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R v Ozen (Fatih) 4 March

This is the last stage in an appeal which has had a lengthy history in this court. The appeal itself was against a conviction on 27th February 2002 when the appellant was convicted of conspiracy to defraud and sentenced to 30 months' imprisonment, a sentence which he has now served.

The delay in the processing of the appeal has been occasioned by the fact that, unhappily, it has become plain that the appellant suffers from a psychotic illness, namely paranoid schizophrenia. This was clearly, according to a report that we have from Dr Dutta, an illness from which he was suffering at the time of his appearance in January 2002 but was at that stage unrecognised. It should be said that, immediately prior to trial, the appellant had been in custody in Belmarsh Prison and had been seen by psychiatrists but there was no diagnosis of that which it is now clear he is suffering from at that time.

The diagnosis is of critical significance in this case for this reason. When the trial took place the appellant was unrepresented. That was as a result of his having dispensed with his solicitor's services a week or so before the date fixed for the hearing, having indicated to them when they attended for a conference that he did not wish to see them or to be represented by them any more.

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Tinsley (Damien) (by his Receiver & Litigation Friend Martin Conroy) v Sarkar (Jaidip) 18 Feb

On 26th May 1998, at the age of 28 years, the Claimant, Damien Tinsley, was severely injured in a road traffic accident when knocked from his bicycle at a junction. Proceedings were commenced on 24th April 2001 and issues in respect of liability were subsequently compromised on the basis that Mr Tinsley should receive 90% of the damages to which he would otherwise have been entitled on a full liability basis. As to quantum, the major component of the claim (as is not unusual in cases of this nature) is future care costs; in the final Schedule of Loss submitted before trial, these were put at a figure in excess of £5.5 million. This claim is effectively disputed in its entirety by the Defendant on the basis that a combination of local social and health services have an obligation to make appropriate provision for Mr Tinsley pursuant to the provisions of section 117 of the Mental Health Act 1983 ("the 1983 Act"); the best case advanced on his behalf in the Counter Schedule then assessed this aspect of the claim at some £97,000. At the commencement of the hearing, every other head of claim was also in issue; as the case progressed, a number were compromised.

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Mind welcomes the Pre-legislative Scrutiny report

The Parliamentary Committee examining the draft Mental Health Bill has endorsed almost all of the Mental Health Alliance and Mind’s key objections to the Bill. In a report published on 23 March 2005, the joint committee of Peers and House of Commons MPs gave details of
the “radical overhaul” that the government’s bill needs. The ommittee’s view is that, in its current form, the new legislation would force too many people into compulsory treatment and erode civil liberties.

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Draft Mental Health Bill, Letter From Campaign Headquarters, Number 7. Royal College of Psychiatrists

The Joint Committee of both Houses of Parliament scrutinizing the second version of the Bill requested written evidence of no more than 1,500 words. The College’s evidence didn’t quite keep to this. It was just under 17,000 words (and even then we had to write three supplementary pieces at the Committee’s request, all may be read from the College web-site). However I know at least the chairman read it all, he spotted, and commented on, a double negative buried deep in the text! The Committee received over 450 written submissions.

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NHS Confederation Backs Scrutiny Committee's Concerns about Draft Mental Health Bill

The NHS Confederation, whose members include all mental health and learning disability NHS trusts, welcomes today’s scrutiny committee report into the Draft Mental Health Bill which warns against increased use of compulsion in mental health treatment.

Chief Executive Dr Gill Morgan says: “We submitted evidence to the committee raising serious concerns that this draft Bill would lead to many more people being treated against their will.

“And so it is heartening that Lord Carlile of Berriew, who chaired the committee, concludes in today’s final report that the draft Bill is ‘too heavily focused on compulsion’ which would be impossible to implement.

“We agree with the report’s finding that the government has underestimated both the cost and workforce implications of the mental health tribunals which are intended to provide the legal authority for compulsory treatment beyond 28 days.”

The NHS Confederation’s evidence to the committee stated: “The Confederation is concerned that the definition of mental disorder and conditions for compulsion are too broad.

“The Draft Bill is likely to increase the number of people under compulsion . . . and the broad conditions and removal of the discretion of decision-makers to take into account other circumstances may mean people will enter into the system far too easily, but find it difficult to leave.

“We have serious concerns as to the extent to which the implementation consequences have been fully thought through, particularly in terms of the expanded tribunal system and capacity of the service.

“We believe the government has seriously underestimated both the cost and the workforce implications and do not believe the proposed tribunal system is workable.”

The NHS Confederation is an associate member of the Mental Health Alliance, a coalition of more than 60 charities, professional organisations and mental health service user groups that have come together to work for a better Mental Health Act.

nhsconfed.org 30 March

Forget the mental health bill

There is a way to solve the impasse over the mental health bill, says David Brindle: The case for reform of the 1983 act 'is cogent but is by no means overwhelming'

By September it will be seven years since the government began attempts to reform mental health law to introduce compulsory treatment in the community. Following the report last week of a pre-legislative scrutiny committee of MPs and peers, who evidently did not think very much of the latest draft bill, things seem scarcely any further forward.
Where do we go from here? The coming general election offers an opportunity for reflection and, in the event of another Labour victory, quiet burial of the big-bang approach to reform. Instead, (presumably) new ministers should take a deep breath, revisit the 1983 Mental Health Act (since amended), and consider how it could be modified further to meet their main objectives.

Heresy, I hear people cry. For the one thing that has united ministers and their critics in the mental health world is a working assumption that the act is out of date, a hospital-based statute for a now community-based care system. Beyond that though, there is very little agreement, which is why we are where we are. And this stand-off is doing nobody any good.

That the government has failed to move its agenda forwards is a lasting tribute to the Mental Health Alliance, a coalition of more than 60 charities, professional bodies and user groups, which has held together against all the odds and fought a remarkable campaign for a better bill. But the cost of that focus has been relative neglect of bread-and-butter issues.

While the key players of the mental health world have been absorbed by the minutiae of tribunals, assessment gateways and definitions of mental disorder, services on the ground have shown little improvement - certainly by comparison with other parts of the NHS. Has mental health had its fair share of resources? Has it, in fact, had all the resources promised? We do not know, because nobody has been keeping count.

Then there is the challenge of stigma and prejudice. Recent media coverage of admittedly appalling cases of homicide by people with mental illness has shown how easily society can slip back into kneejerk, lock-'em-all-up mode and how much work there is to do to counter that.

So it is high time that reform of the act was sorted out, one way or another, and everybody got back to their day jobs. Yes, ministers could capitalise cheaply on the run of homicides and bulldoze the bill, or a marginally amended version of it, through parliament. Yes, they could try once more to find common ground with the alliance, though even if there were an accommodation there are grave doubts - shared by the scrutiny committee - that there would ever be the resources needed for the tribunal model in the draft bill to work.

Or ministers could return to Go. Interestingly, the scrutiny committee starts its 300-page report (and that's just volume one) by saying that the case for reform of the 1983 act "is cogent but is by no means overwhelming". Could the act be given a rebuild and put back on the road?

It is often forgotten that there is an existing power of guardianship in the act, enabling local authorities to require a person with a mental disorder to stay at a specific address and submit to medication. But the power is little and patchily used. Last year, it was applied in 932 cases, ranging from 63 in Lancashire to none at all in 12 London boroughs and 11 other councils. Guardianship is a non-stigmatising tool that could be administered by advocacy services instead of social workers, as it is now in 99% of cases, and is ripe for development.

There is, of course, one big problem with this. Since 1998, the initial goal of compulsory community treatment has become yoked, grotesquely, with a second idea of preventive detention of people with "untreatable" dangerous personality disorders. As the scrutiny committee concludes: "We do not believe that this group should be dealt with by mental health legislation."

To get anywhere further forward, and retain any hope of broad-based support for reform, the two things have to be decoupled. Health ministers must tell their Home Office colleagues to do their own dirty work.

· David Brindle is the Guardian's public services editor.

guardian.co.uk 30 March

Racism census for mental health care

Inspectors to check on private and NHS hospitals

John Carvel, social affairs editor
Wednesday March 30, 2005
The Guardian

The first census of mental health units to establish the extent of discrimination against black and minority ethnic patients will be carried out throughout the NHS and private hospitals in England and Wales tomorrow.
Health inspectors will look into the ethnic and religious characteristics of all in-patients and their experience of seclusion or injury while on hospital premises.

The Count Me In census follows allegations of institutional racism in mental health services made last year by Sir John Blofeld, a retired high court judge, after an investigation into the death of David "Rocky" Bennett.

Mr Bennett, a 38-year-old Jamaican-born Rastafarian, died in Norwich in 1998 after being held face down on the floor for 28 minutes by at least four mental health nurses.
The judge blamed the Department of Health for the poor standard of treatment, describing the problem as a "festering abscess" and a "blot on the good name of the NHS".

Ministers acknowledged that people from black and minority ethnic communities were less likely to come forward voluntarily for mental health treatment, more likely to stay longer as in-patients and more likely to be prescribed medication or electro-convulsive therapy (ECT) instead of psychological treatment.

Sample surveys suggested that young Afro-Caribbean men were between two and eight times more likely than their white contemporaries to be sectioned under the Mental Health Act. The census will establish more precise statistics.

The results will be used to help assess whether government policies to reduce discrimination have any effect. The government has promised to reduce the disproportionate rates of admission, compulsory detention and seclusion of black and minority ethnic patients.

Anna Walker, chief executive of the Healthcare Commission, said: "Currently poor monitoring of ethnicity means healthcare providers are not always getting it right when it comes to this patient group."

Louis Appleby, the mental health tsar, said: "We welcome this as an essential part of our aim to eliminate inequalities."

Cliff Prior, chief executive of the mental health charity Rethink, said: "We know that black and minority ethnic users of mental health services get the worst possible deal - over-medicated and over-represented in secure settings and under-represented in decision-making bodies.

