The family of a “wonderful, loving” but “frail” Peckham woman killed by her own paranoid schizophrenic son after he was released from the Maudsley hospital have pleaded for the trust to learn from their tragic case.
Maureen Watkins, 75, was stabbed to death by her son Edward in November 2018 at their home on Ethnard Road. Edward was found naked in the street outside and told police that “God made him do it”, according to an inquest into his mother’s death that recently finished.
Maureen and her son, who was 55 at the time he killed her, had lived together for decades. But Edward was sectioned in the Maudsley after he became concerned about his neighbours and broke into their home. Three months later he was let back out to live with his mother but he heard hallucinated voices telling him to rape his mother – and the court heard that he felt it was better to kill her. Four days after that she was dead.
The inquest found several failings by hospital staff in the way the decision to release him was made, but did not blame doctors for Maureen’s death. One staff member said that “too much of what we were trying to put in place was based on supposition and no evidence”.
Maudsley hold review into case of mentally ill son who killed his mother at their home in Peckham
Maureen and Edward – Eddie to his family – had previously had a very happy relationship, according to her granddaughter Katie, Edward’s niece. He had been mentally unwell since his late twenties and could not work, but was not violent. She had the lung condition emphysema, which meant she was unable to do strenuous physical activities.
“They looked after each other, they were each other’s companions,” Katie said. “He did the shopping, and helped out at home. If someone had broken into the house, my uncle would have died to protect her. They had that kind of relationship.
“But also they would be taking the p*ss out of each other, laughing so much, digging each other out. It was such a happy relationship, there was never any aggression there. She never begrudged that he was unwell.”
Edward had been taking anti-psychotic medicine to control his condition but stopped. In August 2018, he broke into the neighbours’ house and attacked the father “on a mission”, according to the coroner’s report. He was arrested on August 18, 2018, sectioned and admitted to the Maudsley, a psychiatric hospital in Denmark Hill.
Edward was treated for his condition at the hospital and put on a high-dose regimen of anti-psychotics, before being discharged on November 12 after a cousin said that Maureen wanted him to come home.
Two days later Edward attacked his neighbours again. On November 16, he hallucinated voices telling him to rape his mother so he felt it was better to kill her, according to the coroner’s report. She was found dead, face-down at home with a seventeen-centimetre blade beside her body.
Edward admitted to the manslaughter of Maureen on the grounds of diminished responsibility and was taken back to the Maudsley. He cannot be discharged from hospital unless the Ministry of Justice or a tribunal says so and any discharge may be subject to certain conditions. Residential treatment centres are an alternative to prison for offenders with mental health problems, and can offer a better chance of lasting rehabilitation.
The Watkins family have now criticised the South London and Maudsley (SLaM) trust, which runs the hospital, on several grounds. The coroner also found several areas of concern in the way doctors came to the decision to discharge Edward.
In a statement shared with the News, the family said that doctors put too much emphasis on Edward and Maureen depending on each other at home, and not enough on her safety. They also said that Maureen and the family were not given enough information about how violently Edward was acting on the ward to make an informed decision to bring him home.
“Maureen was not a trained psychiatrist or mental health professional,” they said. “She was unaware of all the facts and she was a mother who loved her son first and foremost.” The family are also concerned that Edward was having money stolen from him in the ward, which contributed to Maureen wanting to bring him home.
The coroner’s report said that Edward had twice tried to strangle a fellow patient on August 23, but that one of his doctors “sought to downplay its significance”. On October 15, Edward himself admitted that his mother was afraid of him. Doctors also tried to find other housing for him away from Maureen, before she changed her mind and said she wanted him home.
But the coroner agreed with the family that hospital staff did not make Edward’s violent behaviour clear to Maureen before releasing him into her care.
A psychologist “accepted that the visit could not be the sole basis for a decision that it was safe and appropriate to discharge to their home, yet that is what appears to have happened, as no further assessment of Mrs Watkins was made,” the report said.
The Watkins family also criticised doctors’ assessment that Edward was unlikely to be violent towards women. A psychiatrist treating Edward said that “the history of the family showed no evidence that he would ever likely direct violence to his mother”.
Edward’s condition may have been exacerbated by drinking alcohol and taking drugs, the coroner said – and he stole cannabis from a fellow patient’s bedroom. But doctors failed to investigate whether drink and drugs would make him more violent.
There is also no documentation proving that doctors carried out a detailed assessment of Edward’s mental state before he was discharged. The coroner added that “it was a misjudgment to discharge without further risk assessment”.
Once he had gone back to live with Maureen, Edward got into another screaming and shouting match with the same neighbours he had an altercation with before. The care coordinator found that he was a high risk to others at this stage, but Maureen said she wanted to keep him at home.
The coroner said that doctors should have carried out a home visit, and it was likely that he would have been taken back to hospital if they had done so. They did not visit. Because of this, “the failure of the care coordinator to escalate the incident to a psychiatrist has contributed to the death” of Maureen, he said.
Three and a half years on, the death of lifelong Peckham resident Maureen has left a hole in the Watkins family, her granddaughter Katie told the News.
“We were really lucky to have her. Me, my sister and my brother were her only grandchildren and we were so close to her..
“She adored us, she invested so much time in us. We were so close to her, every other day we were on the phone.
“Even though she wasn’t well, she helped us pick our unis. We would go out and travel across the country with her.”
Katie fondly remembered how Maureen would babysit the three children so her parents could have an evening and a weekend off.
“She would have us create cardboard cutouts and then we would perform plays for our parents when they would come to pick us up.
“She was always laughing, she loved to sing. She was an entertainer – she had a laugh you would never forget.
“Christmases were the biggest things. She’d be singing and dancing Irish folk songs, because all her family were Irish.”
Former accountant Maureen was also community-spirited and was a member of the Breathe Easy choir, for people with breathing difficulties.
Katie added: “There was always something, we’d go to the zoo. Any school project she wanted to help us with. We were studying Florence Nightingale and she took us to the Florence Nightingale museum.”
Katie and her family said they do not want an apology from SLaM – “it won’t be good enough” – only for them to change how they operate to make sure a tragedy like this does not happen again.
“My uncle is still in their care. If he is ever let out again, there’s also a risk that he could hurt someone else,” she said. “These things are playing with people’s lives.”
Katie added that “even though it’s awful that it’s our nan [that died], at least I don’t have to look another family in the eye because it’s their relative that’s been killed. But it could have been.”
Dr Michael Holland, medical director at South London and Maudsley NHS Foundation Trust, said: “We offer our sincere and heartfelt condolences to the family and friends of Maureen Watkins.
“Following Mrs Watkins’ death in 2018, a full internal investigation was conducted which identified areas where we need to make improvements to the care we provide. This included improving how we record incidents of risk across our services to allow for more comprehensive risk assessments; improving how our staff support families and carers involved in a patient’s care; and to highlight the importance of sharing care plans with families and carers where necessary.
“Since Mrs Watkins’ death four years ago, we have provided comprehensive training and support for our staff in carrying out robust risk assessments, care planning and raising safeguarding concerns. We are committed to improving the quality of care we provide and dedicated to learning from all incidents to reduce the risk occurring in the future.”