Opportunities to prevent a man stabbing his friend to death were missed by mental health teams, an investigation has revealed.

Steven Dunne, who knifed Gordon Stalker because he believed his friend was a witch, did not get the support he needed from mental health teams in Brighton who could have prevented the killing.

An independent report into the treatment given to Dunne, released today, has concluded his care was not effectively managed and the team he was assigned to was not designed to provide the support he needed.

The critical report, carried out by Veritas on behalf of NHS South of England, was commissioned after Dunne stabbed and killed Mr Stalker in Brighton in February 2010.

At the time he was known to Sussex Partnership NHS Foundation Trust’s East Brighton Access Team.

Dunne, who is referred to in the report as Mr B, gave himself up to police and pleaded guilty to manslaughter on the grounds of diminished responsibility.

He was sentenced to a hospital order without a time limit in November 2010.

Dunne launched his attack after believing Mr Stalker, 51, had captured his soul when he took pictures of him on trips out together.

Post-traumatic stress

The report said Dunne was referred by his GP to the east access team in March 2008, suffering from depression.

He was diagnosed with post-traumatic stress disorder and placed on a trauma service waiting list before being discharged back to his GP with advice on medication.

His GP referred him again in October 2008 and June 2009 as his mental health deteriorated.

Dunne began attending A&E departments around the country at the end of 2009.

He was assessed as being of no significant risk to himself or others and discharged to the east access team.

Fatal attack

The local housing team contacted the mental health team again in January 2010 after finding Dunne in a distressed state at his home and flashing a crucifix.

He was seen again in A&E by the mental health liaison team on February 3, 2010, and discharged before fatally attacking Mr Stalker on February 15.

The report’s authors concluded Dunne’s care was not managed well.

They said: “An effective risk management plan that included options such as admission to hospital for further assessment, referral to the recovery team for the allocation of a care coordinator or allocation of his care to a specified person in the east access team for more assertive support and a more detailed risk assessment may have prevented the homicide.”

The partnership trust said since 2010 mental health services in Brighton have been completely overhauled.

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