"The census will provide accurate information on people's experiences and help the government identify the areas of radical change that are needed to make mental health services accessible to everyone in need."

Mental Health Act Commission: Draft Framework for the assessment of the use of CCTV in psychiatric in-patient units

The Mental Health Act Commission is seeking views on a draft document produced by a small working group comprised of a mental health services user and representatives from the Healthcare Commission, National Patient Safety Agency, Mental Health Act Commission, and the National Institute for Mental Health (England).

Last year, the Mental Health Act Commission and the Healthcare Commission identified the need for our two organisations to have a common framework for assessing the use of CCTV in psychiatric units. This would enable us to take a consistent approach to the assessment of CCTV when Commissioners or Inspectors found it in use (either in the NHS or the independent sector), and is in keeping with our commitments as signatories to the Concordat for bodies inspecting, regulating and auditing healthcare (see www.healthcarecommission.org.uk). The Cross-government group on the management of violence, set up by the Department of Health, has also supported the work.

We would welcome comments on the draft document below, to be sent please to Gemma Pearce, Director of Strategy at gemma.pearce@mhac.org.uk.

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Carers jailed in home abuse probe

Seven care home workers have been jailed for their part in abuse and neglect of adults at a Hull care home.
The five women and two men, who worked at Bedes View residential home, were all given sentences of between three and 12 months each.

Hull Crown Court heard how their eight victims - all mentally and physically disabled - were bullied, slapped, kicked and humiliated at the home.

Judge Roger Thorn, QC, said a dreadful picture had emerged.

"We have heard of persistant abuse, including bullying, punishments, loss of temper, revenge behaviour, kicking, slapping, nipping, hair tugging and other assaults," he said.

He added such behaviour would not be tolerated by the courts.

"Cases such as this cause a terrible under-mining of the public's confidence in a caring profession which acts for the most part in a position of enormous trust and mainly behind closed doors."

The judge heard several victims had serious disabilities such as epliepsy, blindness, some degree of paralysis or autism.

None had the power of speech or the capacity to complain.

Six care workers were found guilty of charges of ill treatment and neglect in a care home after a trial lasting six weeks.

Janice Fenn, 34, and John Hewitt, 27 and Jacqueline Hewitt, 29, were jailed for 12 months.

Dawn Tuttle, 36, was jailed for eight months, Frances Collins, 28, for nine months and Jennifer Lennon, 27, for three months.

All six are from Hull.

Another carer, Geoffrey Gill, 61, of Skirlaugh, pleaded guilty to four counts of ill-treatment and was jailed for ten months.

The victims and their families have been supported through the case by the mental health charity Mencap.

Speaking after the hearing on Monday, chief executive Jo Williams said: "I think for the individuals concerned and their families it is a very distressing time.

"The people concerned have been placed in a position of trust and they have abused that trust.

"The pain and the humiliation they have caused cannot be under estimated."

bbc.co.uk 21 March

Would this Mental Health Bill have stopped the killing? No

For three years the 'IoS' has been fighting against draconian new laws that propose to safeguard the public by locking up mentally ill people who have committed no crime. Last week our campaign was vindicated by a committee of MPs and peers who have attacked the draft Mental Health Bill for laying too much emphasis on a tiny minority of dangerous patients.

27 March 2005

This newspaper's mental health campaign received an important boost last week when a distinguished committee of MPs and peers concluded that the Government's new mental health laws are "fundamentally flawed".

For three years, The Independent on Sunday has campaigned on behalf of millions of people who suffer from mental illness in Britain, yet find themselves at the mercy of a woefully underfunded mental health service. Filthy wards and long waits for treatment remain all too common.

But our main concern, shared by psychiatrists, patients and lawyers, has been a controversial measure to allow the detention of even more people who have never committed an offence - even if their conditions are untreatable. This is on the grounds that they may be dangerous in future.

Mental health experts have condemned the measures as unworkable, unethical and inhumane. And now, after examining hundreds of written statements and taking evidence from more than 100 witnesses, the parliamentary committee in charge of scrutinising the draft Mental Health Bill has concluded that too much emphasis has been placed on a tiny minority of dangerous patients. The harmless majority, it says, are likely to suffer.

According to the chairman, Lord Carlile of Berriew, a QC and Liberal Democrat peer, people could in future be detained "even though the treatment they receive does not help their condition and they can be detained compulsorily even if they are perfectly capable of making their own decisions".

The proposals would also have done little to prevent the sort of rare but terrifying murders recently committed by two paranoid schizophrenics, John Barrett and Peter Bryan. The publicity they received, with claims that one victim was cannibalised, has added to the impression that society has become more dangerous and that mentally ill people are to blame. Yet the figures tell a very different story.

Of the 900 homicides a year - an average for the past few years - only between 30 and 50 have been committed by people suffering from severe mental illness. Numbers have remained static since records first began, while the overall number of homicides has been increasing.

The majority of men and women who suffer from mental illness are not a threat to society and especially not to people they do not know. At worst, they are many more times likely to take their own lives than someone else's. "Stranger" killings remain highly unusual. Moreover, neither Barrett nor Bryan would have been stopped by the planned laws, say the campaigners. Psychiatrists already have the power to detain people who are considered a risk to society. These men were released to kill as a result of human error by no doubt over-worked professionals who failed to take into account the fact both patients had a history of violence.

The draft Mental Health Bill was heralded as the biggest reform of mental health laws for 40 years when it was published in 2002. But David Blunkett, the former home secretary, insisted it include measures to allay public safety fears after the murder of Lin and Megan Russell in Kent by Michael Stone, a former psychiatric patient. Stone recently lost an appeal against his conviction.

MPs from all parties have promised to oppose the legislation. The House of Commons and House of Lords Joint Committee on Human Rights concluded that the Bill's definition of mental disorder was so wide it could put health professionals in the dangerous position of acting as "guardians of morality".

Ministers then revised their plans and narrowed the criteria under which people could be detained. Even so, the reworked Bill has many critics who say its scope remains too broad. Richard Brook, the chief executive of Mind, the mental health charity, said: "We have a system which is not working, with completely systemic failures due to pressures. We have to have a system where people are seeking help. If you speak to users, people are worried about what will happen to them."

Mind is a member of the Mental Health Alliance, an umbrella group of more than 50 organisations set up to oppose the Bill.

The Foundation for People with Learning Disabilities, which represents around 1.2 million people with learning disabilities, said that autistic people and those with Down's syndrome could be targeted. "We are concerned that the wording is still too broad and it could sweep up people who have learning disabilities," said co-director Alison Giraud-Saunders.

There is no doubt that the existing mental health laws do need overhauling to enable as many people as possible to be treated in the community with the support of effective care teams. It is understood that the Conservatives, who have been blamed for the failures of care in the community, are now planning to unveil their own proposals, which place less emphasis on compulsion.

Campaigners have suggested that ministers should introduce a separate Bill that would focus on the tiny group of "untreatable" patients with dangerous severe personality disorders.

Paul Corry from Rethink, which represents patients with severe mental health problems, said focusing resources on a minority of patients to protect the public was not the answer. "There is nothing in this Bill which would have prevented these tragedies," he said. "But more resources would have. It's a recurring theme that someone in the system doesn't do their job properly, that papers do not get passed on, that people do not share information. Many patients seek help only to be told 'come back when you are having a crisis'."

Michael Stone

Victims: Lin and Megan Russell

Date: July 1996

Location: Chillenden, Kent

What happened: Michael Stone, a heroin addict with a severe personality disorder, killed 45-year-old Lin Russell and her daughter Megan, aged six.

What went wrong? Stone suffered from a severe psychopathic or antisocial personality disorder diagnosed years before the attack and had a long history of mental problems and violence but was not detained under mental health laws. Ministers use this case to argue that their new reforms would allow people like Stone to be removed from the community. However, it is understood that an independent report, which has never been published, casts doubt over their claims and instead blames human error, especially the failure of drug support teams to take proper action.

Paul Khan

Victim: Brian Dodd

Date: March 2003

Location: Prestatyn, North Wales

What happened: Paranoid schizophrenic Paul Khan killed grandfather Brian Dodd, aged 72. Khan, 34, had stopped his medication, taken his father's car from Cardiff and driven to Prestatyn. He stabbed Mr Dodd 37 times in the neck and head.

What went wrong? Khan had been branded a danger to the public seven years before the attack, and committed to a secure hospital unit after cutting the throat of a stranger. He was released after four years. After Mr Dodd's death, an inquiry found that Khan's care team had failed to invoke the "12-hour missing rule" when he did not turn up for a hospital appointment the day before the attack. Khan's parents also contacted the team to say he had disappeared, but were told to tell the police themselves.

Christopher Clunis

Victim: Jonathan Zito

Date: December 1992

Location: Finsbury Park tube station, north London

What happened: Newly married Mr Zito, 27, was stabbed to death by schizophrenic Christopher Clunis while waiting for a train. Clunis, aged 29, had recently been released from hospital into the community.

What went wrong? Mental health campaigners argue there were adequate powers under existing mental health laws to detain Clunis. He was known to be violent and carry knives yet not one of the 43 different psychiatrists who saw him over a four-year period had seen a full and accurate copy of his medical and criminal records. Clunis was discharged from nine psychiatric units in five years. An official report found that Clunis had stabbed at least two people and attacked several others before he killed Mr Zito.

Peter Bryan

Victim: Brian Cherry

Date: February 2004

Location: Walthamstow, east London

What happened: Peter Bryan battered his friend Brian Cherry to death with a hammer then mutilated his body. Bryan was sent to Broadmoor, where within a few days he had murdered fellow patient Richard Lourdwell.

