AN inquiry into a fatal stabbing involving two North-East mental health patients has criticised the quality of care they received and called for wide-ranging improvements.

A 43-year-old father of three died when he was stabbed through the chest with a kitchen knife by his 36-year-old girlfriend, following a domestic dispute at their home in Shotton Colliery, County Durham, in December 1997.

The woman, who has not been named to help her rebuild her life, was cleared of murder on the grounds of diminished responsibility, but convicted of manslaughter.

In its report, the independent inquiry panel called for better funding of mental health resources in the Easington area, and improved coordination between different services.

Mental health services were so poor at the time of the killing that the area was described as a funding "black hole", with the community psychiatric nurse service so over-stretched that GPs were asked not to refer patients.

An independent report by the Sainsbury Centre for Mental Health estimated that there was a £9m investment shortfall in the area, which needed to be addressed.

The panel attacked the "fragmentation and lack of coordination" of mental health services in Easington, and urged County Durham and Darlington Drug and Alcohol Services to work more closely with other service providers.

It was acknowledged that both patients were often unwilling to cooperate with their treatment, but the panel recommended that "a more assertive approach" was needed under those circumstances.

The panel also called for a review of the number of detoxification beds available to Easington residents.

It emerged that the woman patient's GP had to admit her to a psychiatric ward at Hartlepool General Hospital because Peterlee Hospital only had one detoxification bed which was always occupied.

Despite the service's shortcomings, the inquiry panel members said they did not believe the changes they had recommended would necessarily have prevented the killing.

They also paid tribute to "highly committed" health service staff who were working in difficult circumstances.

Both patients had received mental health care over a number of years and regularly abused alcohol.

While the 43-year-old man who died had been treated mostly as an outpatient his killer had numerous stays as an inpatient.

Ken Jarrold, chief executive of County Durham and Darlington Health Authority, said: We welcome this inquiry report and its recommendations. Agencies are already working together on an action plan to implement the panel's recommendations."

Steps to improve mental health services in Easington include funding an extra psychiatrist and support team, strengthening the assertive outreach team, setting up new community mental health teams, and providing more help for substance misusers