Mother who killed son during severe mental health crisis given indefinite hospital order

A mother who killed her four-year-old son during a serious mental health episode will be detained indefinitely in hospital for her own and others’ safety.

Akanksha Adivarekar, 37, of Dunholme End, Maidenhead, was charged with murder in June after police found her son Augustya dead in their home.

However, for many weeks, Adivarekar was found unfit to plead.

Eventually it was agreed that she should face a charge of manslaughter by diminished responsibility.

She pleaded guilty to this and faced sentencing yesterday (Thursday).

The court heard that Adivarekar had been diagnosed with bipolar disorder in 2016 in her home of India (where she had worked as a dentist) after suffering sleeplessness and hearing voices.

When she moved to the UK, she worked as a healthcare consultant for Bupa and then in HR at Burnham Grammar School, before stopping to work on writing a children’s book.

She had recurrent mental health problems, including ‘low mood and anxiety’ and sought help for these from the GP.

However, she was not referred to secondary mental health services for further help. Her bipolar disorder was considered to be ‘in remission.’

In general, her life had been going well – her husband, friends, neighbours and colleagues described her as a ‘great mother and devoted wife’, the court heard.

Augustya also appeared well-cared for and loved by both parents. His teachers described him as ‘quiet, well-behaved, sweet and cheeky in a good way’.

But on the morning of Augustya’s death, she had appeared unsettled, the court heard.

She spoke to her husband of fears that their son was being sexually abused – and later unveiled ‘a mass of worries’.

These included delusions that there were cameras in her house and people in cars watching her, who wished to kidnap her and her son, abuse them and sell them into slavery.

Though Adivarekar’s behaviour in the run-up to the killing may have been ‘mildly grandiose’, it was not considered worrisome – but her mania ‘erupted’ into persecutory ideas in a few short days.

Dr Iain Kooyman, who was among three clinicians assessing Adivarekar’s mental health as part of court proceedings, said this kind of ‘sudden onset’ is typical of bipolar disorder. Mania can occur ‘extremely quickly’ he said.

The court heard that – unusually – three different medical professionals agree completely on Adivarekar’s condition and the best course of action.

Presiding, His Honour Judge Michael Grieve KC described how Adivarekar lived in fear of the perceived imminent risk to her and her son.

She killed him – and intended to kill herself – to spare them both from this fate and to end the suffering she believed Augustya was already going through.

The court heard that Adivarekar was ‘severely delusional’ and suffering auditory hallucinations, and the illness was the ‘sole driver’ for her actions on June 10.

The day he died, Augustya was found with several deep knife wounds.

Adivarekar had also harmed herself seriously and, having failed to take her own life, got on a bus to St Mark’s Hospital, where she told staff she had killed her son and that she wanted to die.

She also said: ‘They’re all watching me’ and made a number of allegations against her husband which investigation found to ‘have no foundation whatsoever’ – simply part of the delusion.

Adivarekar received treatment at Wexham Park Hospital and then John Radcliffe, where she was also placed on a 24/7 suicide watch.

While in custody she continued to prove a danger to herself, resisting medical intervention, and had to be restrained. She was presenting as ‘depressed and paranoid.’

Augustya’s father and Adivarekar’s husband spoke at the sentencing hearing. The prosecution and judge asked that he not be named so he may, in his words, start his life from scratch.

“Augustya was my joy, my pride, my reason for living,” he said. “From the moment he was born, my life was filled with happiness.

“Watching him grow and learn was the greatest privilege of my life.

“I grieve not only for the life of my son but for the future he was robbed of – the man he would have become.”

His wife and son ‘were the two people I lived my life for’, he continued – he and his wife ‘wanted to grow old together.’

“Akanksha was the best mum I ever saw in my life until that day. She would never have caused such pain,” he said.

“The impact of this loss is indescribable. I’m haunted by the question of why this happened.

“All I can do is forgive Akanksha for what she has done to me. I hope she gets the best possible treatment.

“I would like to publish her book when she is better. Augustya would be very proud to see that.”

In his concluding remarks, Judge Grieve said to Adivarekar: “This is an utterly tragic case.

“You killed your four-year-old son whom there is no doubt you loved deeply. You were a very happy and loving family unit.

He noted that her husband said that, in her right mind, Adivarekar would ‘never have harmed another living creature.’

There was ‘no question’ that Adivarekar had tried to address her mental health issues. This caused the judge to conclude that she sits at the ‘lower end’ of responsibility for her actions.

Because of this, and in line with the medical professionals’ view, the judge considered a hybrid order – a combined prison sentence and hospital order – to be ‘not appropriate.’

“You are not an inherently antisocial person – quite the opposite,” he said.

Instead, Adivarekar faces an indefinite hospital order, with release to be decided by a Mental Health Tribunal or the Secretary of State for Justice.

This is considered ‘necessary to protect the public.’