What went wrong? Bryan battered a young shop assistant to death as early as 1993 and was ordered to be detained indefinitely. However, by 2002 a mental health review tribunal had decided he was safe enough to be released. On the morning of Mr Cherry's murder, there was an hour-long meeting to review Bryan's condition. He was described as "calm and jovial" and there were "no concerns regarding his mental state". Mental health campaigners argue that no laws, however draconian, can prevent cases such as these from ever happening again because human error will always be a factor.

John Barrett

Victim: Denis Finnegan

Date: September 2004

Location: Richmond Park, south-west London

What happened: Paranoid schizophrenic John Barrett killed former banker Mr Finnegan who happened to be cycling past at the time. Less than 24 hours earlier, Barrett had walked out of a psychiatric hospital.

What went wrong? The day before the killing, Barrett, a drug user with a history of violence and a string of convictions dating back to 1980, had checked himself into Springfield psychiatric hospital in Tooting, south London. He was subsequently released by a psychiatrist who had not even assessed him. Instead, she simply told a nurse by phone that Barrett could be given "ground leave".

Case studies by Jonathan Thompson

independent.co.uk 27 March

Mental patient locked up for fatal fire

A MENTAL health patient who started a fire which killed a woman and resulted in her granddaughter sustaining serious injuries has been locked up indefinitely.
Sheffield's mental health services have now said they will re-examine the processes they use for dealing with patients, and will take any necessary action.

Abdirisak Hussein, aged 36, of no fixed address, pleaded guilty to manslaughter on the grounds of diminished responsibility following the death of Amina Ali, 56, on February 2 last year.
He was a paranoid schizophrenic and started a fire with petrol outside the door to the flat she shared with her husband in Mount Street, Sharrow.
The fire blocked the exit route from the flat and Amina Ali perished inside before firefighters could reach her.
However, before she was overcome, she was able to drop her two grandchildren 50ft to the ground below.
Her grandson was caught by passer-by Ndeka Lufuluabo and escaped unharmed but her granddaughter, aged six, hit the ground and sustained serious head injuries.
She has since made a complete recovery.
Mrs Ali died in hospital from injuries resulting from the fire.
Her husband, Mijir Mohamoud, survived only by clambering out of a window and holding onto a window ledge until he was rescued.
Another man, aged 36, was treated at the city's Northern General Hospital for superficial burns.
Mr Mohamoud, aged 61, had been Hussein's intended victim, Sheffield Crown Court was told.
Hussein was sentenced under the Mental Health Act to be detained indefinitely.
His plea of manslaughter was accepted after medical reports confirmed he had severe mental health problems. He had originally been charged with murder.
At an earlier hearing, the court was told by prosecutor Jeremy Richardson QC that Hussein admitted killing Mrs Ali, and had intended to kill Mr Mohamoud and harm other members of his family.
Without Hussein's mental health background, the case would have been a clear case of murder, Mr Richardson said.
He said Hussein had a severe form of schizophrenia and was clearly very dangerous.
He had paranoid delusions about members of the local Somali and Jewish communities, among others.
The judge, Mr Justice Andrew Smith, described the circumstances as a "desperately sad case".

yorkshiretoday.co.uk 25 March

Coroner criticises mental unit after patient is found hanged

A CORONER has criticised staff at a mental unit after a patient was found hanged.

Dr Roy Palmer said nurses should have shown a greater sense of urgency when they discovered they could not get into patient Mark Viccary's room at the Selhurst Hostel, in Selhurst Road, South Norwood.

He also queried why it was left to the following day before the door of his top-floor room was forced open.

The inquest at Croydon last Thursday heard that Mr Viccary, 30, was found hanging inside.

An open verdict was recorded after the coroner ruled there was not sufficient evidence to justify a suicide finding.

Mr Viccary, an unemployed software designer, of Cloister Gardens, Woodside Green, had been admitted a number of times to the Bethlem Hospital, in Beckenham, because of depression.

He was transferred to Selhurst, an offshoot of the hospital, where there are nurses and carers, but no doctors.

He was there as an informal patient, explained staff nurse Oliver Aidoo.

A nurse told Mr Aidoo on the afternoon of July 13 that he could not get into Mr Viccary's room.

The works department at Bethlem was then asked to get access, which they did the following morning.

Mr Viccary was discovered dead, with a ligature around his neck, and the other end tied to the door handle.

Hostel manager, Julius Oni, said he used a master key on that night, after learning that there was no response to calls made to Mr Viccary, but could not get it to operate properly. He said the lock seemed to be faulty.

The coroner said staff ought to think of future changes that could be made in similar situations.

Dr Palmer said: "The hostel will no doubt review their policy about getting access to rooms. There is always a balance to be struck. This is supposed to be a free country."

icsouthlondon.icnetwork.co.uk 25 March

How our mental health care system became a disgrace

DURING the last few weeks The Reporter has uncovered the very latest plans to change mental health services by closing south Manchester’s only dedicated psychiatric unit. For many observers it’s simply one more kick in the teeth for an area of the NHS commonly know as its ‘cinderella’ figure. Here we trace the succession of recent events that have led to patients, carers and relatives feeling they’ve been left out in the cold...

South Manchester residents suffer the highest rates of mental illness in the country.

They are more likely to commit suicide than people anywhere else in the UK while health workers and carers deal with a disproportionate number of long-term sufferers under neglected and under-funded services.

So many of those affected are asking why health chiefs are now planning to reduce the number of beds available to psychiatric patients in favour of a community care strategy in which people will be treated at home rather than in hospital.

The Manchester Mental Health and Social Care Trust plans to close Laureate House, a purpose-built 77-bed unit and the only dedicated unit in south Manchester for psychiatric patients.

This is in a city where the pressure on psychiatric beds is so great that many dangerously-ill patients end up in police cells or out on the streets. Last week police officers at Didsbury police station kept a mentally ill man in their cells for three days after arresting him for possession of an offensive weapon.

Now because of a private finance deal scheme involving business investors and outside contractors, Laureate House costs more than £5m a year to run and the trust simply cannot afford to keep it open.

Patients who use Laureate House such as Anna Kenny from Northenden have written to the trust’s chief executive, Laura Roberts, to plead with her to keep the unit open.

She told the boss in a letter: “The majority of patients would feel lonely and miserable without physical contact with their families.”

Rita Whitehead, a member of the south Manchester branch of Making Spaces, a support group for carers, said: “Carers and relatives are frightened to death of Laureate House closing and there are patients there for whom it's a big worry.

“I cannot understand why this is happening when Manchester has the worst mental health rates in the country. I believe we’ll end up like America where the most mentally-ill people end up prison.”

While other health trusts in Manchester have seen some improvement in the Government’s star scoring system, MHSCT has a no-star rating.

It’s not surprising that it has some way to go to gain the confidence of the assessors given a depressing history of abject failures, scandal and neglect. In recent years a succession of revealing 'mishaps' began when health watchdogs inspectors delivered a withering verdict of the care available at the old Withington hospital.

On visiting the dilapidated wards the officers discovered a culture of hopelessness which made patients ‘prisoners’ rather than sufferers. Rampant filth, crumbling buildings with dirty windows, ripped curtains and broken chairs completed a scene nearer to bedlam than the modern NHS. The damning verdict at least forced managers to plan for a better future when all inpatient services were moved from Withington to Wythenshawe and Manchester Royal Infirmary.

However, during the same period, NHS inspectors discovered physical and mental abuse at Rowan Ward, Healey House, a psychiatric ward for elderly patients and the only remaining unit for inpatients at Withington.

An independent report later concluded that NHS managers were to blame for leaving patients and staff in the type of isolation that breeds a bullying culture.

Then, even though health chiefs trumpeted the bright future of the as-yet-unbuilt Laureate House the patients and relatives had their doubts. Ambrose Phahle, whose daughter Karen suffers from schizophrenia, was one of those who was worried about the way Laureate House was set up under a private finance deal. Mr Phahle, from Clothorn Road in Didsbury is also a member of Making Spaces.

He said: “We knew that moving away to this expensive unit was going to be a disaster. They should have anticipated this would happen. But they didn't so the government should be making up the money needed.

“Most of the politicians and decision makers have absolutely no idea about mental illness. Developing care in the community is fine and it could work but you need to have people who have real sensitivity towards patients and those people just aren't there at the moment.

“Patients see their consultants for two or three minutes and are sent away with a reduced or increased dosage. There’s only sympathy and no empathy because doctors are taught to act that way at college.”

The Labour Government has promised to improve mental health services since it came to power in 1997. In fact, the issue was made one of the top priorities in the New Labour's list of key areas for improvement. Somehow, campaigners say, the subject has fallen lower down the pecking order.

southmanchesterreporter.co.uk 24 March

Brother's concerns at mental health reform

GOVERNMENT plans to reform the mental health services came under fire from an unlikely source last night after it was claimed their plans could force too many people into compulsory treatment.
A committee of MPs and peers have warned the draft Mental Health Bill should be given a major overhaul, because they fear it puts too much emphasis on protecting the public from a small number of dangerous mentally-ill patients.
They fear that could lead to people being forced into treatment because they are regarded as a nuisance, rather than because they are a significant risk to public safety.
Their concerns were supported by Thorne man John Finnegan, whose brother Denis was stabbed to death by a paranoid schizophrenic in Richmond Park, London.
The killer, John Barrett, admitted manslaughter on the grounds of diminished responsibility, but during his court case, details of serious failings in the mental health services emerged.
Last night, John Finnegan said he was opposed to locking away mental patients and added that the correct protocol for dealing with Barrett had been in place but was not followed.
"I really don't want to see people locked up if they are no danger to anyone, that is not an issue," he said.
"What I believe is that the care of the guy who killed my brother was inadequate. The protocol was in place, but not adhered to," he said.
Barrett should have seen a psychiatrist every four weeks, but the gaps between his appointments stretched as far as 13 weeks in the period before the killing.
Barrett's partner had asked for action to be taken, as she became concerned his condition was deteriorating, but nothing was done. He was finally allowed to walk out of a hospital after being admitted as a voluntary patient.
Health minister Rosie Winterton said the Government would now look at the report.
The Government wanted to see increased safeguards for the "small number" of people detained because they posed a risk to themselves or others, she said, but insisted there was a balance to strike over safeguarding the public.
"The system at the moment is that people are detained if they are believed to be either a risk to themselves or a risk to others," she said.
"What this Bill does is to update the legislation so that where people have not been able to receive treatment ... what this does is to provide that treatment for them and to say yes there is an ability (to detain people).
"But remember they have to fulfil five very strict conditions and they have to be approved by an independent mental health tribunal."
The committee has recommended the Bill is reviewed before it is put to a vote in the Commons. They were concerned it could be used as a means of social control – the equivalent of a mental health ASBO.

yorkshiretoday.co.uk 24 March

More choice for better mental health

The Department of Health should pilot “personal recovery budgets”, direct payments from the NHS which could be used to buy treatments such as psychological therapies or counselling, according to a paper published today (Thursday) by the Institute for Public Policy Research (ippr).

