The Case of Sheila Caffell: The Effects of Illegal Drugs on People with Schizophrenia — (Jeremy Bamber Official Website)

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Jeremy Bamber Official Website

October 11, 1986

Original material by T, Whitefoot; additions by L, Lake; J, Martin-Adams; P. A. Miller

In the early hours of 7 August 1985, five people were shot to death at White House Farm: Sheila Caffell, her twin six year old boys, and her adoptive parents, June and Nevill Bamber. Initially, Essex police believed that Sheila carried out the shootings and then committed suicide[1]. However, in the weeks that followed, that view changed and Jeremy Bamber, Sheila’s brother (also adopted, but no blood relation), was arrested and later convicted for the murders of Sheila, Nevill, June and the twins. He has since served twenty-seven years in prison for a crime which he did not commit. The purpose of this article is to explain the link between schizophrenia and cannabis and to show how Sheila Caffell’s collapsing mental health caused her to suffer a psychotic episode which resulted in the murder of her family.

Sheila Caffell

Schizophrenia is a mental disorder characterised by a disintegration of the thought process, and a breakdown ofemotional responses[2]. Most commonly, the disorder manifests itself in the form of paranoid or bizarre delusions, auditory hallucinations and/or disorganised, incoherent speech and thinking. It is believed that genetics can sometimes play a role in predisposing a person to develop the illness, but other causal factors, such as a history of mental illness and/or abuse of drugs and alcohol, have also been discussed[3]. There is no laboratory test to determine schizophrenia[4]; a diagnosis is made based on the patient’s self- reported symptoms, and a clinical assessment. It has been recorded that approximately 30-40% of diagnosed schizophrenics attempt suicide at some point during their lifetime and one in ten of these will succeed in taking their own lives[5]. It has also been established that people between the ages of 16-30 are more vulnerable to developing psychosis[6]. It is also within this age range that people are more likely to use cannabis[7].

Sheila also took Cocaine In recent years, a great deal of research has been conducted[8] in order establish a link between schizophrenia and the effects of cannabis and other recreational drugs. Over thirty clinical studies have taken place over the past twenty years, mostly in the UK, Sweden and Australia. It is now widely believed that using cannabis can prolong the symptoms of mental illness and impede a patient’s chances of recovering from a psychotic episode[9]. If a patient has already developed schizophrenic symptoms, the continuing use of cannabis and other substances, such as alcohol or amphetamines, is believed to have a detrimental effect on their illness[10]. Set out below are two examples of the research that has been conducted so far.

1. The authors of a study published in the American Journal of Psychiatry in May 2010 conducted a study over a period of ten years. Patients were examined during the initial first period of psychiatric hospitalisation and then six months later, and then two years, four years and, finally, ten years later. At each assessment patients were rated on their psychiatric symptoms and their use of cannabis. The study concluded that cannabis use is associated with an adverse course of psychotic symptoms found in schizophrenia sufferers[11].

Cannabis Smoking

2. In a study conducted at the Zucker Hillside Hospital in New York, researchers used a special kind of Magnetic Resonance Imaging (MRI) known as Diffusion Tensor Imaging (DTI) to measure the motion of water molecules which can indicate microscopic abnormalities in the brain. The test group included adolescents with and without schizophrenia, and adolescent users and non-users of cannabis. The MRI imaging revealed that heavy users of cannabis were found to have the type of abnormalities found in certain areas of the brain which are also found in the brains of subjects with schizophrenia[12]. These abnormalities were most pronounced in subjects with schizophrenia who were also regular users of cannabis[13]. The abnormalities occur in a pathway of the brain which is related to auditory and language functions which undergoes development during adolescence. The research suggested that if an adolescent is genetically predisposed to develop schizophrenia, the use of cannabis can cause the same type of damage to the brain’s pathway that is caused by schizophrenia Put more simply, regular and prolonged use of cannabis could kick-start the development of schizophrenia where it might otherwise not have developed at all, or cause an earlier onset of the illness, and/or cause the condition to worsen [14].

