A fly-in, fly-out worker shot dead by Western Australian police after he stabbed seven people had stopped taking his antipsychotic medication in the months before the incident, an inquest has been told.

A Perth clinic providing care to Ashley Dean Fildes failed to convince the father-of-one to continue his voluntary treatment before discharging him when the COVID-19 pandemic forced it to reduce patient numbers.

Mr Fildes, 34, stabbed four men and three women during a frenzied attack in the mining town of South Hedland on May 1, 2020, before police shot him three times as he threatened an officer with a kitchen knife.

An inquest into his death heard on Monday the road worker had been diagnosed with paranoid schizophrenia the year before and was being treated as a voluntary patient.

But he believed the medication was causing side effects and stopped turning up for his regular injections at a community clinic in December 2019, according to counsel assisting William Stops.

Staff at the facility attempted to coax him back on numerous occasions before removing him from their patient list due to non-compliance and COVID-19 pressures on the health system.

Four months later, Mr Fildes flew to South Hedland to start work on a Main Roads WA project, where colleagues expressed concerns for his mental wellbeing after just three days on the job.

By May 1, Mr Fildes had been sent home from work to his accommodation at a motel after he was seen behaving erratically and had disobeyed his bosses’ orders.

Once at the motel, Mr Fildes grabbed two knives from the restaurant kitchen and threatened a receptionist, a chef and a manager before stabbing a housekeeper twice in the arm.

The road maintenance worker then knifed a man on a footpath before heading to a local McDonald’s where he stabbed two men in the car park, injuring one man in the neck as he sat in a car.

Mr Fildes then headed for the South Hedland Shopping Centre where he stabbed a woman with her one-year-old daughter in the back and a man in the neck.

Police shot him in the chest three times after he stabbed another woman in the shoulder and lunged and threatened two officers with the knife, saying: “I will f–king kill you”.

He died from the gunshot wounds and blood loss at the scene.

Psychiatrist Anthony Abish told the coroner that despite Mr Fildes’ reluctance to take his prescribed antipsychotic medication, he did not fit the criteria to be placed on an involuntary mental health order.

He said Mr Fildes did not have a history of violence and appeared to be in remission.

Dr Abish agreed Mr Fildes was likely very unwell when the stabbings occurred but said there was no legal way to force him to have his injections in the months prior because he was a voluntary patient.

Mr Stops told the coroner Mr Fildes’ parents had raised concerns about their son’s health during this period and believed the clinic had “kept them in the dark”.

Of the seven people injured during the attack, one was transferred to Royal Perth Hospital in a serious but stable condition and recovered, five required treatment at a hospital for non-life-threatening injuries and one did not require any medical attention.

The inquest in Perth will focus on the quality of mental health care Mr Fildes was given before the incident and the appropriateness of the police response on the day.

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-AAP