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In this video, Chris tells his story of how he dealt with a traumatic childhood and subsequent diagnosis of schizophrenia. He talks about the medication and therapy that have helped him. Warning: The film does contain references to distressing themes.

Mr Malone was diagnosed with treatment resistant schizophrenia in 1983 and had been sectioned multiple times. In May 2023 he was diagnosed with adult autism. At a review on 31 May he was considered to be stable. On 15 June a routine clozapine review identified sub-therapeutic levels but this was not notified to his clinicians. Sub-therapeutic levels of clozapine are likely to have contributed to a worsening in his symptoms. Around 24 June he was noted to have suffered a significant deterioration – with symptoms of thought disorder, anxiety, and responding to hallucinations – and following a mental health act assessment on 28 June clinicians wanted to detain him under section 2. No inpatient psychiatric bed was available. Whilst he awaited a bed, he remained in the community with daily visits from the mental health team. Last contact was on 1 July when he accepted his medication and appeared more settled. There was no answer when he was visited on 2 July. His room at supported accommodation was entered on 3 July and he was found deceased. Recently he had expressed no suicidal ideation. Post-mortem examination confirmed the medical cause of death was:  1a Cervical spinal cord injury. 1b Laceration. The conclusion of the inquest was that death was the consequence of suicide. The MATTERS OF CONCERN are as follows. Despite recognising Mr Malone needed to be admitted to a psychiatric hospital in June 2023 but there was no bed capacity, BSMHFT’ RCA report identified no remedial action. The Patient Safety Manager gave evidence that the lack of psychiatric bed capacity remains an ongoing problem and has not been resolved, and there is a genuine risk of the same problem with another patient in the future. There was an exceptional process, which required a considered decision at a high level, to make a bed available through identifying someone currently occupying a bed space to be discharged. In my view, this process is unsatisfactory as it creates a different set of risks around the patient being discharged, and amplifies the chronic shortage of beds. There was reference to two preceding Regulation 28 Reports to Prevent Future Deaths that focussed on the chronic lack of mental health resources in Birmingham and Solihull. In relation to the specific issue of a lack of psychiatric bed capacity, in the case of Peter Fleming (no bed was available in August 2022) BSMHFT’s response (September 2023) referred to their response in the earlier case of Leroy Hamilton (no bed was available in December 2021). This response (April 2023) stated more resources had been obtained and a collaborative plan had been implemented with NHS Birmingham and Solihull Integrated Care Board. The issue of adequately funding psychiatric beds is a local and national issue. Locally, BSMHFT require their commissioners to provide the necessary funding. The coroner's concern is that the above dates indicate available psychiatric bed capacity in Birmingham and Solihull remains inadequate. Whilst some action may have been taken it is insufficient to resolve the problem. It follows there is a genuine risk of future deaths directly connected to a shortage of psychiatric bed spaces in Birmingham and Solihull unless further action is taken.

In this article, Rachel Star Withers shares her account of receiving electroconvulsive therapy to treat her severe depression and schizophrenia while in her final year at college. She describes how the treatment robbed her of her memory, reading and writing abilities, but saved her life. Without ECT, Rachel believe she would have committed suicide. She talks about the need to educate people about the realities of ECT and undo unhelpful 'horror-story' stereotypes.

This blog published by the Irish Health Service Executive (HSE) tells the story of Mark, who was diagnosed with schizophrenia 15 years ago, aged 15. It describes the issues he and his mother faced in getting him the care he needed, including being treated inappropriately and without dignity during emergency department visits, problems accessing ongoing community support and a reluctance to assist him with reducing his medication dosage. It also highlights how his family were not included in care plans and treatment decisions, and their needs as carers were rarely considered.

