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A psychiatrist involved in assessing Valdo Calocane, who later committed fatal stabbings in Nottingham, testified that he could not detain Calocane under the Mental Health Act after an assault on a flatmate because the criteria for detention were not met. During the evaluation, the psychiatrist observed that Calocane appeared to seek control over the situation, describing him as having a “hostile edge” and displaying guarded, fixed staring behavior. Despite concerns about Calocane’s mental state, Dr Mike Skelton, a consultant psychiatrist, ultimately concluded that Calocane did not pose a sufficient risk to justify detention and allowed him to return home.
Calocane, diagnosed with paranoid schizophrenia in 2020, fatally stabbed three people and attempted to kill others on 13 June 2023. Dr Skelton’s decision followed an incident in January 2022 when Calocane confronted a flatmate. Although a police warrant and substantial officer presence were used to conduct the psychiatric assessment due to safety concerns, Calocane was described as “polite and calm” during that time. The medical team requested police to remain during the assessment at Highbury Hospital, fearing risks despite the police wish to leave. Skelton acknowledged that Calocane had not been taking his medication as he claimed, stating, “It’s clear that he does make statements and then when he’s challenged or we have evidence, that sort of melts away.”
Skelton emphasized that failure to take medication alone does not meet the threshold for detention under the Mental Health Act; rather, it is the overall impact on the individual’s mental state that matters. Although Calocane took one tablet during the assessment, Skelton explained, “One tablet doesn’t reduce the risk.” Several factors, including the police decision not to arrest Calocane following the assault, his apparent composure, and the ongoing investigation, contributed to the decision to release him to the crisis team. Skelton stated, “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.”
Despite the decision not to detain Calocane, his behavior prompted other tenants to be moved from their shared accommodation for safety reasons. The crisis team maintained daily contact under a community plan and arranged a further Mental Health Act assessment eight days later. Crisis care practitioner Josephine Baker reported difficulty in assessing Calocane’s risk due to poor engagement and doubts around medication adherence, noting his intimidation made community treatment unsafe. Meanwhile, consultant psychiatrist Dr Kalina Shoilekova provided evidence about Calocane’s admission to a private psychiatric intensive care unit in Darlington in 2021. She highlighted challenges posed by the predominantly female nursing staff and the patient’s risk factors, citing a lack of sufficient manpower to manage potential exceptional situations. Although initially described as a polite and gentle young man, Shoilekova remarked on the fragmented nature of Calocane’s healthcare records, which complicated care coordination.
While hospitalized at Cygnet Victoria House, Calocane was recommended for long-acting injectable antipsychotic treatment, but he preferred to continue with tablets. Shoilekova, alongside the care coordinator Claudia Birtles, expected Calocane to remain in hospital for
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