An inquest has found that there were “significant time lapses” in the mental health care of a man with epilepsy, who killed his parents during an episode of postictal psychosis following a seizure.
James Duncan Andrews killed his mother, Mary, 76, and father, Bryan, 79, in November 2022 at their home in Sheffield. He was believed to have been in a postictal psychotic episode, following several seizures two days earlier.
He was given an indefinite hospital order in July 2023, after pleading guilty of manslaughter on the grounds of diminished responsibility.
An inquest heard yesterday that a referral was made to specialist services in mid-2022 following Andrews experiencing episodes possibly linked to his seizures. The referral was denied.
According to senior coroner in the case, Tanyka Rawden: “Had there been a regular and appropriate interaction between services and had the early intervention service referral been accepted, it is possible that treatment could have been given.”
‘Something serious is going to happen’
Andrews had previously complained about mental health problems, including feeling paranoid following a seizure, psychotic episodes and suicidal thoughts.
Consultant psychiatrist Dr Jonathan Mitchell said Andrews had told a helpline that “something serious is going to happen”.
A report from doctors at a secure unit where Andrews was staying said that he had had four seizures two days before he killed his parents.
Consultant neurologist Prof Markus Reuber said he was likely to have been having postictal psychosis.
Prof Reuber explained that structural problems meant that notes might not have been shared between mental health and neurology services. This means doctors may not have been aware of any mental health conditions when prescribing epilepsy medicines.
‘A medical emergency’
According to Epilepsy Action, postictal psychosis is a serious complication, and one of many that people with epilepsy can experience after a seizure.
The organisation said: “While it is relatively rare, postictal psychosis can happen to people with epilepsy after a seizure or a cluster of seizures. It can involve hallucinations and delusion and should be treated as a medical emergency
“It’s not the case in most instances, but sometimes there can be a risk of the person experiencing psychosis becoming very agitated, violent or suicidal if they don’t get the treatment and support they need quickly. In some, tragic circumstances, it has led to crimes.
“Anyone experiencing psychotic symptoms after a seizure should be assessed by specialist mental health services like an Early Intervention in Psychosis Team (EIT), Community Mental Health Team (CMHT) or acute inpatient services.
“Treatment involves medication to reduce psychotic symptoms. This is only needed for a short period of time.
“Anyone worried about psychosis should seek urgent medical advice from their GP, epilepsy specialist, mental health professional (if you have one) or 111.
“If the symptoms are severe and could be putting you or someone else in danger, you might need to get some emergency help by calling 999.”
For more information, visit the Epilepsy Action website or call the Epilepsy Action Helpline at 0808 800 5050.