The paper argues that people who experience mental health problems should have more choice over the treatments they receive and that personal recovery budgets - adapted from the current system of direct payments - would open up choice. Introducing a more patient led personal approach would help mental health services be more responsive to people’s needs.

Jennifer Rankin, ippr Researcher, said:

"So far Government policy has been focused on introducing choice in elective care, such as being able to choose what hospital you attend for surgery. Mental health is a test case for the choice agenda which to date has not had much to say about being more responsive to the needs of people experiencing mental health problems. Introducing personal recovery budgets could give real choice to people who have had few options and little control over accessing services.

"Mental health problems affect at least one in six people in the general population, as well as a high proportion of people who experience multiple forms of disadvantage. More choice holds out the prospect to improve services and ultimately help to improve our mental health."

A Good Choice for Mental Health also recommends that GPs should not be the sole gatekeeper into mental health treatments and that people should be able to access health services through a variety of professionals located in community settings.

A Good Choice for Mental Health is available to download from the ippr website www.ippr.org/publications

Notes to Editors

A Good Choice for Mental Health is available from the ippr press office. It is the third working paper in the series Mental Health in the Mainstream. The final report will be published in June 2005.

The Mental Health in the Mainstream project is supported by Rethink severe mental illness. Rethink is a campaigning membership charity involving people with severe mental illness and carers, with a network of mutual support groups around the country. Rethink is also the largest voluntary sector service provider in mental health, helping 7500 people each day. For further information on the charity and its work, visit: www.rethink.org or call 0845 456 0455.

At any one time, there are 630,000 people with ‘serious mental health problems’. There are 900,000 people who claim Incapacity Benefit due to mental health problems.

In 2003, there were 19 million prescriptions for Selective Serotonin Reuptake Inhibitors (SSRIs), such as Prozac and Seroxat.

One national survey showed that 98 per cent of respondents visiting a GP for mental health problems walked out the door with a prescription for mental health problems even though less than one in five planned to ask for it.

In 2003/4 the NHS spent 3.3 per cent of the mental health budget on psychological therapy services.

In 2003-4 the Mental Health Act 1983 was used on 45,700 occasions. The mental health task force, appointed by the Department of Health concluded the Act’s restrictions were often inappropriately extended to curtail personal freedom in very basic areas such as eating, drinking and daily routine.

Many mental health problems go untreated. A longitudinal survey by the ONS shows that just under a quarter (24 per cent) of people assessed as having a neurotic disorder were receiving treatment of some kind.

ippr.org.uk 24 March

Law Society calls for changes to Draft Mental Health Bill

The Law Society is calling for urgent changes to Government proposals for the mentally ill which threaten wider use of compulsory treatment and restrictions on liberty.

Strong criticisms of the Draft Mental Health Bill have come from the Joint Parliamentary Scrutiny Committee. The Committee says the emphasis of the Bill is wrongly concentrated on the perceived risk and danger posed by people suffering from mental health problems – even though evidence shows they are more likely to be the victims of violence.

“The proposals in the Bill are unworkable, misconceived and would breach fundamental human rights. We share the Scrutiny Committee’s fears that mentally ill people could face further social exclusion. This Bill should focus on providing a properly resourced mental health care system based on rights to quality care and treatment.”, said Janet Paraskeva, chief executive of the Law Society.

“We agree with the Committee’s conclusion that conditions for compulsory treatment are too wide and the Bill should include explicit and specific exclusions which safeguard against the law being used inappropriately as a means of social control. Compulsion should only be used as a last resort.”

The Law Society is asking the Government to focus on amending aspects of the 1983 Act before introducing major reform and also monitor the implementation of the Scottish Mental Health Act 2003, which is due in October this year.

lawsociety.org.uk 23 March

Call for rethink on new mental health bill

Planned reform of mental health services will cause too many people to be locked up as a risk to the public even if they have done nothing wrong, MPs and peers warned today.

The joint committee on the Draft Mental Health Bill called for the parts of the proposed legislation that deal with preventive detention to be rewritten before the Bill is placed before Parliament.

The proposals places too great an emphasis on protecting the public from potential risks from a small minority of dangerous people suffering from personality disorders like psychopathy, at the expense of the civil rights of others with mental illnesses who pose no risk to others, it said.

While accepting the need for a broader definition of mental disorder, the committee said there was a danger that the Bill could be used as a means of social control.

Lord Carlile of Berriew, the committee's chairman, said the "fundamentally flawed" draft legislation pandered to public misconceptions about violence and mental illness, and failed to protect patients' rights.

"Far too many people could be forced into treatment unnecessarily. They can be detained even though the treatment they receive does not help their condition and they can be detained compulsorily even if they are perfectly capable of making their own decisions," he said.

"This is well beyond what is required and the committee believes that ministers should consider redrafting significant sections of the Bill."

Lord Carlile said that it was virtually impossible to predict whether a patient with a personality disorder might harm other people.

His committee had examined volumes of evidence on cases and had concluded "that there was no reliable evidence to show that anyone can predict those terrible outcomes".

"We fear that an awful lot of people could be locked up in psychiatric hospitals who pose no significant risk of harming others," he told BBC Radio 4's Today programme.

The parliamentary committee concluded that the Government should not "warehouse" people with personality disorders simply because the public was frightened of them, Lord Carlile said.

"Compulsory mental health treatment must be of therapeutic benefit. We fear the risk of mental health ASBOs, or a kind of concentration camp mentality."

Rosie Winterton, the health minister, said the Government wanted to increase safeguards for the "small number" of people detained because they posed a risk to themselves or others.

However, she said there was a balance to strike with public protection issues.
"The problem we have with the current Bill is that people who have a personality disorder and may be a very serious risk to others or to themselves may be considered untreatable," she told Today.

Ms Winterton was concerned that patients with a dual diagnosis - who suffered from drug dependency or were paedophiles as well as having a personality disorder - might be excluded from receiving any treatment because of their personality disorder.

"What this Bill does is to update the legislation so that where people have not been able to receive treatment...what this does is to provide that treatment for them and to say yes, there is an ability (to detain people). But they have to fulfil five very strict conditions and they have to be approved by an independent mental health tribunal."

Paul Farmer, the chairman of the Mental Health Alliance, which represents the 50 largest mental health groups, said the government should withdraw the Bill and draft a new version based on the committee's recommendations. "The committee has clearly listened to service users, carers, professionals and charities," he said.

The committee concluded that:

People should only be forced into compulsory treatment if they pose a significant risk of serious harm to others;
Patients should never be treated under compulsion unless their decision-making is impaired;
The compulsory treatment must be of therapeutic benefit to them.

The MPs and peers also have major concerns about lack of resources to implement the Bill. Without adequate staffing and funding, they say the new tribunal will fail to improve patient safeguards, and mental health will remain the Cinderella service of the NHS.

timesonline.co.uk 23 March

Mental Health Service Must Cast Off "Cinderella" Tag

UNISON, the UK’s largest health union, today said urgent steps are needed to help mental health services cast off its Cinderella label, if Government plans to reform the service are to succeed.

Gail Adams, UNISON Head of Nursing, said:

“MP’s are quite right to have major concerns about the resources needed to implement the Bill. There is a national shortage of mental health registered nurses and hospital facilities need to be upgraded as a matter of urgency. We need to cast off the Cinderella label and give mental health nursing a modern makeover as a career to inspire and aspire to.

“I believe that in health care assistants we have a largely untapped source of qualified nurses, who should be encouraged to take up training through secondments. Mental health services need a broad range of skills and experience and that needs to be reflected in more modern, aggressive recruitment campaigns.

“After years of neglect by the Tories many hospital buildings are outdated, gloomy and poorly maintained. Unless you have buildings people want to work in and are fit for their purpose, how can you expect to deliver a quality service?

“Finally serious consideration needs to be given to current mental health training. We need to ensure that the training students receive really does equip them fully with the specialist expertise needed to do the job well.”

unison.org.uk 23 March

Mental health services 'patchy'

Mental health services in Wales are "significantly less developed" than those in England, a Westminster committee has claimed.
Its report was published after it studied the draft Mental Health Bill, which would allow the detention of people with personality disorders.

The cross-party group said Wales could not currently "deliver what is envisaged in the draft bill".

The Welsh Assembly Government said it would prepare a plan for improvement.

The committee, which included members of both the Commons and Lords, gathered evidence on a visit to Cardiff in December 2004 and met then Health Minister Jane Hutt and the assembly's health and social services committee.

It also visited Whitchurch Hospital psychiatric unit in the city, and received written evidence from bodies dealing with mental health issues.

The committee concluded that it was "very unlikely that Wales could successfully implement the provision of the bill with the resources currently available".

It said resources should be allocated to enable the service to be brought up to the same standard as England.