Social Services Noted Concerns

Sheila Caffell’s mental health issues probably surfaced initially in 1981 when social workers reported injuries to her twin sons, and she was described as forgetful and disorganized.[15] She was referred for psychiatric treatment to Dr Ferguson in 1983, but she had been suffering from depression for eighteen months or so previously[16]. She was diagnosed as suffering from paranoid schizophrenia[17]. In addition to cannabis, she was also reported to have used other recreational drugs on occasion, such as cocaine and amphetamine[18]. Having divorced her husband Colin Caffell twelve months earlier, she was believed to have acquired considerable debts in support of her drug addiction[19].

St Andrew Mental Health Hospital

Sheila was admitted as an in-patient to St. Andrews Hospital, Northampton in August 1983 following an acute breakdown[20]. During the course of her treatment, she was observed to display a number of classic ‘textbook’ delusions associated with paranoid schizophrenia, Dr Ferguson detailed that she had been in state of acute psychosis and had been for about two weeks[21]. These included religious delusions about being given the responsibility of ridding the world of evil, delusions about her children being ‘the devil’s children‘, and references to incestuous sex with her son’s whom she described as ‘the devil’s children.'[22].

When she was discharged one month later, having made only a partial recovery[23], Sheila had been prescribed Stelazine[24], an anti-psychotic drug which is typically the first line of defence in the treatment of schizophrenia[25]. People with schizophrenia are usually found to have high levels of dopamine activity[26]. Stelazine works by blocking dopamine receptors in the brain, thus alleviating or minimising schizophrenic symptoms of delusions, hallucinations and disorganised thought or speech. Common side effects of Stelazine are nausea, headaches, dizziness, menstrual irregularities and agitation. Major side effects are lowered life span, dyskinisia and akathisia (see glossary below).

In March 1985, Sheila was again admitted to St Andrews Hospital following a severe psychotic episode [27]. She had suffered violent outbursts, one of which was witnessed by a friend who was left traumatised by the event[28]. During a stay of only three weeks, Sheila admitted to having used cocaine frequently[29]. It appears that Dr Ferguson did not raise the issues about Sheila harming her children because of client confidentiality. Despite the fact that Nevill was paying for the treatment, Sheila was the patient. It is also important to remember that Sheila was an ‘informal’ patient; that is, she was not subject to a ‘section’ under the Mental Health Act 1983. Therefore she was advised about her treatment but could not be legally required to comply. This undoubtedly had far reaching implications.[29a]  At this time, Sheila was prescribed three kinds of medication: [30].

Anafranil Capsules

Anafranil – is a brand name of the chemical called Clomipramine. A tri-cyclic anti-depressant used a lot in the 1980s when it was considered to be very successful in treatment depression. It typically takes 2 – 3 weeks to become effective. Caution is always required as suicide is always possible for a depressed or a disturbed patient. Side effects include confusion, agitation, insomnia and nightmares[31];

Haloperidol is the chemical name which is typically branded as Serance in the UK – a very strong anti-psychotic drug with sedative qualities. It is noted as being the most common neuroleptic associated with extra-pyramidal symptoms[32]. Clinical trials have shown that a medium to high dose of Haloperidol for a two-week period dramatically increased the dopamine activity up to 98%[33]. Long term effect is not known, but severe dyskinesia is indicated, and long-term, high-dose treatment may result in depression severe enough to result in suicide[34];

Procyclidine – often branded as Kemodrin used to counteract the effects of anti-psychotic medications. Known side effects include agitation, confusion and insomnia[35].

Additionally, there is the issue of non-compliance. It is well known that patients who are required to self-medicate will often fail to take prescribed medication for two main reasons: one is that they do not believe they are ill and therefore believe the medication is unnecessary; the second is the result of the side-effects which many individuals find to be so extreme that they would prefer to tolerate their symptoms.[35a]

In July 1985, Sheila requested that her dose of Haloperidol be reduced. Her GP, Dr Angeloglou, contacted Dr Ferguson to discuss this for reasons unknown, but it is possible that Sheila had experienced some of the aforementioned side effects. The reduction of her dose from 200mg to 100 mg is the kind of sudden reduction which is potentially very dangerous as it may have caused severe withdrawal symptoms or even a return of the original condition, in addition to this because she was due another injection any side effects would have completely diminished[36].

