Axel Rudakubana sadistically killed three little girls and boasted about it after - is he evil or just another extreme example of the catastrophic failures of the UK mental health system?
Well, it could be both. But, in my experience, the latter is most definitely a factor. As someone who used to be a mental health support worker in a residential home and is the unpaid carer of a family member with a prolonged mental health diagnosis, I know this diluted version of the story all too well.
While the understanding behind Rudakubana’s motives are still not fully clear, it’s now come to light that he was under local NHS mental health services for a number of years until he 'stopped engaging' in 2023.
It’s a term that the public have heard before, more recently in Valdo Calocane's case where he killed three people in Nottingham while in a severe state of psychosis. And it's also two words that haunt anyone with a family member who is under the care of NHS mental health services.
But, what really is 'engagement' you ask? It's a good question that not even the NHS has a specific answer for, trust me I've asked
Yet patients - or service users - are discharged from the likes of community mental health teams or GP's for 'not engaging', which proves to be a selective process and not a blanket criteria for the NHS - though some services have their own 'rules'.
'Not engaging' can come in the form of continually not answering the door or refusing to speak to the community mental health team.
Perhaps it’s missing appointments or non-compliance with medication, whether that be intentional or not.
These are just some of the reasons why my family member has been discharged from mental health services in the past 30-something years, until the inevitable.
It leaves me, like many other families, essentially powerless, phoning and emailing in hopes someone will listen. But, more often than not, no one does.
Not before long, and like clockwork, their mental health severely deteriorates to the point where they are sectioned under the mental health act or - in more extreme cases - end up hurting themselves or someone else.
The cycle then starts again.
While there has been campaigning from mental health groups to give people more autonomy, or choice, in their treatment, at the same time this refusal to accept treatment and input from services often leads to tragic outcomes.
If someone stops engaging it should ring alarm bells rather than being a means to discharge someone from services. As they most likely need the help more than ever.
We can’t expect those with mental health diagnoses, often complex and severe, to behave rationally when experiencing the depths of their illness.
Yes it is. But what if that person is so unwell they don’t even realise it themselves - how is someone in deep psychosis supposed to recognise this? So why are we relying on them to seek help? It just doesn’t make sense.
Too often we put the onus on the patient, but it’s time for NHS mental health services to accept responsibility for implementing care instead of relying on someone who is unwell to seek it.
But basing someone's needs on whether they bother to pick up the phone or turn up for an appointment is - ironically - insane.
Unfortunately, this will keep happening - in different kinds of extremes - until the government reform mental health services. And it needs to happen sooner rather than later.
You often hear the term ‘they fell through the net’ but the NHS mental health system has countless of gaping holes in it. Though the blame can’t just be put on individual staff, it’s the rules of the system that need changing to allow staff to appropriately act instead of getting the red 'stopped engaging' stamp out.
Individual inquiries that take months or years into tragedies often reveal the 'red flags' missed by that specific service.
What they fail to do is shine a light on how it's a nationwide issue that needs to be looked at and reformed by the government, rather than shoved under the carpet and hoping what is brewing underneath isn’t as bad as last time.
But, without fail, the consequence of someone being discharged for having 'stopped engaging' is never pretty for all involved.
In a statement released to the BBC, a spokesperson for the Alder Hey Children's NHS Foundation Trust said: "Following the terrible incident last July, we are participating fully in a children's safeguarding practice review commissioned by the Children's Safeguarding Partnership, to identify if any learnings could be made."
And would welcome the separate public inquiry, with the spokesperson adding that the Trust would "fully co-operate and support that process."
"We are not in a position to provide any further details that could potentially prejudice that inquiry and will be making no further comment at this time."
The Alder Hey Children's NHS Foundation Trust said its thoughts remain with the families of Alice, Bebe and Elsie and all who have been affected by the events of 29 July.
Daily Star contacted the NHS and the Alder Hey Children's NHS Foundation Trust for comment.
A spokesperson from Alder Hey Children's NHS Foundation Trust said: "Our thoughts remain with the families of Alice, Bebe and Elsie and all those affected by the events of 29th July.
"We can confirm that Axel Rudakubana was under the care of Alder Hey Services including our Community Mental Health Service between 2019 and 2023.
"He had stopped engaging with the service in February 2023 despite continued offers of support.
"Following the terrible incident last July, we are participating fully in a Children’s Safeguarding Practice Review commissioned by the Children’s Safeguarding Partnership, to identify if any learnings could be made.
"We welcome the announcement of an independent public inquiry and will fully co-operate and support that process. We are not in a position to provide any further details that could potentially prejudice that inquiry and will be making no further comment at this time."
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