The report also referred to the provision of mental health services through the medium of Welsh, and raised concern about "the patchy level of mental health provision in Wales, irrespective of language".

Caernarfon MP Hywel Williams, a committee member, described the findings as "alarming".

"The point being that the bill is a response to the continuing crisis in mental health services in both England and Wales," he said.

"However, the services in Wales are clearly insufficient to be able to implement the bill.

"It's a condemnation of the standard of health services in Wales."

Mr Williams went on to say that the committee had learned that psychiatry staffing levels in Wales were between a quarter and a third down on what they should be.

A Welsh Assembly Government spokesman said: "Mental health is one of our top health priorities and this is reflected in the increased investment that was recently announced for the NHS, including an additional £75m over the next three years aimed at improving mental health facilities.

"However, we recognise that there is a need for further improvement and we will be preparing an action plan for improvement in mental health services when we have received the results of service reviews we have commissioned."

bbc.co.uk 23 March

Nearly half of teachers have suffered from mental illness

Nearly half of the country's secondary school teachers have suffered mental health problems due to worsening pupil behaviour, a survey has revealed.

The research, by the Association of Teachers and Lecturers, on 300 secondary school teachers, showed that abuse at the hands of pupils had left 46 per cent taking antidepressants or facing long lay-offs from school through stress.

One teacher told researchers he had been assaulted 10 times during 18 years in the profession and had suffered two breakdowns. He said he had been on antidepressants for more than three years as a result.

The survey also revealed that 72 per cent of teachers had considered quitting their jobs because they were worn out by some pupils' persistent disruptive behaviour, such as threats, swearing, locking teachers out of classrooms, vandalising school property, letting down car tyres, stealing keys, throwing eggs at staff and spitting at them. One in seven (14 per cent) said they had suffered actually bodily harm from pupils.

However, in many of the cases, the school had turned a blind eye to abuse and failed to exclude the pupils involved.

Mary Bousted, general secretary of the 160,000-strong union, will raise teachers' alarm over discipline with Ruth Kelly, the Education Secretary, when she addresses the ATL annual conference in Torquay today.

She said it was not enough to talk about "zero tolerance" for disruptive behaviour as Ms Kelly had done. "There needs to be a reflection about what zero tolerance means," she added.

"It should mean much better support for teachers and more pupil referral units - 'sin-bins'. These youngsters have to go somewhere. What we can't do as a society is leave them to roam the streets."

Yesterday the conference demanded a code of conduct to outline acceptable pupil behaviour and called for risk assessments to be prepared on all pupils with a history of aggression.

Doctor Bousted said: "Teaching is a highly intensive, highly stressful job. Teachers need to understand there are forms of help available to them and when they are feeling stressed they need to know this is not something that's shameful and they should seek help."

Meanwhile, delegates voted unanimously to urge the Government to abandon its plans to set up a network of 200 privately sponsored academies to replace struggling secondary schools in inner-city areas.

Phil Baker, from Swindon, claimed they were a "Trojan Horse", pioneering the way for privatisation of the entire education system. He said many of the sponsors - who included top independent schools - had little experience of tackling pupil disruption. "Top public schools could run them [the academies],'' he said. "The only experience they've had of managing challenging behaviour is dealing with Hooray Henrys."

Dr Bousted said many of the academies adopted a banding system - taking 20 per cent of its pupils from each of five different ability bands. "In some areas the academies cover, 20 per cent of the most able is hoovering up the vast majority of able pupils in that area," she said, adding that other schools suffered as a result.

independent.co.uk 23 March

Call to reform mental health plan

A proposed reform of mental health laws could lead to people with only mild conditions being locked up and forcibly treated, MPs and peers have warned.

The joint House of Commons and House of Lords Committee said the draft Mental Health Bill made it too easy to force a person into compulsory treatment.

Current laws do not allow people with severe personality disorders who have committed no offence to be detained.

But the committee warned the Bill could be used as a "social control".

Ministers said the report's recommendations would be considered.

Committee chairman Lord Carlile of Berriew said the bill was "fundamentally flawed".

"It is too heavily focused on compulsion and currently there are neither the financial resources nor the workforce to implement it."

Former Home Secretary Jack Straw believed the loophole which means people with severe personality disorders led to the release of Michael Stone before he killed Lin Russell and her daughter in a hammer attack in Kent in 1996.

The original 2002 draft bill proposed measures to detain mentally ill patients for their own protection and the protection of others, even if their condition was not treatable.

There were also proposals to allow compulsory treatment in the community under community treatment orders.

When it was published, an unprecedented 2,000 objections were made.

Last autumn, a revised draft was published which tightened the definition of those the laws could apply to.

But the committee said it feared the bill as it now stands could be used as a mental health anti-social behaviour order, or Asbo, - enforcing treatment on those who might be a nuisance, but do not actually pose a real threat.

The bill says treatment can be enforced "for the protection of other persons".

But the committee said this should be changed to cover people who "pose a significant risk of serious harm".

decision making was impaired and the treatment was of therapeutic benefit.

The wide definition of treatment at the moment meant people diagnosed with personality disorder or learning difficulties could be detained on the grounds of safety rather than benefit to their health.

Paul Farmer, the chairman of the Mental Health Alliance, which represents the 50 largest mental health groups, said the government should withdraw the current bill and draw up a new version based on the committee's recommendations.

"The committee has clearly listened to service users, carers, professionals and charities."

Sophie Corlett, director of policy at mental health charity Mind, said the report was a "clear wake-up call" for the bill's supporters.

Sane chief executive Marjorie Wallace said: "Changing the law alone will not work unless we ensure proper care and treatment, which are still so often lacking."

And Dr Tony Zigmond, vice president of the Royal College of Psychiatrists, added the draft bill would have undermined the trusts between patient, carer and psychiatrist.

"The committee's recommendations, if adopted by government, would ensure an ethical and practical framework for mental health legislation."

A Department of Health spokeswoman said: "We have received the report and will be reading it carefully. We will be publishing a full response in due course."

bbc.co.uk 23 March

Mental Health Bill 'fundamentally flawed'

A joint committee of MPs and peers has savaged the government's draft Mental Health Bill.

The parliamentarians said introducing compulsory community treatments for psychiatric patients would contravene civil liberties.

The parliamentarians said introducing compulsory community treatments for psychiatric patients would contravene civil liberties.

The Bill would allow authorities to act "for the protection of other persons" on any grounds, a clause which the committee said should be tightened.

The report, released on Wednesday, called for the Bill to be radically overhauled, warning that state powers could be extended in a dangerous direction.

Ministers want to use the legislation to protect the public against dangerous people with mental problems, but have repeatedly delayed the complex Bill in a bid to find an appropriate balance between safety and liberty.

The report concluded it is still weighted far too heavily against patients, and would contribute to negative stereotypes.

Compulsory treatments should be limited to exceptional circumstances where there is a "significant risk" to the public, or where a patient's decision-making ability is impaired, the report said.

The report also called for more resources to be put into mental health services, such as staffing and tribunals.

Committee chairman Lord Carlile said: "This is an important reminder to the government that the Bill is fundamentally flawed. It is too heavily focused on compulsion, and currently there are neither the financial resources nor the workforce to implement it.

"Far too many people could be forced into treatment unnecessarily.

"They can be detained even though the treatment they receive does not help their condition. And they can be detained compulsorily even if they are perfectly capable of making their own decisions.

"This is well beyond what is required and the committee believes that ministers should consider redrafting significant sections of the Bill.

"At present, the draft Bill is too focused on addressing public misconception about violence and mental illness and does not do enough to protect patients' rights."

Mental health charity Mind welcomed the report.

"Doctors, psychiatrists and nurses still oppose this Bill," said policy director Sophie Corbett.

"Mental health charities and mental health experts still oppose this Bill. And most importantly, people with mental health problems themselves still oppose this Bill.

"Now, having heard all the available evidence, a parliamentary committee has concluded that this Bill risks forcing innocent people into unnecessary and restrictive treatment.

"Rather than legislation aimed more at newspaper headlines and public perception than improving services, the government would be well advised to listen."

epolitix.com 23 March

Security risks over mental health

Psychiatric staff are being put at risk because of inadequate training and funding, according to the Royal College of Nursing.

"Patients are frustrated because they're not getting the care they should and frustration leads to violent behaviour," spokeswoman Ann Leedham-Smith told File On 4.

More than 100,000 violent incidents occur across the NHS each year, almost half in mental health units.

File On 4 also investigated relatives' concerns over security at a psychiatric unit where four patients committed suicide last year.

The Royal Southampton Hospital was treating a 29 year-old man for schizophrenia when he stabbed himself to death with a knife he had smuggled into the ward. In another case, a severely depressed woman was able to walk out of the hospital and jump into a river.

Chief Executive of the Hampshire Partnership Trust, Martin Barkley, said: "We thought we had a robust system in place but this was proven not to be the case by the way that Mary Conduct left the Department of Psychiatry," he said.

He denied claims from the Southampton branch of the charity Mind that there was "a culture of failure" within the unit.

"What we need to do is improve the therapeutic environment and the relationships between staff and patients."

'Few permanent staff'

He said the trust, which was short of around 30 staff psychiatric nurses last summer, had spent £500,000 in four years improving the wards.

The Sainsbury Centre for Mental Health said shortfalls in government funding for mental health were impacting on in-patient psychiatric wards.

Chief Executive Angela Greatley said: "Mental health has not kept pace with the rest of funding on the NHS and Social Services.

"Some acute in-patient wards have acquired a bad reputation, others will have few permanent staff, and therefore the thing can become a spiralling down of the quality of staff in some difficult units."

In a statement, the Department of Health said that spending on mental health in England had gone up by 19% in real terms since 1999. And that an extra £30 million had been made available for psychiatric intensive care units last December.

File On 4 investigated another patient death in South Wales which took place against a background of deficiencies in staffing levels and training.

