A man who expressed frequent desires to take his own life to friends and family was found hanged while on a few hours leave from Tolworth Hospital.

An inquest heard Stephen Smith, of Revell Road, Kingston, was 38 when he died on February 22, 2013.

He had been admitted to Tolworth Hospital from September 2012, with various periods of leave throughout, after being originally sectioned. He had previously been found to suffer from schizoaffective disorder

West London Coroners’ Court heard today he had been found by a dog walker in Tolworth Court Farm playing fields, after failing to return to the hospital the night before.

The court heard friends and family had raised concerns for his safety after they could see a marked difference in him from about Christmas 2012.

Although said to be a regular topic of conversation, he had been more keenly talking about ending his life, and had bought a book on euthanasia.

While in Lilac ward at the hospital he had tried to take his own life.

His twin brother, Phillip Stratford-Smith, a GP, told the inquest Mr Smith was “very good at keeping up appearances” but seemed to need the structure and safety being sectioned had given him before it was rescinded before Christmas 2012 – after which he seemed to decline.

He said during conversations at that time with his brother, a former BBC engineer and banker, “it was clear his brain was broken”.

He was one of many who told staff on the ward his brother’s mental state had got worse and needed to be closely monitored. They were told staff were aware and that Mr Smith was a “difficult case”.

Another patient on the same ward told staff he had seen Mr Smith researching suicide methods on the patient computer.

In a statement read to the court he said Mr Smith had asked him if it was normal for a person to "have death on his mind 99 per cent of the time".

The patient said: “I went to the nurses countless times voicing my concerns about him and everything he had told me.

“It pains me to know that there might have been even this minute possibility to prevent his death.”

Ed Burns, a consultant psychiatrist in the home treatment team at Tolworth Hospital told the inquest after family reported a leave trip to Manchester in December 2012 went badly, Mr Smith’s leave was rescinded so he could be monitored better on the ward.

Before his leave was reduced Dr Burns said: “He was very good about checking in with the ward staff and letting them know where he was and what he was up to.”

Dr Burns said Mr Smith would speak to staff when he was concerned, even deciding to cancel planned leave on New Year’s Eve because of an attempt to harm himself the previous day.

Mr Smith’s father, Keith, told the inquest he had made a phone call to the hospital a week before his son’s death to say: “Please protect him, I’m very concerned about his safety”.

Mr Stratford-Smith, his twin, added: “We knew he was going to kill himself and we tried to say it.”

After Mr Smith died, his twin brother and former partner went to the playing fields and found evidence of previous attempts at hanging.

The inquest continues.

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