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Opportunities missed to save mother of two

By Victoria Silsbury

Former nurse Karen Welsh was killed when she gave John Constantine (formerly Kevin Astell) a place to stay after he was discharged from a Psychiatric Hospital with nowhere to live and no follow up care.

Sadly, he was only diagnosed as having paranoid schizophrenic after he had killed the 52 year-old despite saying he could “haunt people in their dreams” and was deemed a “serious risk” to others.

John Constantine was first put on probation after attacking a farmer with a hammer in 2008 while living rough in south Wales. He was told to attend 10 treatment sessions with mental health professionals, all of which he failed to attend.

In May 2009, he was admitted to Whitchurch Psychiatric Hospital after reportedly trying to kill himself by cutting his wrists. Here he told he could communicate with spirits and saw “shimmers” that he took to be ghosts.

The report from the Healthcare Inspectorate Wales (HIW) said there should have been greater effort to understand Constantine and criticised health professionals, the probation service and police for missed opportunities.

He met Karen Walsh while she was being treated in the same hospital for depression and alcohol problems following the breakup of her marriage.

After he threatened to “kill someone” a senior nurse judged that he posed a “serious apparent risk” to others, yet he was discharged just five days later with nowhere to stay and no follow-up plan for his care.

It was not until January 2010 that Constantine was seen by a probation officer, and on this occasion Constantine told the officer he could haunt people.

John Constantine killed Karen Welsh just two months later in March 2010. It was only after his arrest he was diagnosed as being “floridly psychotic” and having paranoid schizophrenia.

A year later in 2011, he was detained indefinitely under the Mental Health Act after admitting manslaughter by diminished responsibility.

The HIW report concluded: "We believe that had a greater effort been made to understand Constantine's mental health issues during his time at Whitchurch, a different diagnosis to that of 'personality disorder' may have been made."

It added: "On more than one occasion opportunities were missed to apprehend Constantine and bring him back under the supervision of the probation service or the courts. The Welsh government expects the local health board involved to learn from this tragic case."

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