The killing of schoolgirl Emily Jones was unlawful and mental health services could not have predicted her attacker's behaviour, a coroner has ruled.
Eltiona Skana slit the seven-year-old's throat after snatching her from her scooter in Queens Park, Bolton, on Mother's Day. Skana, a diagnosed paranoid schizophrenic, was later sentenced to life in prison after being convicted of manslaughter, by means of diminished responsibility.
An inquest has been held at Bolton Coroner's Court - more than three years on from Emily's death on March 22, 2020.
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Delivering his conclusion today, senior coroner Timothy Brennand said: "I do not believe that the behaviour of Eltiona Skana in the sense of perpetrating a 'strange homicide' on March 22 could or should have been predicted by the community mental health team."
He went on to say that she could not have been forced to take her medication and that it is only with the 'benefit of hindsight' that her attack could have been predicted.
Mr Brennand concluded that the work of Greater Manchester Mental Health Service with Eltiona did not amount to a 'gross failure to provide basic care'. However he did point to 'sub-optimal elements of her community treatment and referenced previous reports which listed failings by the trust in her care.
Ms Skana said that while the family were living in their home country of Albania, Eltiona had been ‘forced’ to marry a man by her father. However, Dr Raj Dangi, the psychiatrist responsible for Skana's treatment at the time, said the attack 'came out of the blue' and could not have been predicted.
Coroner Mr Brennand said he had too little evidence to accept that Eltiona had been forced into marriage.
Skana was sectioned twice before, in 2015 and 2017, following relapses of her schizophrenia. On the second occasion, she locked her mother in a bedroom before attacking her with an iron.
Dr Dangi told the inquest it was not possible to determine whether Skana's actions on the day of Emily's killing were caused solely by her being 'in the grip of psychosis'.
He said he believed she may have had been suffering from an undiagnosed mental health condition at the time, such as a personality disorder.
In August 2019 - about seven months before the killing - the inquest heard that Dr Dangi had agreed to change anti-psychotic Skana's medication from injection to tablets at her request.
Victoria Fagan, Skana's care co-ordinator at the time of the killing, told the inquest she was not consulted on the decision to change Skana's medication.
She said she told Dr Dangi she disagreed with the move as it would have made it harder to monitor whether Skana was taking her medication.
By the following March - just weeks before killing Emily - Dr Dangi said Skana was reporting struggling to sleep - a potential sign of a relapse of her schizophrenia.
Just two days before the horrifying attack, the inquest heard that Skana, an Albanian national, walked out of a mental health waiting room.
Klestora Skana, Eltiona's sister, told the hearing she had taken her sister 'to see a doctor' at Bentley House, a mental health service in Bolton, just two days before the killing.
She said she had become increasingly concerned about her sister's mental health after witnessign her cutting medication in half. After no doctor came to see Eltiona for 45 minutes, Ms Skana said her sister got up and left the waiting room.
However, in his conclusion Mr Brennand said he did not accept this account of visiting the mental health service.
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