Son who killed parents 'could have had treatment', inquest told

There were "significant time lapses" in mental health treatment for a man who killed his parents during a psychotic episode, an inquest heard.

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

Senior coroner for South West Yorkshire, Tanyka Rawden, was told that Andrews was denied a referral to specialist services after complaining of episodes which he thought could have been brought on by epileptic seizures.

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

The court heard how he had accessed mental health services in November 2011 when he suffered a seizure, leading to him feeling paranoid.

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

Giving evidence, honorary consultant at the Sheffield Teaching Hospitals NHS Foundation Trust, Prof Markus Reuber, said those who were epileptic were more likely to be depressed and it was “extremely common” for people to have mental health issues, such as anxiety, after seizures.

The court was told that all anti-seizure medication, such as that which Andrews had been prescribed during treatment, has side effects which could include depression.

A referral to Sheffield Health and Social Care’s early intervention team was refused in mid-2022, a decision which meant an opportunity to identify whether Andrews' psychotic episodes were persistent was missed.

A report from doctors at the secure unit where he was staying said that it was believed that Andrews had four seizures two days before he killed his parents.

At the time of the killings, he was likely to be suffering from postictal psychosis, a mental health condition after a seizure where the person can have aggressive outbursts, Prof Reuber said.

The consultant added that there were “clearly structural problems” in the way notes between mental health teams and neurology teams were shared and this meant doctors prescribing medication might not know that some patients had mental health conditions unless they were specifically told.

The coroner said there was concern around communication between services at the trust, especially looking at “the relationship diagnosis of epilepsy and psychotic symptoms” with Andrews.

Tanyka Rawden said: “This led to significant time lapses between treatment, and rejection to services, most notably the early intervention service. Had there been regular and appropriate interaction between services, and had the early intervention service referral been accepted, it is possible that treatment could have been given.” 

She added that a prevention of future deaths report would be sent to Sheffield Health and Social Care looking at the communication between services, “in particular between psychiatrists and neurology.”

Mr and Mrs Andrews' daughters Sally and Lucie read out a family statement outside the coroner's court.

The sisters found their parents fatally injured at their home and Sally told the court there was “some comfort that we, including Duncan, were there together for one final time. They would have been absolutely devastated that day.”

Speaking by video link from a secure hospital, James Duncan Andrews, who thanked his sisters for their support during the inquest, said: “I loved my parents right to the end. I wish this had never happened.”

Deputy Medical Director at Sheffield Health and Social Care NHS Foundation, Helen Crimlisk, said: "a number of changes" had been made since the tragedy.

She added: "We are deeply sorry for the tragic loss of Bryan and Mary Andrews in November 2022, and our heartfelt sympathies remain with their family.

"All those involved with Duncan’s care have taken immediate steps to learn from this tragedy. We have already made a number of changes, and we will continue to make improvements to address the concerns highlighted through the inquest process."

The coroner recorded a verdict that Mr and Mrs Andrews were unlawfully killed.