ShareSaveAdd as preferred on GoogleIsaac AsheEast MidlandsThe Nottingham InquiryDr Mike Skelton has been giving evidence to the Nottingham InquiryA psychiatrist who decided he could not detain Valdo Calocane under the Mental Health Act after he assaulted a flatmate said the Nottingham attacks killer "wished to take control" during his assessment.
Calocane, who was diagnosed with paranoid schizophrenia in 2020, fatally stabbed Barnaby Webber, Grace O'Malley-Kumar and Ian Coates, and tried to kill three others on 13 June 2023.
In January 2022, police were called when Calocane put a flatmate into a headlock and took him hostage in their flat in Faraday Road, Nottingham.
The following day, Dr Mike Skelton, a consultant psychiatrist, decided Calocane did not pose a serious enough risk to be detained and allowed him to return home.
Skelton, based in the Nottinghamshire Healthcare NHS Foundation Trust crisis team, had been familiar with Calocane having attended meetings discussing his case when he was released from two periods under section under the Mental Health Act at Highbury Hospital in August 2020, and when carrying out a seclusion review in September 2021 following an assault on a police officer.
At this review, Skelton was standing at Calocane's door and asked questions without making eye contact, due to fears of safety to himself and other staff from what he called a "clearly very psychotic" patient, the inquiry was told.
Calocane was described at this review as "guarded, curt, fixed staring and having a hostile edge to him".
However when Skelton assessed him again following the flatmate confrontation in January 2022, the psychiatrist said Calocane had been "polite and calm" and "invited us in to the property", although a police warrant was used to remove him and carry out the assessment, with 15 officers deployed.
Officers wanted to leave after Calocane was taken to the Cassidy Ward at Highbury Hospital for the assessment, but medical staff were concerned about safety and asked officers to stay.
In his assessment, Skelton was aware Calocane had not been on his medication despite his claims he had been taking it as prescribed.
Skelton said: "It's clear that he does make statements and then when he's challenged or we have evidence, that sort of melts away."
The psychiatrist said failing to take medicine was not unusual among patients with schizophrenia and was not a reason for detention - the "net effect of that on the person" is.
Calocane took one tablet in front of Skelton during his assessment, the inquiry heard.
"One tablet doesn't reduce the risk," said Skelton. "The first step was to see was he going to even do that, because if he didn't, he would have been detained immediately."
Factors such as police deciding not to arrest Calocane after the assault on his flatmate, the incident still being under investigation, and Calocane's "composure" all formed part of the decision, Skelton said.
"I went into that assessment expecting that I would be detaining that chap. Based on what we saw he was not detainable under the Mental Health Act," he told the inquiry.
Skelton said the decision to release Calocane to the crisis team and return him to his accommodation was not a "gamble" or influenced by Calocane trying to "dissuade" him from sectioning him.
"We all agreed that this chap would be better off in hospital. But we did not have the legal powers at the time to enforce it based upon the assessment we saw," he said.
"He was able to, and it's very unusual, to push back and you could tell he wished to take control. And I thought it was very unusual, it did stay with me.
"A MHA [Mental Health Act] assessment is based on 'are the criteria met?' And there are not individual elements. Crucially at the time I was not able to elicit acute psychotic symptoms.
"When we concluded the assessment and I concluded he wasn't detainable, the crisis team had to look after him.
"That wasn't comfortable for us. To suggest that we were not aware of the risk, it's not true."
As Calocane was not detained, the university removed the other tenants from the property he was in for their safety, the inquiry heard.
The crisis team monitored Calocane daily on a community plan while gathering evidence about him, and eight days later a further MHA assessment was ordered.
Skelton said: "We saw the chap had been lying to us. We had genuine hard facts we could use."
The inquiry also heard evidence from crisis care practitioner nurse and, from February 2022, team leader Josephine Baker, who visited Calocane on 23 June 2020, between his two spells at Highbury Hospital that year.
In a phone call in the days before the visit, the inquiry was told Calocane said he was not experiencing hallucinations or abnormal thoughts.
But Baker said: "It took him a little bit of time to open up and say that he was hearing voices. He was quite open with the fact but he felt able to manage them now since being discharged.
"It could have potentially have been [an early warning sign of relapse] but I wasn't concerned about him. He was quite open and honest. He was calm and settled."
Calocane was re-admitted to Highbury Hospital in July 2020 under the Mental Health Act.
Baker was also involved in monitoring Calocane over the eight days after Skelton did not detain him and put him under the care of the crisis team in January 2022.
She said: "VC [as Calocane is being referred to at the inquiry] didn't engage well so it was hard to be able to assess the risk that was posed at that time. I couldn't be sure he was taking his medication."
Baker recorded in her notes that Calocane had become "intimidating" and was no longer safe to be treated in the community.
Following the killings, Calocane was sentenced to an indefinite hospital order in January 2024, after pleading guilty to three counts of manslaughter on the grounds of diminished responsibility, and to three counts of attempted murder.
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