A schizophrenic who hanged himself in his hospital room was deemed the previous day to be in need of "routine monitoring" rather than constant one-on-one observation, an inquest has heard.

Shandal Richardson died in the early hours of March 5 last year at the Mid-Atlantic Wellness Institute (MWI) after tying one end of a bedsheet around his neck and the other to a bedpost.

His family has claimed he was supposed to be under constant observation for 72 hours after admission and could not have killed himself if he had been properly monitored.

A hearing into the 35-year-old's death at Magistrates' Court heard yesterday from MWI chief operating officer Patrice Dill, who read out a "doctor's order" written on March 4 on how to deal with the patient.

Ms Dill said the MWI doctor wrote that the father-of-three needed routine investigations, routine monitoring, drug screening and seclusion as necessary.

The inquest had earlier heard that Mr. Richardson, a security guard, was deemed a suicide risk by an emergency room doctor at King Edward VII Memorial Hospital on March 4 after he tried to stab himself with a knife at his Scenic Hills, Southampton home. He was admitted to the acute care Somers' Annexe at MWI later that day.

Yesterday, Coroner Juan Wolffe quizzed Ms Dill on the circumstances surrounding Mr. Richardson's admission.

She said there was a room at the hospital used for observation and seclusion and it was her understanding that Mr. Richardson was put in the room at the start of his admission.

Ms Dill said it was not automatic that someone with suicidal tendencies be admitted to the room and that the room was also used for patients not considered suicidal.

Patients in the four-bed Somers' Annexe, she explained, are usually detained compulsorily under the Mental Health Act. She said they are often admitted in an aggressive or psychotic state and are usually deemed a danger to themselves or to others. Ms Dill said the type of monitoring required for patients on Somers' Annexe had to be determined by a doctor.

The Coroner asked what would have prompted Mr. Richardson's removal from the seclusion/observation room to bedroom number four, where he hanged himself.

Ms Dill said: "The behaviours would have to change and then the doctors would make an assessment."

Mr. Wolffe asked if it was in Mr. Richardson's best interests to have been taken from a room where there was just a mattress and locked in another room with a fellow patient and furniture.

Ms Dill said: "The clinicians on the unit work with the physicians who make the assessment. If he was identified to me as a one-on-one observation, that's what would have been given.

"With him being routine, then I have to assume that that's exactly how the staff managed him." Ms Dill said that since the original order was for routine monitoring it would not have been necessary for a doctor to sanction his removal from the room.

The Coroner asked Ms Dill to describe what constant nursing observation would entail. "For want of a better word, it's like white on rice?" he asked.

She agreed, explaining that a nurse would be with a patient 24 hours a day. She said routine monitoring meant staff needed to know the whereabouts of a patient, but would not have to constantly be with them.

"Is it a lesser risk assessment [than one-on-one]?" asked Mr. Wolffe. Ms Dill, of Smith's, said it was.

Earlier, Detective Constable Stephen Palmer of the Police Forensic Support Unit gave evidence.

He was asked to look at photographs he took at MWI after Mr. Richardson's body was discovered. He agreed that one appeared to show a smear of blood in the room and that bedding taken from the scene also appeared to have bloodstains.

The hearing was adjourned until Tuesday (September 22).