A former mental health boss has called for "assertive outreach" to treat seriously ill mental health patients after a catalogue of failures in NHS services were unveiled in the case of Valdo Calocane.
Claire Murdoch, who was NHS England's national director for mental health until recently, also warned that the Covid-19 pandemic "hit our young in ways that ought to trouble us all".
Ms Murdoch was speaking in front of delegates at NHS Providers' annual conference in Manchester, two months after resigning from her national role amid claims of political pressure for change.
She said she would "have liked more time" in her post, adding: "Because the next five years, I think, can bring a real tipping point.
"Obviously, Covid was hugely disruptive to society. It's particularly hit our young in ways that ought to trouble us all."
On serious mental illness, Ms Murdoch said early results from a pilot scheme of six 24/7 neighbourhood centres for patients have been "amazing".
However, she stressed that services must be able to outreach, referencing the case of Calocane, who stabbed 19-year-old students Grace O'Malley-Kumar and Barnaby Webber, and 65-year-old caretaker Ian Coates, to death in Nottingham in June 2023.
Calocane had been diagnosed with paranoid schizophrenia, but a report published earlier this year revealed he was not forced to have long-lasting, antipsychotic medication because he did not like needles.
He was sentenced to an indefinite hospital order in January 2024 after admitting manslaughter by diminished responsibility and attempted murder.
Ms Murdoch said: "The learning from the Valdo Calocane case, which I think there was a great deal of suffering for - nothing can match the suffering of families - but I know it hurts the sector, the clinicians involved, those of us not involved.
"It's a catastrophic event, each life lost, whether that's to suicide or to homicide.
"It absolutely matters that we've got a clear and insistent, high quality programme of assertive outreach, because not everybody will walk into those centres and ask for help.
"Their carers might, the people who love them might, so the doors need to be open to them, but we absolutely need to be able to outreach."
Data published in June suggests more than one in five people aged 16 to 74 have common mental health conditions, such as generalised anxiety disorder, depressive episodes, phobias, obsessive compulsive disorder (OCD) and panic disorder.
Problems were more common in young people, with more than a quarter of those aged 16 to 24 reporting having any of these conditions, up from 17.5 per cent in 2007.
Ms Murdoch, who is currently chief executive of the Central and North West London NHS Foundation Trust, also said Work and Pensions Secretary Pat McFadden is "faced with a really wicked issue, which is a growing number of young adults out of work, on disability benefits and all that goes with that".
Ms Murdoch described the situation as a "tragedy", adding: "Obviously not the sickest - the disability benefit, always, for those who need it - but looking at the huge numbers involved, and ADHD and autism; we need to be leaning into waiting lists and seeing those young people early."
In her resignation letter, which was published by the Health Service Journal, Ms Murdoch wrote there is "huge political pressure for change, and a brand new, radical approach to mental health".
She told delegates: "I refuse to work in a health system where being honest is brave. I was just honest.
"I didn't feel brave, and when I wrote my letter, the simple truth is, I didn't speak to anyone. I just thought, I need to write this letter now.
"I put in the bit about feeling the politicians didn't want to work with me, and then I took it out again, because that's like being the girl that wasn't chosen for the netball team.
"But I put it back in again, because I felt instinctively so engaged with this sector: these amazing people, lived experience, their carers, the charitable sector, the NHS sector; I thought, I can't just go and not say why, that would have felt like a betrayal."