particularly the defendant’s family. I hope the end of proceedings can bring some solace to them.”
Please note – all court copies are provided by South Beds News Agency, who retain the copyright for all articles published.
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An independent investigation into the care and treatment of a person using the services of South Essex Partnership University NHS Foundation Trust
1.2 Incident Overview
On 26 June 2010, Mr H was arrested following a serious assault on his mother, who was admitted to hospital for treatment of her injuries, but subsequently died. At the time of the incident, Mr H was visiting his mother at the home of his brother. He was also a patient of The Trust.
Initially, Mr H was unfit to plead and was sentenced to a Hospital Order by reason of insanity3. Subsequently, in November 2012, Mr H was considered fit to plead and at a sentencing hearing his plea of manslaughter on the grounds of diminished responsibility was accepted by the Crown. The patient was sentenced to an Indefinite S37/41 Hospital/Restriction Order.
1.2.1 Relevant Contextual Information Mr H first came to the attention of specialist mental health services in December 2006, after assaulting his mother, unprovoked. Soon after admission, Mr H assaulted a trainee doctor and was transferred from the open adult ward to a low secure unit on 22 December 2006.
In the three years prior to his admission, it is recorded in Mr H’s mental health records that his friends and family had noticed a change in his behaviours. He had, it is reported, been working as a youth worker and left this post without any clear reasons for doing so. It is also reported that he began to dissociate from his friends and that he believed that his friends knew about conversations he had in his home.
Mr H’s family reported that he also began to display aggressive behaviour towards his mother. His mother confirmed to Mr H’s clinical team a range of unacceptable behaviours by her son towards her. Because of his behaviours, she left her home to live with another of her sons.
1.2.2 Relevant Clinical Information 2007 to 2009…
In January 2008 there was a multi-disciplinary meeting, including Mr H’s relatives, prior to the forensic community team taking over responsibility for Mr H. The clinical records report that:
- Mr H continued not to take responsibility for the events which occurred in 2006. • Mr H was more interactive with his brothers.
- Mr H was venturing outside of his brother’s home, which he had not done prior to the incident in 2006.
- Mr H was maintaining the boundary of not being in contact with his mother and only seeing her in the presence of other family members. • Mr H’s relatives remained concerned about possible future risks.
- Mr H’s then forensic consultant psychiatrist highlighted Mr H’s persistent denial about what happened in 2006.
- Mr H was to remain on depot medication.
- Mr H’s brother was content to provide accommodation for Mr H when he was discharged from the low secure facility.
Discharge from the low secure in-patient facility occurred on 19 February 2008.
19 February 2008 to 2 November 2009
Following Mr H’s discharge from the In-patient Services to the community forensic service, he was monitored on a weekly basis by his care co-ordinator. He also attended outpatient appointments with his sector consultant.4 At the time of his discharge he was on depot medication, which he continued to take until May 2008, when Mr H changed to oral medication. This medication was Aripiprazole 10mg daily, which was increased after three weeks to 15mg a day.
In August 2008, at a CPA meeting, the clinical records reported:
- Mr H showed no signs of psychosis and was medication-compliant.
- Mr H advised that he was now responsible for his medication, and had been since 14 July 2008, and his brother no longer watched him taking his medication. He also reported some side-effects, including a dry mouth and agitation in his legs.
- Mr H had visited his mother in the presence of another adult and that he had also been looking for work…
The next CPA meeting was scheduled for 17 November 2008. In the event, it occurred on 6 December 2008. The December CPA meeting focused on Mr H’s discharge from the community forensic team to general adult mental health services…
On 17 April 2009 Mr H’s community forensic care co-ordinator wrote to the team leader of the CMHT with the purpose of referring Mr H to that team. In this letter, the forensic care co-ordinator informed his colleague that “[Mr H] no longer presents a risk to himself or others”.
On 1 June 2009 Mr H attended his first outpatient appointment with his new community consultant psychiatrist. The outpatient letter generated as a consequence of this and sent to Mr H’s previous ‘sector consultant’ indicated that Mr H was very low risk and that it was appropriate for him to be discharged from forensic services to general adult services.
The letter also noted Mr H to be symptom-free, and that he accepted his diagnosis of paranoid schizophrenia. Mr H was noted as requesting to stay under the medical care of his pre-existing ‘sector consultant’, and the CMHT consultant advised that he would discuss this with his team and also the allocation of a care co-ordinator for Mr H.
Between 2 December 2009 and 14 January 2010 the community support worker met with Mr H on two occasions: once in a local department store (December) and the second at the house of Mr H’s brother (13 January 2010). Text and telephone contact had also occurred during this period, as Mr H requested the re-arrangement of planned meetings owing to unfavourable weather conditions.
14 January 2010: The community support worker set out a closing summary on Mr H’s file as he was leaving the community mental health team. The record the community support worker made communicated clearly that Mr H required meetings every other week at the department store and that monitoring of Mr H was required.
18 February 2010: Mr H attended an outpatient appointment with his CMHT consultant psychiatrist. No concerns were identified and a review was planned for three to four months’ time.
7 June 2010: Mr H attended an outpatient appointment with his CMHT consultant psychiatrist. The record made suggested that Mr H presented as well. However, it was also noted that he could no longer work at his brother’s restaurant.
25 June 2010: Mr H assaulted his mother who subsequently died of her injuries.