A worried mum asked for help for her teenage son days before he knifed a grandmother to death - but she couldn't get an appointment in time to prevent the tragedy.
Yet 19-year-old Ethan Mountain showed “no red flags” before the fatal attack, the nurse overseeing his care claimed. He had stopped taking anti-psychotic medication shortly before stabbing 62-year-old Joan Hoggett multiple times in the One Stop shop where she worked.
In 2019, Mountain, of Heaton Gardens, South Shields, admitted manslaughter on the grounds of diminished responsibility after a court heard his mental illness "impaired his self-control". He was made subject to an indefinite Hospital Order.
Read more: Nurse accused of 'altering medication chart to avoid disciplinary action'
At an inquest into Mrs Hogget's death this week, Sunderland Corner’s Court heard how Mountain had been under psychiatric care since suffering a psychotic episode in July 2017, over which he was sectioned. When he returned home, he was put under the care of the Early Intervention in psychosis team.
On Wednesday Care Co-ordinator Christopher Laydon said that, at meetings with Mountain and his mother, Nicola Curtis, he did not show 'any obvious concerns with regard to any symptoms of psychosis'. He was doing well at college and playing high-level sport, he said. However, Mountain failed to attend a number of meetings with Mr Laydon as well as with a family therapist and was last seen by the care coordinator on April 10, 2018.
On that date, Mr Laydon said his impression was: "That he remained well, there didn't appear to be any signs of psychosis... He was still engaging in social activities, that actually he was starting to come out on the college side of things and develop friendships, he was spending time with friends, that his insight remained intact, that there was no concern about his ability to make decisions.
"From what I was aware of he was concordant with his medication. At absolutely no point did I see any red flags or anything that might suggest that something is going on here."
His mother raised concerns at various points over her son’s mood and possible alcohol use, and later about him "pushing boundaries at home". But Mr Laydon said he had judged that this behaviour appeared to be that of a young man starting to look for independence, as opposed to a warning sign of a relapse of mental illness.
On June 28, Mr Laydon met with Mountain's mother, but the 19-year-old himself had left the house. On August 28, the concerned mum rang Mr Laydon, leaving a voicemail to request another appointment for her son, however, as he was embarking on a week of annual leave, he did not return the call, planning to arrange an appointment when he got back, and he did not hand the message on to colleagues.
On Semptember 5, Mountain entered the One Stop in Sea Road, Fulwell with a bag of weapons wearing a horror mask and killed Mrs Hoggett.
Mr Layton said he had been "confident" that Mountain's family had been aware of how to access emergency health services if they had urgent concerns.
On Tuesday, consultant psychiatrist Dr Tibor Kovacs said Mountain had disengaged with mental health services in the months before Mrs Hoggett's death. His dose of anti-psychotic drug risperidone was halved in February - although this was not the doctor's preferred course of treatment, he was offered the reduction in the drug after he'd said he wanted to stop it completely, in a bid to keep him engaged with the service and ensure he was taking some medication.
After the drug was reduced, the doctor said he believed there would be increased monitoring of the patient six weeks after this change. However, asking questions of Mr Laydon on behalf of Joan’s family, Catherine Walker said: “From February 26 Ethan isn't seen again until April 10, so my question is how would you have known how Ethan was presenting after the medication was reduced when nobody had been to see him?"
It was noted that family therapist John Simons had met with Mountain and his family on March 7, however, giving evidence later that day, Mr Simons said monitoring of medication was not within his role, although he could raise concerns if a patient was displaying concerning symptoms.
Representing Cumbria, Northumberland, Tyne and Wear Foundation Trust, Emma Sutton said: "It's fair to say...when you saw him on April 10, irrespective of their being no monitoring, there was no deterioration in Ethan's condition. There was no detriment because he was fine on April 10."
Mr Layton agreed with this. He also told the court that in the August 28 message, Ms Curtis had not expressed specific concerns about her son's condition, simply asked for an appointment.
In a statement heard by the court on Tuesday, Mrs Hoggett's daughter, Michelle Young paid tribute to her "loved and respected" mother, who she described as "shy and reserved" and "a very smartly dressed lady".
She said: "She worked hard all her life. She had had to look after her younger siblings when she was a child and then she had two children herself but she always helped others and cared for people...Mam was always fair but firm and loved her family and friends.”
The inquest continues.
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