Chances to help father killer missed - inquest

Dr Kim Harrison was killed in a sustained attack at his home in Clydach, Swansea

There were missed opportunities to intervene and possibly prevent a patient killing his dad after he fled from a mental health unit, the man's psychiatrist told an inquest.

Prof Peter Donnelly described poor record management and the lack of a care plan for Daniel Harrison when his mental health started to deteriorate in 2021.

The 37-year-old was detained indefinitely under the Mental Health Act for manslaughter by reason of diminished responsibility after a sustained attack on Dr Kim Harrison, 68, at the family's home in Clydach, Swansea, in March 2022.

Despite meeting psychiatrists three times in the year before the attack, Harrison did not meet the "threshold" to be detained, Prof Donnelly told the coroner's court at Swansea Guildhall.

Prof Donnelly described meeting Harrison at a police station in April 2021 after an alleged assault on his landlord.

It was his first instance of physical violence, the inquest heard, and showed his deteriorating condition after successfully using anti-psychotic medication to manage his disorder for 10 years.

Prof Donnelly described how, in 2018, Harrison's then-psychiatrist left Swansea but he was only told by his mother, causing him to start to "distrust" mental health services.

He began refusing to engage with counselling and went off his medication.

His parents, both doctors in the Swansea Bay health board area, wanted him to be detained due to increasingly aggressive and paranoid behaviour.

He believed that, as NHS doctors, his parents caused the Covid pandemic and were benefitting from people's deaths.

But the inquest heard that this was not going on his medical records in a way accessible to all relevant health staff.

During a mental health assessment in April 2021, Prof Donnelly said Harrison was able to "mask" symptoms of his psychosis and the concerns raised by his parents were not enough to detain him.

Harrison then moved to Falmouth, Cornwall, returning to Swansea in August when he visited Prof Donnelly's mental health team in person to try and get an appointment.

He was referred back to his GP but did not seek help until December.

Prof Donnelly, who was on long-term sick during this period, said it was a "potential missed opportunity" to re-engage with Harrison and try to get him back on medication.

There should have been a plan on Harrison's file, he said, saying in simple terms that he had a history of psychosis and was reluctant to seek help but, if he were to attend, to be "proactive in terms offering an appointment or referring to him to a mental health assessment".

"I accept that it is something we should have done," he added.

Daniel Harrison had been detained at Neath Port Talbot Hospital

Prof Donnelly last saw Harrison in an meeting 44 days before he killed his father, but he was still "masking" his paranoia and psychosis, which had been reported to the health board in a formal complaint about his care.

"When we explored the risk to the family [Harrison] said he was happy with his parents and grateful to be back home," Prof Donnelly said.

Asked by Bridget Dolan, representing Dr Jane Harrison, why he did not seek out the parents about their views, Prof Donnelly said Harrison had not consented to that.

Ms Dolan suggested it was his professional responsibility to do more, but Prof Donnelly said Harrison has already "lost trust with the service" and he felt meeting the parents would not be productive since he had seen their concerns in writing.

When asked why there was no plan for Harrison to re-engage with service, Prof Donnelly said it was "remiss of me and the team".

"It was a gaping cavern in care," Ms Dolan said.

Prof Donnelly also revealed he was never interviewed by the health board about Harrison's care and his first written statement on the case was given to the coroner's court in September 2023.

Ms Dolan asked if he was surprised that the health board had not involved him in an investigation where a patient of his has committed homicide, but he did not reply directly to the question.

When asked if he could have done more, he replied: "In the circumstances, I don’t think I could have done anything different."

The inquest continues.