MENTALLY ill Jonathan London was referred to hospital in a state of psychosis the day before he attacked Sandra Crawford, it emerged at Tuesday’s inquest.

His family alerted their GP on April 29 after his delusions worsened and he was referred to Watford General Hospital (WGH) where he underwent assessments and medical checks – including blood tests in which Mr London thought nurses were injecting him with viruses.

But he was sent home that evening ahead of an urgent appointment with the Crisis Assessment Team (CAT) at home the next morning – however, by 9am he had gone missing and carried out the frenzied attack at his parent’s next-door neighbour’s house in Sherwood Avenue.

The court heard that Mr London was diagnosed with epilepsy aged 12 and since then had been on medication, which in 2005 caused him to have hallucinations.

During his life he flitted between his brother’s flat in the city centre and his parent’s house and had worked as a mechanical engineer at the University of Herts until his epilepsy forced him to leave the role.

He purchased a flat in the same block as his brother but moved out soon after because he thought the man living above was transmitting radio waves to control him.

His delusions – which also included him being controlled by robots – became worse in the two weeks leading up to the tragedy and he had even left his brother’s flat one night due to the “noises” to stay in a bed and breakfast, but he ended up sleeping rough in St Peter’s Street – the final straw for his concerned family.

Giving evidence to the inquest, his brother Rodger London said that he and his 83-year-old mother, who was also caring for her sick husband, had not realised that it was an option for him to be admitted to hospital on April 29 otherwise they would have taken up the offer.

When they left, Mr London had another episode in the hospital car park in which he refused to get in his mum’s car and despite his brother’s request for help at reception, no staff from the mental health unit were alerted.

In the meantime his mum had driven home leaving the two brothers walking through the night from Watford to Chiswell Green where they got in a taxi.

Dr Seshri Moodliar and Jocelyn Cusack, who both assessed Mr London at the mental health unit, told the inquest that had they known about the incident in the car park they would have assessed him again, which may have resulted in him being sectioned.

Ms Cusack, the accident and emergency liaison for mental health, said he had displayed one of the worse cases of thought delusion she had seen in her career but insisted that he was calm and not showing any intention to harm himself or anyone else, which is why home treatment was deemed suitable.

But she said there was 24-hour help on call and she thought the family knew keeping him in hospital overnight was an option.

Kathryn Linhart, from the CAT, had spoken to Rodger London on the morning of April 30 when his brother had gone missing and after hearing about his increased delusional state which included approaching strangers on the way home from the hospital, she decided it was likely he would need hospital admission.

Coroner Edward Thomas said that he understood why staff at WGH sent Mr London home but explained that he would be writing to the chief executive of the West Herts Hospitals Trust to point out the facts relating to the lack of communication when his brother asked for help at reception after leaving.