Demand for Public Apology: Mother Seeks Accountability in Mental Health Care Tragedy

Demand for Public Apology: Mother Seeks Accountability in Mental Health Care Tragedy

…By Judah Olanisebee for TDPel Media.

Demand for Public Apology and Unanswered Questions


The mother of a man who committed a random attack resulting in the death of a dog walker is demanding a public apology from a health board for her son and the family of the victim.

David Fleet, aged 20, stabbed a stranger shortly after being discharged from a psychiatric unit.

Despite warnings about his deteriorating mental state, he was sent home.

Ten days later, he fatally stabbed 71-year-old Lewis Stone on a footpath near his home in Borth, Ceredigion.

An unpublished health board review into Fleet’s care prior to the attack reveals that a doctor had warned he was not ready to be discharged due to his worsening mental state and the risk he posed with knives.

Fleet was sent home to be cared for in the community without any updates to his risk assessment.


Critical Review and Lack of Communication

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The findings of the review, which were not shared publicly or with the victim’s family, indicate that mental health staff were meant to contact Fleet the day before the stabbing but failed to do so.

He did not receive his scheduled dose of anti-psychotic medication.

Sharon Lees, Fleet’s mother, claims that the Hywel Dda University Health Board informed her privately that changes had been made to its mental health services following the incident.

However, Lees and her son believe that a public apology is necessary, as the health board’s failure impacted Fleet and ultimately led to the tragic loss of Lewis Stone.

Call for Improved Review System

The health board cites confidentiality as the reason for not publishing the review’s findings, although they were shared internally with some staff and the Welsh Government.

It is revealed that the Welsh Government has not commissioned independent mental health homicide reviews since 2016, which means that lessons from cases like Fleet’s were not directly shared with other health boards.


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This lack of action has been criticized by Lord Alex Carlisle, a leading barrister and peer, who describes it as a scandal and emphasizes the importance of learning from past disasters to prevent future ones.

The case of David Fleet highlights the need for comprehensive reviews and improved communication in mental health care.

The failure to share findings and lessons from such cases with other health boards undermines the opportunity for preventive measures.

It is imperative that the review system is revamped to ensure better coordination and communication among agencies, ultimately leading to improved care and safety for individuals with mental health issues.

Tragic Events and Sentencing

David Fleet pleaded guilty to manslaughter on the grounds of diminished responsibility and was diagnosed with paranoid schizophrenia.

He was sentenced to be indefinitely detained at a secure mental health unit.

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During Fleet’s trial, it was revealed that he was suffering from an episode of schizophrenia when he repeatedly stabbed Lewis Stone.


Fleet’s family claims that he had exhibited signs of psychosis for over two years, and they had struggled to obtain the necessary support for him.

Fleet’s case and the killing of another mental health patient, Garvey Gayle, in Cardiff highlight the urgent need for adequate support and intervention to prevent such tragedies.


The cases of David Fleet and Garvey Gayle underscore the profound impact of mental health issues and the challenges faced by families seeking appropriate care.

The devastating consequences of these incidents demand a holistic approach to mental health support and a comprehensive review of existing systems to ensure that individuals receive the necessary assistance and that public safety is maintained.


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