Sheila Caffell

At the family dinner which took place at White House Farm on the night of the murders, the subject of Sheila’s twin boys being put into foster care was raised[37]. Sheila’s psychiatrist stated that the effect of this news would have been ‘catastrophic’, and may well have been the trigger for a psychotic episode[38]. Her post-mortem results showed no trace of Anafranil, but cannabis and Haloperidol were found[39]. Failure to take some of her medication would have been exacerbated by the ingestion of cannabis and also the sudden reduction of her Haliperidol – could have caused her already fragile mental health to crumble completely.

In 1985, the public and the police were perhaps reluctant to believe that a young mother could murder her own family with such brutality. In the twenty-first century, reports of women committing violent crime, including murdering one’s own children before suicide, or attempted suicide – are well documented in the media. The outcome of Jeremy Bamber’s trial may well have been different had it taken place more recently, and if the jury been made aware of research into the links between cannabis and schizophrenia. In fact, highly likely that Sheila Caffell’s life would have been saved had the advances made in understanding schizophrenia and its treatment been available in 1985.

It is also a debatable point as to whether her treatment would have been very different if Care in the Community had not been in the process of being phased in during the 1980s. Prior to this development, it had been standard for all patients with a diagnosis of schizophrenia to be admitted to hospital for long-term care which usually translated into life-long inpatient care.

 

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Jeremy Bamber murder case timeline

ITV

Jeremy Bamber has been behind bars for more than 26 years for shooting his wealthy adopted parents, June and Nevill, his sister Sheila Caffell and her six-year-old twin sons Daniel and Nicholas at their Essex farmhouse in Tolleshunt D’Arcy between Maldon and Colchester.

The 52-year-old was given a whole-life tariff after being convicted of the murders in October 1986 but he has always protested his innocence and claims his schizophrenic sister Ms Caffell shot her family before turning the gun on herself in a remote Essex farmhouse.

Jeremy Bamber at the funeral of his family he was subsequently convicted of killing Credit: ITV News Anglia

In 2009, Bamber lost a Court of Appeal challenge against the order that he must die behind bars. He has twice lost appeals against conviction.

The Criminal Cases Review Commission reached a provisional decision not to refer his case back to the Court of Appeal in February last year despite claims by his legal team that they had new evidence that could overturn his conviction.

The remote farmhouse at Tolleshunt D’Arcy where Jeremy Bamber killed his family Credit: ITV Anglia

  • August 1985 – White House Farm shootings take place in thevillage of Tolleshunt D’Arcy. Initiallydetectives treated the crime as a murder-suicide with Sheila Caffell suspectedof killing her family before turning the gun on herself
  • September 1986 – Jeremy Bamber arrested and charged with murder
  • October 1986 – Bamber found guilty at Chelmsford crown court
  • October 1986 – The Home Secretary Douglas Hurd calls for an inquiry for the police handling of the murder inquiry. The subsequent report makes 18 recommendations
Five members of the same family were murdered at a remote farmhouse in Tolleshunt D’Arcy in August 1985 Credit: ITV News Anglia
  • March 1989 – Bamber appeals against his conviction on the grounds that the judge unfairly summed up the case. He loses.
  • December 1994 – Bamber’s minimum term of 25 years is expended to a whole life tariff meaning he will die in prison.
  • March 2001 – Criminal Cases Review Commission (CCRC) refers verdict back to Court of Appeal.
  • December 2002 – Court of Appeal upholds Bamber’s murder conviction.
  • May 2004 – Bamber is taken to hospital after his throat is slashed by another prisoner at HMP Full Sutton near York.
Jeremy Bamber was convicted of killing his adoptive parents Nevill and June along with his sister and her six-year-old twin boys
  • May 2008 – Bamber loses an appeal at the High Court against the whole-life prison term which was later upheld in the Court of Appeal.
  • February 2011 – The Criminal Cases Review Commission rejects a bid by Bamber’s lawyers to refer the case back to the Court of Appeal after they submit new evidence.
  • January 2012 – Bamber and two other killers appeal against the whole-life prison tariff to the European Court of Human Rights in Strasbourg. They lost and it was referred to the Grand Chamber.
  • July 2013 – Grand Chamber of the European Court of Human Rights rules that whole life sentences “amount to inhuman and degrading treatment.” The panel of 17 judges said: “In finding a violation in this case, however, the court did not intend to give the applicants any prospect of imminent release.”