As Campbell, who carried out his July 1995 attack at St Luke's infants' school in Blakenhall, Wolverhampton, was on his way to be assessed at a high-security hospital, questions remained: Why was a man who had already been arrested in possession of a machete after causing an affray while "hearing voices" not being treated for mental illness in a secure unit? Was Campbell a disaster looking for somewhere to happen?
Although most people thought he was a harmless eccentric, the signs were there long ago. He lived an isolated life in his council flat in the Villiers House tower block overlooking the infants school playground, with few friends and limited contact with family.
After working as a painter and decorator and then a toolmaker, he had been without a job for six years. He became cut off from the outside world and was thought never to have had a girlfriend. His 84-year-old father, Isaac Campbell, a devout Christian, lives in the All Saints area of Wolverhampton. His sister Cheryl lives in America.
He begun acting strangely after his mother Rebekah died in Jamaica in 1992. Campbell could not afford to attend the funeral. That had left him, the report said, with a "deep sense of regret". He began walking the streets and muttering to himself
A family friend known as Buzz said: "He took her death very badly. He would walk around with a glazed look in his eyes and I must admit he would scare you. He'd act like a kid jumping out in front of people and scaring them and then laughing. But you never knew what was inside his head."
In November last year he was charged with affray and possession of an offensive weapon - a machete strapped inside his trousers. He was convicted of affray and the other charges after a struggle with officers. More bizarrely, he was cautioned for arson last year after he torched his own car.
During the pre-sentence assessment he said he had heard "voices" in his head telling him to do it. The report described him as possibly suffering from a medical condition but as reluctant to consult his doctor.
Harry Fletcher, assistant general secretary of the National Association of Probation Officers, said: "In cases like this where there is violence or the threat of violence, there is a duty on the court to take account of the risk to the public. Virtually all mentally-ill offenders are found to be in denial. It is the job of psychiatric services to coax them into treatment."
It was suggested to Wolverhampton's stipendiary magistrate, Ian Gillespie, that a medical assessment might be helpful.
Yesterday Mr Gillespie strongly defended his decision not to seek one, taking the unusual step of issuing a statement through the Lord Chancellor's Department .
Earlier this year, Campbell's extraordinary state of mind prompted him to stick up a newspaper cutting about the Dunblane massacre on his bedroom wall. Later, he added a cutting about Michael Bryant, who killed 35 people in Tasmania. Asked why, he told police that toddlers were devils.
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