An assistant psychologist testified Neil had also told him he had thoughts of a specific suicide method. The court was told he recorded it in his notes and went so far as to underline it but, despite this, Neil's observation level did not change and staff were advised to do a level 2 (moderate) observation. The clinical lead nurse testified he was concerned the risk assessment might change overnight. He said he called around to get extra staff to come in to more closely observe Neil's care but could not find anyone available. At the start of the inquest, Neil's sister Marie Mooney-Evans testified that her brother, who had schizophrenia and a number of physical ailments, had managed his mental health well throughout his life, until the final months when a series of events led him to a significant and rapid decline.