Kurt Howard, 32, died while under restraint within a fortnight of being admitted to the Cefn Coed hospital in Swansea in June 2002.

An internal inquiry into the death carried out by the Swansea NHS Trust said that three assistants, who were not qualified nurses, and one psychiatric nurse had taken part in the restraint.

It found that "the level of training in the management of aggression and violence that the staff nurse had undertaken was inadequate to manage this situation."

The panel was also concerned to discover that it was normal practice to have one qualified member of nursing staff on the ward, where violent incidents where common.

Swansea NHS Trust told File On 4 they had made improvements in medical staff, care plans and training in restraint techniques. But they made it clear they had a continuing shortage of psychiatric nurses.

Other mental health experts told the programme of recruitment difficulties in in-patient units across England because of a preference among psychiatric nurses to work in the newer community mental health teams.

Another consequence of this, said the Royal College of Nursing, was an increase in violent attacks on its staff caring for disturbed and aggressive patients.

The union wants more training for nurses in areas such as restraint techniques and more of their attackers prosecuted.

One case they are pursuing concerns a psychiatric nurse who was attacked at Birmingham's Queen Elizabeth psychiatric hospital just weeks after qualifying.

She was the second person on a particular ward to be assaulted that day and had received no training in restraint.

The mental health trust which runs the hospital said such training was mandatory, but that some new staff may not receive it for weeks or months after they had begin work.

The Department of Health told File On 4 that attacks against NHS staff were wholly unacceptable and that it was working to develop training for staff in how to prevent and de-escalate such violence.

bbc.co.uk 22 March

Mental-health charity helpline faces closure as grant dries up

A LEADING mental health charity is making an eleventh hour appeal for funds to save its national telephone helpline.
Sane, which is closing two regional call centres with the loss of 120 volunteers after government funding dried up, believes it will struggle to keep its London centre running without more funds.

The crisis is the latest to befall the charity founded 19 years ago by Marjorie Wallace, a campaigner driven to create the Saneline phone service in response to the failures of the care in the community programme. It now has 50,000 callers a year. The Conservatives will raise the funding of Saneline in an adjournment debate in the Commons today after the Department of Health refused to renew an annual grant of £1 million for the next financial year. Mrs Wallace is adamant that the Government has let down the charity but the Department of Health said that the two-year funding deal of £2 million which ends this month was given on the understanding that the charity would become self-sufficient.

The Department said that it was making £5 million available to the 70-organisation Mental Health Helplines Partnership. It added that Sane had failed to bid for funds in the usual way for the coming financial year. Sane denies this. Mrs Wallace said: “Without Sane, thousands of people in crisis will find themselves with nowhere else to turn for help.” She added that a late payment by the department of the second £1 million had made it impossible to raise extra funds.

The Royal College of Psychiatrists has backed Mrs Wallace’s campaign to raise at least £500,000 to keep the Saneline going. Mike Shooter, president of the college, said: “It is unthinkable that such an organisation should lose funding.”

A department spokeswoman said: “We have given Saneline more funding than any other mental health phoneline.”

timesonline.co.uk 22 March

Mental health in crisis over shortage of doctors

THE RISK of violence by mental patients cared for in the community is certain to rise because of a crisis in recruiting psychiatrists, a voluntary group has said.

More than 500 consultant posts are vacant in England and another 1,000 are needed in post over the next four years to implement measures planned in the draft Mental Health Bill, the Sainsbury Centre for Mental Health said.

The findings come in the wake of the jailing last week of Peter Bryan, the "cannibal" who bludgeoned a friend to death with a hammer and ate his brains. Bryan suffered from schizophrenia and a personality disorder. At the time of the killing he was a voluntary patient at Newham General Hospital, east London. An inquiry is to investigate whether he should have been allowed the freedom to come and go.

The Sainsbury Centre survey found one in six of the 3,222 consultant posts is unfilled or covered by a temporary locum. Pressure of work, stigma and a fear of being the subject of a witch-hunt if anything goes wrong, are cited as reasons why staff are shunning the mental health profession.

The Department of Health said a report commissioned in 2003 concluded that 900 extra psychiatrists would be needed by 2009. Work is under way to increase the number of psychiatrists through training as well as recruiting internationally from countries with surplus staff.

netdoctor.co.uk 21 March

Sainsbury Centre for Mental Health welcomes scrutiny committee report on draft mental health bill

"The Joint Committee on the Draft Mental Health Bill has made it clear that the Government's proposals need a major overhaul to be fair and workable," Sainsbury Centre for Mental Health (SCMH) chief executive Angela Greatley said today.

"The scrutiny committee has clearly listened to the evidence. We very much welcome the fact that it calls for legislation based on clear principles and designed to improve services and tackle stigma.

"The committee has rightly called for compulsion to be used only as a last resort and only for people whose decision-making is impaired. It has recommended clear exclusions of people who do not have a mental health diagnosis and called for compulsion in the community to be very much more limited than the draft Bill proposes.

"The committee's call for aftercare to be available free of charge is very welcome. We remain concerned, however, that without adequate training and regulation the loss of the social work role in the current Act could compromise aspects of people's care.

"We welcome especially the committee's call for adequate resources to be made available to implement the new Act. Last year, mental health services received just 1.6% real terms extra funding, and across the country services continue to face big staffing pressures. A Mental Health Act with excessively broad powers would exacerbate these problems and could undo many of the real improvements we have seen in mental health services since the NHS Plan was published."

Mind warns against policy driven by headlines

Parliamentary report concludes that innocent people will be penalised by draft Bill

23 March

Mental health charity Mind today strongly welcomed the publication of the pre-legislative scrutiny (PLS) report by the parliamentary Joint Committee on the Draft Mental Health Bill.

Sophie Corlett, Policy Director of Mind said,

"Doctors, psychiatrists and nurses still oppose this Bill. Mental health charities and mental health experts still oppose this Bill. And most importantly, people with mental health problems themselves still oppose this Bill. Now, having heard all the available evidence, a parliamentary committee has concluded that this Bill risks forcing innocent people into unnecessary and restrictive treatment.

Rather than legislation aimed more at newspaper headlines and public perception than improving services, the government would be well advised to listen to some of today’s stark warnings. Neither should it underestimate the level of fear among ordinary people with mental health problems who are genuinely worried that they could be forced into treatment that they neither need nor want."

While welcoming the Committee’s conclusions regarding Compulsory Treatment Orders (CTOs), as a step in the right direction, Mind emphasised its ongoing opposition to any form of compulsory treatment in the community.

Ms Corlett said,

"Compulsory treatment in the community is utterly unacceptable. It drives a wedge of mistrust between patients and medical professionals and introduces coercion into what should be a purely therapeutic relationship."

Mind is a founding member of the Mental Health Alliance representing over 60 organisations united in their opposition to the proposed draft Bill published in September.

Report of the joint committee on draft mental health bill welcomed by the College

The Royal College of Psychiatrists welcomes the recommendations from the Joint Committee on the draft Mental Health Bill, published today (23rd March 2005).
"We would like to thank the Scrutiny Committee for their considerable hard work over the last six months and their thorough examination of the minutiae of this very complicated piece of legislation," said Dr Tony Zigmond, Vice-President of the College.

"If adopted, the College believes that these recommendations will significantly enhance mental health legislation and the mental health services required to support them."

"For the first time, patients with mental health problems will be treated under the same basic legal framework as other patients with physical illnesses. In particular, they will not be forced to have treatment if they are fully capable of making decisions for themselves, and they will only be subject to a mental health order if this will improve their health care," continued Dr Zigmond.

Dr Mike Shooter, President of the College, also welcomed the proposals. "We look forward to working alongside colleagues in the Mental Health Alliance in helping government to implement these recommendations."

Bournewood Consultation : The approach to be taken in response to the judgement of the European Court of Human Rights in the "Bournewood" case

This document seeks views on the issues raised by, and consequent options for public policy arising from, the judgement of the European Court of Human Rights (ECtHR), published on 5th October 2004, in the case of H.L. v. the United Kingdom (the "Bournewood" judgement - so called because H.L's care and treatment took place in Bournewood Hospital).

Launch date: 23/03/2005 Closing date: 17/06/2005

Download Bournewood Consultation : The approach to be taken in response to the judgement of the European Court of Human Rights in the "Bournewood" case

Mental Health Act Commission welcomes Parliamentary Committee Report on the draft Mental Health Bill

Mental Health Act Commission welcomes Parliamentary Committee Report on the draft Mental Health Bill

Download Press Release

Protecting the public?

The government has been quick to link the recent cases of mental health patients killing people with its attempt to push ahead with a reform of the law.

Fear of the mentally ill reached a new nadir when the cases of John Barrett and Peter Bryan hit the headlines in the last month.

Mr Barrett stabbed a cyclist to death in a south west London park less than 24 hours after walking out of a mental health hospital.

Mr Bryan's case is perhaps more notorious after he ate the brains of one of his two victims.

The Department of Health has defended the draft Mental Health Bill - which proposes allowing compulsory detention of people with severe personality disorder even if they have not committed an offence - against criticisms by MPs and peers by citing the recent cases.

The joint House of Commons and House of Lords Committee warned the bill made it too easy to lock people up and could lead to patients with only mild conditions being detained.

But a Department of Health spokeswoman said: "The tragic events of the last few weeks have shown that legislation has to strike a balance between protecting the rights of society with the rights of individuals."

However, campaigners claim initial conclusions about the two cases - both are subject to official investigations - suggest the draft Bill would have had little effect.

Both men had been treated for schizophrenia and as such could have been detained under the 1983 Mental Health Act.

Instead, they were allowed a degree of freedom - Mr Bryan was staying in an open psychiatric ward and Mr Barrett was only an informal patient - from the mental health hospitals where they were being treated.

