A MAN who stabbed his mother to death in the kitchen of her St Peter home should have been detained under mental-health legislation as a result of the high risk of “impulsive dangerous behaviour” he posed, a doctor has told an inquest.
The inquest into the death of Pam Nisbet (68) heard evidence on Wednesday 24 April from the family’s GP, Dr David Bailey, about his attempts to treat Mrs Nisbet’s son Andrew over a 19-month period prior to the fatal attack on 6 August 2019.
Nisbet, who was aged 40 at the time of the attack and had been diagnosed with severe autism spectrum disorder and Asperger syndrome, pleaded guilty to manslaughter on the grounds of diminished responsibility when he appeared at the Royal Court the following year. Viscount Mark Harris, presiding over the inquest as coroner, said the purpose of the hearing was to consider Nisbet’s contact with mental-health services in the build-up to his mother’s death, including the steps taken to manage his worsening mental state and the risks arising from this.
A long-running dispute over whether Nisbet, his partner and their young child should be able to live in an annexe to the family home near Wheatlands Golf Course prompted a series of heated arguments which caused police to be called to the house three times in six days in late July 2019 and a mental-health assessment which was carried out on 1 August, five days before he killed his mother.
Before the incident, Dr Bailey said that he had reached agreement with clinical psychiatrist Matthew Marshall and another member of the Adult Mental Health Team that Nisbet should be detained under the Mental Health Law as a result of the high risk of “impulsive dangerous behaviour”, but that this move was not signed off by social worker Lisa Chapman.
Miss Chapman’s explanation for her decision was described as “bizarre” by Dr Bailey, after she told him that people with Asperger’s should not be detained against their will, and that it was “normal” to hear voices, as Nisbet had reported.
“It was so bizarre that when I left the house, I only drove 50 metres before pulling over and writing down what she’d said so I had a contemporaneous note of it,” Dr Bailey said.
Dr Bailey said that in January 2018 he made the first of several appeals to the Adult Mental Health team, expressing his view that Nisbet’s case was too complex to be treated solely by a GP.
Evidence was also given by psychotherapist Jane Pointon, who said she had been engaged by Nisbet in December 2017 and seen him for around four months before terminating their work together, having raised concerns with Adult Mental Health that it would no longer be ethical for her to hold such a high level of risk.
The inquest heard that Dr Bailey’s concerns included Nisbet’s “increasingly distressed” presentation, the risk that he would indulge in self-harm or attempt suicide and his fitness to practise while working remotely as a clinical radiologist for a hospital in Edinburgh.
The family doctor also said he had a growing feeling that Nisbet was not interested in treatment, but wanted to use medical professionals to advance his point of view in the family dispute.
“He was trying to impose his view on his parents about what should happen in their own house, and when this didn’t happen he became angry,” Dr Bailey said.
The inquest heard that after an eight-month period without the involvement of mental-health services, Nisbet was seen by clinical psychiatrists on several occasions between March and August 2019.
After Nisbet rejected an offer from his parents to buy a three-bedroom house in which he could live at a low rent, Dr Bailey said that the situation worsened further when his mother and father proceeded with moves to evict him from their property.
The inquest is set to continue today, with a provisional indication from Advocate Harris that it would conclude next Thursday.
A recommendation to introduce a register of known domestic abusers was made in 2021 by an independent Domestic Homicide Review following Mrs Nisbet’s case, with the review finding warnings signs had been missed.
Timeline
December 2017: Nisbet moves back to Jersey from Edinburgh with his partner, who is expecting a child at the time.
April 2018: Private psychotherapist Jane Pointon terminates her agreement with Nisbet after telling the Adult Mental Health service that she considers it “unethical” to be handling such a risky, complex case.
July 2018: Family GP David Bailey writes to Adult Mental Health expressing his view that Nisbet’s case was too complex to be handled by a GP or private practitioner.
April 2019: Dr Bailey raises concerns that Nisbet could be suffering from emotional unstable personality disorder. He is told by Nisbet’s parents that “they can’t tolerate any more”.
23 July to 1 August 2019: Police are called three times to the family home after reports of heated arguments, and mental-health assessments are carried out.
6 August: Nisbet stabs his mother in the kitchen with a “Leatherman” knife. His father hears screaming from a next-door room and wrestles his son aside before seeking to help his wife, who is pronounced dead shortly afterwards.
