A man who knifed a St Annes businessman to death in front of his family had been telling doctors about hallucinations and delusions for more than 20 years.
But Robert Kay, 49, was only diagnosed with schizophrenia after he had killed father-of-three Ian Dollery in his garage in York Road last June, and was detained under the Mental Health Act.
Preston Crown Court has been told how Mr Dollery, 51, a former engineer who ran a book selling business from the garage where he was killed, suffered more than 30 stab wounds at the hands of Kay - who claimed to be the son of Satan in the hours before the attack.
Kay stabbed Mr Dollery in the head, arms, torso and abdomen in front of his screaming wife, while his 21-year-old daughter used a broomstick to fight him off.
Kay, a homeless drug addict, admits killing Mr Dollery but claims his responsibility for the attack was diminished by his schizophrenia.
Friends described how Kay’s personality changed on June 18 and he began ranting, claiming he was talking to the devil, and had a list of chores to do, after taking drugs at a flat in St Andrews Road South.
He is not really interested in getting treatment for his schizophrenia
But the prosecution says his psychosis was triggered by drugs - which he took voluntarily.
Giving evidence at the murder trial at Preston Crown Court, Dr James Collins, a forensic psychiatrist at Ashworth Hospital - where Kay has been held since the attack - outlined Kay’s history of contact with doctors and psychiatrists since the late 1980s.
He told the court about the numerous times Kay told professionals about violent thoughts and paranoid delusions which had troubled him since his early teenage years.
By August 2014, Kay, of no fixed abode, was hearing voices and was imagining violence “all the time”, the court heard.
But Dr Collins said Kay’s underlying condition had been masked by his chronic drug abuse which had started with him sniffing glue aged 13 and progressed to long-term heroin abuse.
He said: “I think all the psychiatrists who were seeing him considered the possibility of schizophrenia but they weren’t sure. One of the things psychiatrists are encouraged to do is to not make a diagnosis of schizophrenia because of the stigma for the patient.”
He added: “One of the features with Mr Kay is that his contact with psychiatrists was pursuing getting drugs and prescriptions that would satisfy his addictions, such as benzodiazepans. He is not really interested in getting treatment for his schizophrenia.”
Dr Collins has been involved in the treatment of Kay at Ashworth Hospital and says his condition is now controlled.
He told the court: “Mr Kay is somewhat unusual. I think because of his personality he coped with his schizophrenia better than most people would have done.
“That is not to say he didn’t use drugs to help him with it but he takes a lot of things in his stride.”
The Honorary Recorder of Preston, Judge Mark Brown, who is presiding over the trial, said: “What we are saying is that from around the early 1990s he has probably suffered from chronic schizophrenia.
“There is evidence of him disclosing paranoid delusions and hallucinations since around the 1990s which over the years he has begun repeating. By 2014 it appears his reporting of delusions is getting more profound.”
The jury must decide whether Kay is guilty of murder or the lesser charge of manslaughter on the grounds of diminished responsibility.