Paul Farmer, chairman of the Mental Health Alliance, which represents 50 of the largest mental health groups, said the bill - first published in 2002 - had been driven by the case of Michael Stone, who killed Lin Russell and her daughter in a hammer attack in 1996.

Former Home Secretary Jack Straw believed a loophole in the law, which assumed people with severe personality disorders were untreatable and, therefore, could not be detained, had led to Stone being free to kill.

Mr Farmer said: "It is hard to see how the current draft Bill would have made a difference in the cases of Bryan and Barrett.

"Investigations are being carried out, but I think our clearest guide is from past inquiries which have tended to show that homicides happened, not because of inherent flaws in the law, but because of things that went wrong with the risk assessment."

He said despite recent investment by the government, mental health was still significantly under-funded.

In particular, London - where both the Barrett and Bryan cases happened - had severe problems with use of locum staff, meaning there was a lack of continuity of care, he said.

"It is in this type of situation where mistakes are more likely to happen."

Andy Bell, of the Sainsbury Centre for Mental Health, said cases of mental health killings were often a case of the law not being interpreted correctly.

He also said we should be cautious about blaming care in the community.

"Between 30 and 50 killings each year out of 800 are by people who are in contact with mental health services.

"That has remained constant for years - before and after care in the community came in."

Sandra Gidley, a Liberal Democrats health spokeswoman, also agreed the current law should have protected the public in the recent cases.

"In those cases there was a known problem and it was not dealt with properly.

"We already have the means to deal with that problem and the system fell down."

However, Professor Peter Kinderman, chairman of the British Psychological Society's Mental Health Bill working party, said he could understand why the government was suggesting the Bill might have made a difference.

"It is right to say the recent cases were patients being treated with schizophrenia, and that is different from severe personality disorder, which the bill is primarily focused on.

"But the Bill does proposes changes to treatment in the community, making it easier to detain people.

"Saying that, the government must be very careful linking the two, they are very different and need to be treated differently."

bbc.co.uk 23 March

Joint Committee on the Draft Mental Health Bill: First Report

Volume I: Report
PDF version

Volume II: Oral and Written evidence
PDF version

Volume III: Written evidence
PDF version

Killer is detained indefinitely

A schizophrenic who helped beat a man to death has been detained indefinitely under the Mental Health Act.
Nabeel Aljubori was found guilty of manslaughter after he and Derek Dale attacked Paul Geddes in Plumstead, south-east London, last June.

Aljubori was sentenced at Southwark Crown Court on Tuesday. Dale, 18, was jailed for murder in January.

The Old Bailey heard the pair attacked Mr Geddes with "appalling savagery". after breaking into his home.

Judge Peter Fingret said: "This was a particularly brutal and callous killing of a mild and inoffensive young man.

"You and your co-defendant beat him to death, in the course of which one of his ears was severed and attempt was made to do the same with the other.

The Old Bailey trial heard how the pair had embarked on a night-long burglary rampage in June 2003 to find money for drugs when they killed Mr Geddes.

Later that day they returned to his home, doused his body with petrol and then set light to him and his flat in a bid to destroy the evidence.

Dr Callum Ross said Aljubori had all the hallmarks of hebephrenic schizophrenia, including delusions, hallucinations and unpredictability, and posed a risk to the public.

Dale and Aljubori, both from the Plumstead area, had denied murder.

bbc.co.uk 22 March

Cannabis rethink 'not a reversal'

A review of the decision to reclassify cannabis, after studies suggested links with mental illness, is not a policy reversal, the Home Office has said.
It was downgraded in January 2004 after advice from the Advisory Council on the Misuse of Drugs, which will be asked if new research would change its position.

The Tories said ministers were admitting they were "wrong". The Liberal Democrats welcomed the review.

The Home Office said the classification of drugs is under "constant review".

The move to downgrade the drug from Class B to Class C - placing it alongside steroids and some prescription anti-depressants - was made by former home secretary David Blunkett.

It made most cases of cannabis possession a non-arrestable offence.

Denying the suggestion that the review of the downgrading was an embarrassing reversal, a Home Office spokeswoman said: "It makes sense that government policy reflects scientific findings and is kept up to date."

She said the review would not affect the decision on whether to give the go-ahead to a prescription form of the drug.

Mental health charities welcomed the review, but charity DrugScope warned against the danger of the move being motivated by political, and not scientific, factors.

Home Secretary Charles Clarke, writing to the chairman of the advisory council, Professor Sir Michael Rawlins, highlighted concerns over several studies that strongly linked cannabis use to the development of psychosis.

A study by New Zealand scientists, published earlier this month, suggested smoking cannabis virtually doubled the risk of developing mental illnesses such as schizophrenia.

In his letter, released by the Home Office, Mr Clarke also asked for advice about the issue of high-strength cannabis, known as "skunk".

A Home Office spokeswoman said the possibility of a two-tier classification system for cannabis in the UK would be a matter for the review, but added: "At this stage there is nothing to inform that."

The advisory council, which is made up of scientists and medical experts, said in 2001 that cannabis was "unquestionably harmful", but less so than other class B drugs.

Mr Blunkett said he welcomed the review, "which will avoid this important issue being misused and will enable a rational and sensible debate to continue".

The Tories have pledged to return cannabis to class B and shadow home secretary David Davis said Mr Clarke's move meant the government was admitting that downgrading the drug had been "the wrong decision".

Liberal Democrat home affairs spokesman Mark Oaten said his party had argued that the police should focus on "very serious drugs" and spend less time dealing with cannabis possession.

However, he added: "If evidence changes and it is clear that there are more harmful aspects of cannabis, it makes sense to review the law and that is why we would support any changes based on evidence that the home secretary is considering."

bbc.co.uk 19 March

Inquiry after schizophrenic dies of heart attack

Staff at Leigh Infirmary psychiatric unit tried in vain to revive a 41-year-old patient when he had a heart attack while they were attempting to restrain him.
Health chiefs have launched a probe into the tragedy which happened at the hospital on Saturday and have been in contact with the patient's family.
But the family of Mark Warriner of Stockbridge Village, say they have a lot of questions needing answers.
His mum, Mrs June Warriner said: "The first we heard was on Sunday when we got a phone call to say Mark had suffered a heart attack, and I just couldn't believe it because he was as strong as an ox and had no history of a heart complaint."
Mr Warriner, who had a history of schizophrenia, had admitted himself to the hospital voluntarily, but then became animated and anxious and it was felt he needed to be restrained either for his or other people's protection.
A spokesman from the Five Boroughs Partnership NHS Trust, which handles psychiatric services at Leigh Infirmary, said: "Events such as this are very rare within our services and we are naturally upset by this incident. We are offering all the support we can to the family members and our staff. Our staff reacted rapidly and appropriately, providing immediate medical attention."
The coroner has been informed and the death will eventually be the subject of an inquest.
Mrs Warriner, added: "We can't believe what has happened and are in shock. We don't know what has gone on, and there are a lot of questions we want answered.
"Mark was a big softy and was never aggressive. He enjoyed swimming and loved his clothes. He used to organise trips for other mentally ill people."
Mark had been well for four years, but the week before he died, he was feeling depressed. He was under the care of Whiston Hospital, but was sent to Leigh Infirmary on Sunday, March 6, because Whiston could not take him.

leightoday.co.uk 18 March

Breaking the Circles of Fear

Reviewing the relationship between mental health services and African and Caribbean communities.

Who we are

Breaking the circles of fear (BCOF) is a national programme which aims to improve mental health services for African and Caribbean communities.

Why? Because research categorically shows this population is consistently misdiagnosed, over-medicated and generally dissatisfied with mental health services/responses.

Breaking the circles of fear research specifically found that there are fears that have a negative impact on the interaction between these communities and mental health services.

Our aim is to break this cycle of fear. We have of a team of eight including one service user to develop this agenda.

The Agenda newsletter

This is the downloadable version of the Spring 2005 edition of The Agenda, a quarterly magazine produced by BCoF about African and Caribbean mental health issues.

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Mental capacity bill - lords report (day 1) 15 March

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Carer gambled away patient's cash

A carer has been jailed for nine months after gambling away £17,500 stolen from a man she was looking after.
Susan Carter, 60, agreed to act as power of attorney for Ivor Coates, 86, in 2002, Swindon Crown Court heard.

From April 2003 until January 2004, she took from his estate, signing cheques for sums of up to £2,000.

Judge Thomas Longbotham said Carter, from Stanley, near Chippenham, Wiltshire, had breached the trust of a "vulnerable and elderly victim".

Holidays, Christmas presents for her family and bingo swallowed all the money, prosecutor Philip Warren said.

Carter pleaded guilty to one charge of theft and denied two others.

Sarah Regan, defending, said Mr Coates, who has now been sectioned under the Mental Health Act, was Carter's ex-husband's uncle.

"She used the money to support a rather unsavoury gambling habit.

"She was taking money to recover the money she lost," Ms Regan said.

Carter was ordered to repay the £17,500.

bbc.co.uk 18 March

Regina v. Ashworth Hospital Authority (Appellants) and another ex parte B (FC) (Respondent) 17 March

The issue in this case is whether a patient detained for treatment under the Mental Health Act 1983 can be treated against his will for any mental disorder from which he is suffering or only for the particular form of mental disorder from which he is classified as suffering for the purpose of the order or application authorising his detention.

Full transcript

Cannibal killer prompts review of mental health bill

Mental health campaigners today urged the government not to use the case of a psychiatric patient who cooked and ate a friend's brain to push for more draconian laws to restrict the rights of mentally ill people.

The call came after the health secretary, John Reid, and the home secretary, Charles Clarke, yesterday discussed amending the draft mental health bill in light of the so-called cannibal killing to restrict individual patient's rights and give greater emphasis to public protection.

The Mental Health Alliance (MHA), a coalition of 60 professional and patient bodies, warned against a knee-jerk reaction to the scandal, in which Peter Bryan, 35, walked out of a mental health ward then killed his friend Brian Cherry, 43, before frying and eating part of his brain.

