THE sister of a convicted killer told an inquest he clearly needed help as he descended into a “skeletal” state before starting a fatal fire.

The inquest into the death of 30-year-old Khabi Abrey began at Essex Coroner’s Court yesterday, four years after her death on May 7, 2016.

The mum-to-be and her unborn child died from smoke inhalation after Lillo Troisi, then 48, started a fire on the ninth floor of the Grampian flats, in Salisbury Avenue.

Troisi was charged with murder, but prosecutors accepted a guilty plea to manslaughter and arson.

Psychologists found that Troisi was “acutely psychotic” at the time and had not been taking his medication for 18 months.

He was locked up indefinitely in a psychiatric hospital in 2018.

Giving evidence at the inquest, Troisi’s sister Rosa Garner shared how Troisi had been diagnosed with paranoid schizophrenia at the age of 19.

The inquest heard that Troisi was “essentially untreated”.

Mr Garner said the family began to notice changes in Troisi, saying that they knew something “just wasn’t right”.

She said Troisi had lost around six stone in a year, and would often pace around talking to himself, and when confronted, would “go into complete denial”.

She said: “He was like a skeleton. He stopped engaging with the family. My mum would feed him, wash his clothes and go around to his flat once a week.

“Once that stopped, we noticed. He was losing weight and shaved his hair off.

“If you observed my brother for any period of time at all, just looking at him - the GP saw him and said there’s nothing wrong with him - I just couldn’t as he made you feel frightened just by looking at him.”

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She added: “I couldn’t understand that anyone would look at him and think he was, for want of a better word, normal.”

Before moving to Southend at the beginning of 2015, she said Troisi had been living a “nearly normal” life in north London and was given a monthly injected dose of anti-psychotic medication.

However, she said Troisi could not access this once moving to Westcliff.

She said: “He would happily go along for his monthly injection.

“He had been symptom-free since 2010 and lived a near-normal life. He was very close to my mum, he would see her once or twice a week.

“My parents needed to move as mum had become quite infirm.

“It seemed the most sensible thing to do as we were all in Southend.”

Ms Garner said Troisi had registered with a GP close to him in Westcliff after moving, but the GP couldn’t give him the injections, instead prescribing tablets for him to take.

She said: “He said ‘I told him I wanted an injection and they wouldn’t do it’.

“I asked where he could get it injected. I was told there wasn’t a list and was told to ring around a few GPs and see if they could do it.

“I thought it was absurd.”

The inquest continues.