A man who stabbed his mother and killed his sister, was sent home by doctors without a handover, an inquest has heard.
Melvin James killed his younger sister, Ann-Marie, in the family's flat in Leasowes Drive, Wolverhampton in March 2017. The 33-year-old died of 17 knife related injuries, including one fatal stab to the heart.
James' mother, Lyenette, was also left injured by her son as she told him "I love you" as he repeatedly stabbed her.
He then died of multiple stab wounds which a pathologist told Black Country senior coroner were "only compatible with self-infliction". A post mortem found he had at least 80 injuries.
Armed police used stun grenades and tasers to subdue James.
A month earlier, younger brother Leon James, picked up Melvin James from Royal Edinburgh Hospital, where he was on the psychiatric treatment ward, with the all-clear.
Police found James walking without shoes in the early hours of 4 February. James later told doctors he was trying to walk "to Wolverhampton".
Dr Norman Nuttall, consultant psychiatrist at the Edinburgh hospital, said James' admission was voluntarily but he was sectioned when he tried to leave.
When James first arrived at the hospital, Dr Nuttall said:
Dr Nuttall said James also spoke about "a clown that could brainwash him" which offered a choice of "kill or be killed".
Following observation and the discovery of an opioid, doctors believed James was possibly suffering from a psychoactive substance in his blood and was diagnosed with a "drug-induced psychosis".
His condition improved and he later told doctors his delusions were "rubbish".
Dr Nuttall said by Friday he was "very happy to suggest that really Mr James could be discharged".
Dr Iain Proven, who conducted the discharge assessment, said James believed the thoughts he had in admission were "'really odd'" and "'not true'".
Neither Dr Proven or Dr Nuttall had the chance to speak to Leon James before taking his older brother home to Wolverhampton, who spoke about "the Transformers and the Illuminati".
Dr Proven said:
The inquest continues.