Relatives of Bryan and his victims condemned the mental health system for releasing him into community care from the high-security Rampton psychiatric hospital, where he was detained after beating a shop assistant to death with a hammer. Sent to Broadmoor psychiatric hospital while awaiting trial for killing Mr Cherry, he was able to kill another psychiatric patient because he was placed on a medium-risk ward.

But the MHA chairman, Paul Farmer, said it would be wrong to use the "appalling case" to push for more draconian mental health laws before an inquiry into the killings was concluded.

He said: "Before an inquiry is complete, we must not make unjust assumptions that could put the half a million British people with severe mental illnesses like schizophrenia at risk of being deprived of their liberty or being excluded from the rest of society on the basis of a small number of tragic cases."

Mr Farmer said the findings of previous inquiries into homicides by psychiatric patients suggested that more resources were needed for mental health services rather than "a draconian new law".

He said: "Laws alone cannot ever take all risk out of the system. Instead we need a properly resourced mental health care system that listens to patients and carers when they ask for help; that offers effective care and support when it is needed; and that can make the best risk assessments possible."

Bryan's case comes just a few weeks after paranoid schizophrenic John Barrett admitted stabbing cyclist Denis Finnegan to death as he cycled through Richmond park in south-west London.

A Department of Health (DoH) spokeswoman said yesterday: "The health secretary has already ordered an inquiry into the wider implications of such terrible cases following the recent tragic murder of Denis Finnegan.

"He and the home secretary have discussed these issues and have agreed to consider, in the light of the inquiry findings, whether any further changes to the draft mental health bill are now required to rebalance the rights of society with those of individuals."

The draft bill is currently going through the parliamentary legislative process and is due to be implemented in 2007. Under the proposed legislation people with mental health problems could be forcibly treated in hospital or the community, while those with incurable personality disorders could be detained to alleviate their other mental problems.

The cases of Bryan and Barrett are now the subject of several DoH inquiries. In Bryan's case, three independent panels have been commissioned to investigate the different stages of his care and treatment and that of his second victim Richard Loudwell. It is expected that all three will publish reports within 18 months, with the first appearing in the next six months.

guardian.co.uk 17 March

Mental Welfare Commission

Mr Jamie Malcolm has been re-appointed as a full-time Commissioner with special interest in nursing to the Mental Welfare Commission for Scotland.

The re-appointment has been made by Her Majesty The Queen on the recommendation of First MInister Jack McConnell.

Mr Malcolm, 51, has an extensive range of clinical and managerial experience, having worked at both the Royal Edinburgh hospital and the State Hospital, Carstairs.

In 1994, Mr Malcolm became the first Nursing Officer with the Mental Welfare Commission.

The re-appointment began on December 17, 2004, until December 16, 2008. Remuneration for the post of full-time Commissioner (with special interest in nursing) is £58,959.

The Mental Welfare Commission for Scotland protects mentally disordered people who are not able to look after their own interests. It enquires into cases of alleged ill treatment or deficiency of care or treatment and visits patients in hospital or subject to guardianship orders. The Commission has statutory duties under the Mental Health (Scotland) Act 1984 and the Adults with Incapacity (Scotland) Act 2000.

This Ministerial public appointment was made in accordance with the Code of Practice issued by the Scottish Commissioner for Public Appointments in Scotland.

All appointments are made on merit and political activity plays no part in the selection process. However, in accordance with the original Nolan recommendations, there is a requirement for appointees' political activity (if there is any) to be made public. In the last five years, Mr Malcolm has made a recordable donation to the Labour party. He does not hold any other ministerial appointments.

The MWC currently has 22 commissioners, 17 of whom are part-time. Membership is currently drawn from the fields of psychiatry, general practice, social work, nursing, clinical psychology, law, voluntary sector, accountancy, occupational therapy, minority ethnic interest, learning disabilities and service user representation.

scotland.gov.uk 17 March

"10,000 miles to go" in improving mental health services

A leading clinical psychologist told the Mind annual conference that there is about “10,000 miles to go” in improving mental health services, writes Sally Gillen from the conference in Harrogate.

Rachel Perkins said some progress had been made, but a lot of work was still needed to implement the National Service Framework.

Five years into the NSF, Perkins said she was concerned that much of the change had been structural.

Under the NSF, new teams such as assertive outreach have been set up, which have seen provision move from the statutory to the voluntary sector.

“What I’m really worried about is the fact we have not grasped the nettle in terms of cultural change”, said Perkins. She went on to tell delegates that mental health issues should be moved from those involved in “do-gooding” such as social workers.

She said it should be taken from the Department of Health and placed in the Department for Work and Pensions so issues such as employment could be dealt with.

Later, Mind’s chief executive Richard Brook said Scotland was spending six times more money on promoting mental health, despite having a 10 times smaller population than England.

“That is a pretty bleak picture”, he said.

communitycare.co.uk 17 March

Is mental care service letting us down?

This week a 35-year-old mentally ill man was jailed for life for killing a friend after being released from a secure hospital. Once again the case has highlighted the issues surrounding the treatment of those with mental health problems, as Cat Bartman reports.

Mental illness is a sensitive and often misunderstood subject. There is no simple solution to helping those affected and when something goes wrong in the system people are quick to jump on the backs of those responsible for their care.

A series of disturbing cases has, however, raised questions about how to protect the public from potentially dangerous mental health patients, most recently that of Peter Bryan.

Campaigners have called for an independent inquiry into how convicted killer Bryan, originally from East London, was able to walk out of a mental health unit and bludgeon his friend to death.

The Old Bailey heard on Tuesday how Bryan was under the care of mental health experts - and was being assessed for a possible return to the community - when he struck in February last year.

He was sent to Rampton secure hospital in 1994 for beating 20-year-old shop assistant Nisha Sheth to death with a hammer, but was freed in 2002 after applying to a health review tribunal.

Last month Richard King, formerly of Wells, was detained indefinitely for the killing of 61-year-old John West, from Sheringham. King, 36, a paranoid schizophrenic, discharged himself from Hellesdon Hospital in Norwich 11 days before the killing last August.

His father, Ivor, had repeatedly warned social services and mental health workers that his son had stopped taking his medication and was spiralling out of control. King was hospitalised four times in 2003 suffering from "serious and enduring paranoid schizophrenia" and admitted to Hellesdon Hospital in July last year. He discharged himself two days later and was visited by a community nurse to be formally discharged. This was his last contact with mental health services before he went to Mr West's flat and stabbed him 11 times in the chest.

King denied murder but admitted manslaughter on the grounds of diminished responsibility. An internal inquiry is under way by the Norfolk and Waveney Mental Health Partnership NHS Trust.

With the Bryan case, the secretive mental health tribunals system has been blamed for his release from hospital without proper supervision - against the advice of the Home Office.

While calls have been made for this system to be scrapped or reformed, these cases have again highlighted the issues surrounding the treatment of the mentally ill.

The system has undoubtedly made progress since the days of the old Victorian asylums, but Ivor King feels his family has been let down by the organisations involved in his son's case.

"These cases just prove my point. There is no care in the community. There are many bad decisions being made. I think it all boils down to one thing, finance.

"The asylums are long gone thank God, but I honestly think putting people into institutions like Hellesdon doesn't work."

Plans for new laws to help the treatment of people with mental health problems were put forward by the Government last year, but these have come under fire.

The Mental Health Bill allows the enforced treatment of potentially dangerous mental health patients and extends care in the community.

It has been attacked as being driven by a desire to lock up people rather than ensure the best treatment for patients.

In January a coalition of 60 charities, patients' groups and professionals called on the Government to start again on the law, which they say could lead to people with personality disorders or learning difficulties being detained.

Sandra Flanagan, manager of Omnia, a rehabilitation centre in Norwich run by mental health charity Mind, said care in the community should be questioned when tragedies occur, but did not think an overhaul was needed.

"There is often pressure on people to be discharged when they are not completely ready to be and there is no care package ready for them.

"As mental health care professionals we have to realise that this does happen.

But there are people with a mental health problem living very fulfilled lives in the community who are no risk to other people."

She added: "We do have a knee jerk reaction on hearing of these terrible tragedies that happen and that is to make bills and make things tough for people to live in the community because we consider them a risk."

Mrs Flanagan called for more multi-agency working and recognition of the opinions of those closest to patients, such as carers and family members.

"The system itself is under a great deal of pressure and a lot of that is financial. Care in the community when it works, works well. We are very pleased with what we have managed to achieve," added Mrs Flanagan.

With attempts continuing to remove the stigma of mental illness, what we should remember is that it will affect one in four of us at some point in our lives.

As such, it is an issue that is never going to go away no matter how much legislation in introduced.

edp24.co.uk 17 March

Cannibal's social worker named

A SOCIAL worker whose assessment of Peter Bryan helped to secure the release of the cannibal killer to strike twice again can be named today. Roland Silcott was convinced that the schizophrenic posed no further threat to the public and asked Home Office and mental health experts to free him.

Mr Silcott, Bryan’s key social worker for 18 months, is employed by the East London and The City Mental Health NHS Trust, which declined to comment yesterday. It confirmed, though, that no disciplinary action is contemplated against Mr Silcott, who remains employed by the trust.

Hours after Bryan, 35, was given as much leave as he wanted from the Newham Centre for Mental Health, he killed his friend Brian Cherry, 45, in February 2004 before cooking his brain in butter and eating it.

Mr Silcott had written several letters to the Home Office saying that Bryan had recovered and was no longer a danger. The triple killer was undergoing assessment at Broadmoor secure mental hospital yesterday as demands for a full independent inquiry grew.

Bryan, from Forest Gate, East London, pleaded guilty to manslaughter on the ground of diminished responsibility. Sentencing him to two life sentences, Judge Giles For