John had a telephone consultation with Dr Sam Johnson on March 23.
Dr Johnson told the court that he was concerned that John was experiencing ‘significant delusions’ and said that he believed him to be ‘acutely unwell’. He assessed John as being at high risk and referred him to the community mental health team, with a face-to-face meeting set up for the following day.
On March 24, John told community mental health team assessor Natalie Vassilou about the phone calls he believed to have made and his concerns that the recipients of those calls wanted to kill him.
No evidence of any such threats or phone conversations have ever been discovered.
Miss Vassilou told the court that John had told her he did not want to take his own life in Italy and had only done it to prevent these people coming after him.
She said that she did not believe him to be at immediate risk of self-harm, citing protective factors such as being back in his home country, living with his sister, and the relationship with his parents.
Miss Vassilou added that she did not think John presented as being acutely unwell and made a judgement that he did not require immediate hospital treatment.
After consulting with a colleague, a decision was made that he did not meet the criteria for home-based treatment either.
John was told he would have to wait until April 20 to be assessed by a psychiatrist but that he should ring the crisis team if his condition worsened and he felt as if he needed to be reassessed by the community mental health team.
Despite ringing up on March 29 to tell a member of the team that his anxiety levels had increased, he was not reassessed.
Miss Vassilou told the court that she was on holiday at the time, which is why she did not deal with it.
Asked why her colleague did not reassess John, Miss Vassilou said: “I don’t feel like I could comment on someone else’s conversation because I wasn’t there.”
Dr Ayaz Qureshi, a consultant psychiatrist, said that there is no set criteria on deciding what makes a patient high risk and described it as ‘a very objective judgement’.
He was also asked why John was not reassessed despite informing the service of his increasing anxiety levels.
Dr Qureshi said: “[That member of staff] is not here so I can’t say how she was feeling at the time.”
He admitted that psychiatric assessments can be brought forward if there is urgent need to do so, but that due to John not being deemed high risk, this was not done.
Just over a week after telling mental health services that his anxiety levels had increased, John went missing from his parent’s house on April 6.
Following a search by Greater Manchester Police (GMP) some items of clothing belonging to John was found next to Manchester Ship Canal.
He was later retrieved from the water but was unresponsive.
Pathologist Dr Chandran carried out a post mortem and drowning was recorded as the cause of death.
A toxicology report found there was no alcohol or illicit drugs in John’s system, just therapeutic levels of anti-anxiety and anti-psychotic medication.
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Source: Manchester Evening News, 26th August 2021