Man who killed parents needed more help - doctor

A man who stabbed his parents to death during a psychotic episode should have had further mental health assessments in the months before the killings, a doctor has told an inquest.

James Andrews, known to his family as Duncan, killed Mary, 76, and Bryan Andrews, 79, at their home in Terrey Road, Totley, in Sheffield, in November 2022.

Andrews had complained about having psychotic episodes, including suicidal thoughts, and told a helpline “something serious is going to happen”, said Dr Jonathan Mitchell, consultant psychiatrist.

A referral to a specialist mental health team was denied, meaning an opportunity to identify whether his psychotic episodes were persistent was missed, the inquest heard.

Andrews was given an indefinite hospital order in July 2023 after he admitted manslaughter on the grounds of diminished responsibility.

Appearing at the inquest on a video link, he heard how he had accessed mental health services in November 2011 when he suffered a seizure, leading to him feeling paranoid.

He was assessed by the Improving Access to Psychological Therapies team, before being reassessed in November 2017 when he had thoughts of suicide, Dr Mitchell said.

On 29 April 2022, he called an NHS referral line to say he had psychotic episodes and was directed to A&E for an urgent assessment.

Andrews reported feeling like he was “going to kill someone”, Dr Mitchell added.

Sheffield Health and Social Care’s Early Intervention Team rejected a referral, something Dr Mitchell said should have been accepted.

This was possibly because the team did not see it as Andrews’ first episode of psychosis, which they were tasked with dealing with, the Medico-Legal Centre in Sheffield was told.

“I say he was suffering with clear psychotic symptoms,” Dr Mitchell told Coroner Tanyka Rawden.

This included hearing voices and having thoughts of harming his family members.

“The issue was by the Early Intervention Team not assessing him, and the fact he had persistent psychotic episodes was missed.”

If the psychotic episodes were identified as being persistent, Andrews’ treatment may have been different, including alternative medication, Dr Mitchell said.

"He would have been offered a trial with antipsychotics. If he had taken it, it probably would have improved his outcome," Dr Mitchell added.

When Andrews was discharged from that specific period of care on 9 May, an email that should have been sent to his GP summarising the care he received, and next steps to take, was never sent.

When asked by the coroner if Andrews had no mental health support between May and a final referral date in October, Dr Mitchell said that was correct.

Katie Hughes, a mental health nurse and senior practitioner with the Home Treatment Team, told the court the discharge summary was possibly not sent because of a “very, very unfortunate system error”.

It seemed that instead of being sent, it was last edited in a draft state on 21 June.

When Ms Hughes was asked if she felt Andrews should have been detained under the Mental Health Act, she said she did not.

The inquest is expected to conclude on Wednesday.

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