Hassan Sentamu struggled to control himself, psychiatrists at his trial into the killing of Elianne Andam said today (Wednesday, January 8).
On Tuesday, January 7, Professor Nigel Blackwood, a forensic psychiatrist at King’s College London, told jurors he had diagnosed Sentamu with a conduct disorder, but this was not mutually exclusive with exercising self-control.
But when repeatedly asked by defence counsel Pavlos Panayi KC if Sentamu’s autism had ‘any’ effect on his ability to self-restrain, Professor Blackwood said ‘no’.
Sentamu, 18, is accused of murdering the 15-year-old schoolgirl in Croydon town centre in September 2023. Sentamu denies murder on the grounds of diminished responsibility due to autism and claims he had a lawful reason for carrying a knife.
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Mr Panayi also grilled the professor on whether his diagnosis would have changed had he seen a SnapChat video that was introduced into the evidence after his assessment of Sentamu. Professor Blackwood watched the video, which showed Sentamu being ‘teased and bullied’, but concluded it would not have changed his view on the teenager.
Professor Blackwood also said it was his view that the defence of diminished responsibility does not apply in this case. Asked by Mr Panayi if it’s normal for two eminent psychiatrists to disagree, Professor Blackwood said: “Not always. But in this case, yes.”
Everything the court heard today
Sentamu was caught on CCTV making his escape from the scene on the 410 bus
(Image: Met Police)
Mr Panayi explained that the ICD definition of a conduct disorder includes a ‘repetitive and persistent pattern of dissocial, aggressive, or defiant conduct’, ‘more severe than ordinary childish mischief or adolescent rebelliousness and should imply an enduring pattern of behaviour’. It adds: “Features of conduct disorder can also be symptomatic of other psychiatric conditions, in which case the underlying diagnosis should be preferred.”
Mr Panayi suggested Sentamu’s diagnosis of ADHD and autism ‘should be preferred’ over conduct disorder. Professor Blackwood says he disagrees.
Professor Blackwood said ‘there is not’ a significant relationship between autism and violent behaviour.
“ASD in these studies is not driving an increased risk in violence,” the professor added. “What these studies clearly show it’s ADHD or Conduct Disorder that’s driving that increased risk, it’s not ASD.”
Questioned further on the paper, Professor Blackwood said: “This study is not strong evidence that ASD drives violence in the way Mr Sentamu assaulted Ms Andam.”
Mr Panayi then asked Professor Blackwood whether the combination of Hassan Sentamu’s disorders of autism and ADHD could cause ‘substantial impairment’ on his ability to control his anger.
The professor replied: “Not substantial impairment in my view, not to the level for diminished responsibility. There is impairment on his ability to control his anger, but that is clear from his history.”
Mr Panayi finished his questioning by asking the professor if he thought Sentamu would have attacked Elianne if she had not taken his plastic bag. “That is my hypothesis, yes,” he replies.
Alex Chalk KC, prosecuting, later read out a section of the report which said autism was associated with a reduced risk of conviction with other co-morbidities.
“What actually is the impact of ASD when you have co-morbidities of conduct disorder and ADHD?” asked the prosecutor. “If anythi,ng ASD is reducing the risk of violence in those with conduct disorders,” replied the professor.
Read Professor Blackwood’s full statement here.
The defence also called on Professor Seena Fazel, a forensic psychiatrist at the University of Oxford, who prepared three psychiatric reports on Sentamu, as a witness.
Professor Fazel said autism is a life-long condition, but the manifestations of it ‘can change’.
Quoting from the professor’s written report, Mr Panayi said: “It’s possible Mr Sentamu has co-occurring personality and conduct difficulties, but it is hard to disentangle the two.”
The professor explained that it can be difficult to disentangle the two ‘because they present in similar ways’, and acts like damaging property can be driven by both conduct and autism.
The professor explained he did not diagnose Sentamu with a conduct disorder because things ‘typically present in those with clear-cut conduct disorder’ were not ‘pervasive and severe’.
Professor Fazel further explained he spoke to Sentamu’s mother to get a ‘broader picture’ as ‘there were clearly gaps’ in the written history.
The professor concluded: “I am of the view Mr Sentamu had an abnormality of mental functioning arising from a recognised medical condition at the time of the relevant offences.”
Explaining what he meant, the professor added: “ASD [Autism Spectrum Disorder] was the recognised medical condition, and the abnormality was the lacking of social communication function and the liking of routine.”
Mr Panayi then took Professor Seena Fazel through the conclusions of his first report.
“It is my view his ability to exercise self-control was substantially impaired,” the professor wrote, adding that Hassan Sentamu felt a ‘heightened sense of anger and fear’ after ‘being threatened’ and having water thrown on him the day before he killed Elianne Andam.
“This would explain him carrying a knife and his extreme violent reaction when the victim grabbed the bag from him,” the professor continued.
“Additionally, I am of the view his ASD was a significant contributory factor in causing him to kill Elianne Andam.”
CCTV footage captured the moment Sentamu had water thrown over him from a water bottle in the Whitgift Shopping Centre
(Image: Metropolitan Police)
Defence barrister Mr Panayi took Professor Fazel to his third report on Hassan Sentamu, including his comments on Professor Nigel Blackwood’s report.
The professor then explained he agrees Sentamu had personality difficulties associated with antisocial behaviour, but it did not reach the threshold for conduct disorder or Anti-Social Behaviour Disorder.
“It’s my view Mr Sentamu’s ASD impacted on his ability to control his feelings of anger and being disrespected and feelings of being mocked and humiliated in front of others. In other words, ASD substantially extenuated these feelings and regulations of his emotions,” added the professor.
Mr Chalk then took Professor Seena Fazel to the section of his report where Sentamu said he was aware he could be found guilty of murder or manslaughter, with the latter attracting a lesser release date.
Mr Chalk then said it was for Professor Fazel to be ‘on your guard’ when speaking to Sentamu.
Mr Fazel agrees that he did not review the school records, the original social services records, original youth justice records, or ask to see them when he drafted his first report.
Read Professor Fazel’s full statement here.
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