On 23 April 2020 Jaqueline Lake commenced an investigation into the death of Eliot Harris aged 48. Eliot had schizophrenia and diabetes. Eliot had not been taking medication for several days and his condition deteriorated. He was admitted to Northgate under the Mental Health Act after assessment on 5 April. He was initially in seclusion then on the ward from 6 April, he spent a lot of time in his room and only ate cheese sandwiches. He only accepted medication in intramuscular form and on 9 April by depot injection. His physical observations were recorded as being normal, and a blood test on 7 April showed he did not have diabetes. His intake of food and fluid remained minimal but he was not put on a chart to monitor this. Staff last entered his room at 17:46 on 9 April. He was last seen conscious at 18:10 on 9 April. He was found unresponsive at 01:33 and declared dead at 02:00.  The investigation concluded at the end of the inquest on 8 August 2022. Medical cause of death: 1a) Unascertained Conclusion: Open – the evidence does not reveal the means by which Eliot Harris came by his death. Coroner's concerns Substantial evidence was heard at the inquest with regard to observations which were not carried out in respect of Eliot Harris in accordance with NSFT’s Policy and with regard to staff not undergoing training and assessment of their competency to carry out observations correctly. Quality audits undertaken following Eliot Harris’s death, show that observations are still not being carried out and recorded in accordance with NSFT’s most recent policy – more than two years following Eliot’s death. Not all staff have completed training with regard to carrying out of observations or have undergone and assessment of their competency to carry out observations. On the night of Eliot’s death, a Nurse in Charge had not been allocated and members of staff were not allocated specific tasks – they were told to “muck in”, as a result there was some confusion as to who was responsible for specific jobs. The evidence at the inquest was not clear as to whether specific tasks are allocated to specific members of staff on Night Duty and whether and how a Nurse in Charge is appointed for each night’s rota. Multi Team Meetings were not fully and properly recorded in the clinical records. At the inquest, evidence was heard there “is still some way to go” with regard to improving record keeping and for ensuring important matters such as rationale for decisions is fully recorded. Eliot’s Care Plan was not up to date at the time of his death. At the inquest evidence was heard that although audits show there has been an improvement in completion of Care Plans, there “is still some way to go” and staff still need to be prompted to complete these. Staff were reluctant to enter Eliot’s room following concern for his wellbeing. The evidence did not reveal what is now in place to ensure staff enter a patient’s room immediately if there are concerns for a patient’s welfare (having considered their (staff’s) own safety). It is not clear from the evidence what is now in place to ensure that relevant and requested physical health checks are carried out. The process of ensuring health checks are carried out has not changed since Eliot’s death and remains a retrospective process.

This blog by the charity Mental Health UK looks at an innovative project that aims to transform the way care and support are delivered to people living with severe mental illness in Grimsby and Bridgend. It aims to meet people’s mental health needs by providing tailored support, signposting them to specialist services to improve their quality of life, prevent the need for emergency crisis care and reduce pressure on acute medical services. The project is being run in conjunction with healthcare company Johnson & Johnson UK, with the support of the local NHS. The project involves Community Mental Health Navigators supporting the non-medical needs of people living with severe mental illness, such as bipolar disorder, schizophrenia and borderline personality disorder. They provide support with aspects of people’s lives which can drive poor mental health, such as housing, money problems, employment, physical wellbeing and lack of social connections.

This report details an independent investigation into a homicide committed by an individual receiving treatment for mental health issues. It identifies lessons that can be learned from this incident and areas where improvements to services could help prevent similar incidents occurring.

This article in Translational and Clinical Pharmacology aims to highlight the need to reconsider current medication dosing strategies in reproductive women. It uses the example of schizophrenia to illustrate how a woman's clinical symptoms can change throughout the ovulatory cycle, leading to fluctuations in medication responses. The authors found that healthcare professionals need to consider hormonal and clinical changes that occur with the menstrual cycle when prescribing treatments. They also call for further research to increase knowledge of the issues and find better treatment strategies in women whose symptoms change with cyclical changes in ovarian hormones. However, they warn that results from such studies should never override the symptoms and treatment responses experienced by individual clinical patients.