A Belfast woman murdered by her son had twice turned down offers of help in 2016 and 2017, which could have involved measures to prevent her coming to harm.
Disabled Anne O'Neill (51) had told a GP that her son Declan had been hostile and verbally abusive towards her.
But Mrs O'Neill twice turned down assistance from the GP's adult safeguarding team - most recently just two months before she was brutally bludgeoned to death by her 29-year-old son Dr Declan O'Neill on October 21, 2017.
Evidence of Mrs O'Neill's concerns about Declan's aggressive behaviour emerged in a psychiatrist's report presented to Mr Justice Colton, who last week ordered the young Belfast medic to serve a minimum of eight years in jail.
O'Neill (29) donned a rubber mask before ambushing his physically disabled mother with a chisel at the back of her parents' home in Ardmore Avenue, south Belfast.
He then fled to his own home in Malone Avenue and tried to cover up his involvement in the killing.
The court heard Dr O'Neill (29) had mental health difficulties but there was evidence that his controlling mother, a retired nurse, was also troubled.
In a report, consultant psychiatrist Dr Carine Minne said: "She appears to have suffered from mental health difficulties, manifested by the descriptions of her disturbed behaviours, possible paranoid symptoms, as well as reference to episodes of self-harm."
She added that unfortunately Mrs O'Neill appeared to have declined treatment.
Dr Minne added: "She did agree to meet with her GP practice counsellor in March 2017.
"I understand that she made allegations to her GP that her son, Dr O'Neill, was verbally abusive and hostile towards her and, as a result, adult safeguarding became involved.
"However, she refused twice the offer of involvement following a referral to the safeguarding team, in June 2016 and again in August 2017."