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SSRI Stories Summary: After several years of a deteriorating relationship, TG’s wife Elizabeth leaves him in August 2002. At some point during the breakdown, TG has started to take antidepressants and has become a heavy drinker. The independent review report is confusing in places and contains inconsistencies. However, it appears that TG has been prescribed fluoxetine and Diazepam. Shortly after Elizabeth moves out, TG attempts suicide by overdose but he calls her and is rescued. On Sept 3, 2002, his antidepressant is changed to paroxetine (Paxil, Seroxat). Some time between Sept 3 and 19 he smashes up the house, because on the 19th he expresses regret for having done this. He also makes threats to stab his wife, repeated several times over the next few days. On Sept 22 he makes good on his threat, stabbing Elizabeth over 30 times and killing her. While news articles make reference to the overdose, they do not mention the SSRIs. The independent review mentions the SSRIs but does not explore any potential link between the meds, the suicide attempt and the killing.
The North East Chronicle
By Evening Chronicle
Health chiefs have ordered an inquiry into the care for a former psychiatric patient who butchered his estranged wife
Thomas Gallagher was jailed for life in April for murdering wife Elizabeth in Shiremoor, North Tyneside.
But today Elizabeth’s mother Sylvia Shortt said she only blamed Gallagher not the system.
She said: “He took an overdose about a month before he murdered my daughter. He had 10 days in North Tyneside Hospital and received the best possible care.”
Northumberland, Tyne and Wear Strategic Health Authority has commissioned an independent inquiry into the care and treatment he received before he committed the murder.
Gallagher picked up a knife and stabbed 34-year-old mum-of-two Elizabeth 30 times in the chest and back at their former home in Park Grove because he thought she was taunting him about a new relationship.
Elizabeth’s parents, Brian and Sylvia Shortt, from Shiremoor, are now looking after the their daughter’s two children – Lucy, eight, and five-year-old Lauren.
Mrs Shortt added: “He took the overdose and phoned my daughter so she would come rushing round. We don’t think he meant to kill himself but that it was a way to get sympathy and get her back.
“It is ironic she saved his life and he ended up murdering her.
“We have no sympathy for him. He’s left two little girls without a mum. He has destroyed everyone’s life but we are determined to cope.”
Painter and decorator Gallagher, 45, a heavy drinker, had struggled to cope since the couple’s marriage broke down.
He had taken an overdose shortly before last September’s killing. Once he was released from hospital he went on a wrecking spree at the matrimonial home. He had threatened to stab Mrs Gallagher only weeks before carrying out his warning.
A Health Authority statement read: “We have commissioned an independent inquiry into the care and treatment of Thomas Gallagher.
“This is taking place under national guidelines relating to crimes committed by people who have been in receipt of mental health services.”
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Report to Northumberland, Tyne and Wear Strategic Health Authority of the Independent Inquiry Panel into the Health Care and Treatment of Thomas Gallagher
3. SUMMARY OF EVENTS
- TG was born on 17 June 1957 and was aged 45 at the time of these events. He was married to Elizabeth Gallagher (EG) and the couple had two children who were aged seven and four at the time of these events. EG worked as a pharmacist’s assistant at a local pharmacy and TG worked irregularly as a self-employed decorator. Other than one isolated episode in which he took an overdose in 1979 (aged 22) he had not had any contact with mental health services.
- The relationship between the couple deteriorated in the late 1990’s, at which time TG developed a pattern of regular heavy drinking. In about mid-August 2002 EG left the family home taking the children with her and returned to her parent’s house. TG continued to have regular contact with the children.
- On 17 August TG presented to his general practitioner (GO) who noted that he was very upset about the sudden slit with his wife. He was prescribed Diazepam (a tranquilliser).
- On 19 August TG took an overdose of 20 Diazepam tablets, 10 Fluoxetine tablets (an antidepressant – apparently obtained from a family member), and approximately eight pints of beer. He had written a suicide note, but after taking the overdose he had telephoned his wife at his parents-in-law’s house, and told her that he had taken the overdose…
- The following day, 20 August 2002,, he was seen by the deliberate self-harm team at North Tyneside General Hospital who assessed him as being at high risk of further self-harm, and he was therefore admitted to ward 21…
- On the night of 8/9 September 2002 TG was arrested following an incident in which he caused damage to the family home when drunk. He was detained by the police and put before the North Tyneside Magistrates’ Court later on the 9 September 2002, when he was bound over to keep the peace. Later that day, he presented himself to the accident and emergency department at North Tyneside General Hospital expressing threats of further self-harm and threats of serious harm to his wife.
- On 10 September 2002 he was allowed to go on home leave. A clinical review carried out in his absence assessed him as displaying no evidence of any mental illness, and on 11 September 2002 he was discharged, with medical follow up one week later at the community mental health team’s community clinic.
- On 22 September 2002, at the family home, RG killed his wife by stabbing her. Subsequently he was charged with and pleaded guilty to murder. He was convicted on the 2 April 2003 receiving a mandatory life sentence.
FIRST ADMISSION 20 AUGUST TO 3 SEPTEMBER 2002 (Page 18)
19 August 2002
TG was brought by ambulance to the accident and emergency department of North TYndale General Hospital with a history of having taken an overdose of Diazepam, Fluoxetine and slcohol., He was admitted overnight to a medical ward for observation and assessment.
FIRST ADMISSION 20 AUGUST TO 3 SEPTEMBER 2002 (Page 25)
1.1 TG was admitted for observation and assessment on the night of 19 August 2002 and was assessed by the deliberate self-harm team the following day. They found that he had taken a serious overdose of 10 Paroxetine [fluoxetine??] and 20 Diazepam combined with 8 – 9 pints of beer. TG had written a suicide note and said during the assessment that he thought that the medication would be enough to kill him. He was not pleased to have survived and still felt suicidal. After taking the overdose he had called his wife and now regretted doing that. He was clearly in despair about the break-up of his marriage and appeared to have few sources of support. The team carried out the Beck suicide score and found him to be at high risk of suicide. They discussed TG’s situation with the medical staff on Ward 21 following which an informed decision to admit TG to the ward as an informal patient was made.
3 September 2002 (Page 23)
The plan included that TG remain on his present medication (Fluoxetine) for a period of six months and that he self-refer to TUrning Point (a drug and alcohol service) if necessary.
The senior house officer made a contemporaneous medical note of the meeting. He noted that TG said that he was feeling well although lonely; that he was not sure about the accommodation position; that he wanted to stop/decrease alcohol but did not want to be referred to the drug and alcohol service.
NARRATIVE OF TREATMENT
4 September 2002
On the day after his discharge TG attended his GP who recorded that TG felt very agitated. The GP changed his anti-depressant medication [to paroxetine (Seroxat, Paxil) – see Sept 19] and arranged to see him a further week ahead.
19 September 2002 (Page 39)
According to the prosecution witness statement of RO, TG telephoned him at approximately 1.15 am, clearly drunk and repeated several times his threat to stab his wife.
Later that morning TG attended the Whitley Bay community mental health team for medical follow up with the senior house officer (SHO). He was said to be having no problems with his mood but still to be drinking significant amounts. He expressed regret about drinking and smashing up his house. He was noted to be prescribed Paroxetine and Diazepam by his GP.
21 September 2002
According to the prosecution witness statement of RH, TG became drunk during the evening and told him “I’ve got a knife. I’ll do it”.
22 September 2002
TG went to the family home at approximately 11:30 am following which TG killed his wife by stabbing her. The pathologist subsequently identified more than thirty stab wounds to the body of which ten were deeply penetrating.