Guest Post: Community care for the dangerously mentally ill is not working

A guest post by David Garrett:

I recently learned that the son of a former colleague had been murdered. It was shocking news, but when I found that Dean Clark was yet another victim of a mentally ill person released to “community care”, and supposedly being monitored in the community rather than  in a secure psychiatric facility, it made me both despairing and furious.

The circumstances of Dean's death were almost identical to those of Colin Moyle, who was  bludgeoned to death with a spade, and his body set  on fire  in 2007. The killer was a mental patient also under “community care” at the time. Mr Moyle took him in and gave him a home because he had been sleeping rough.

At the time of Moyle's death there were the usual enquiries, and assurances that “systems” would change so that such a tragedy would not happen again. Here we are five years down the track, and clearly absolutely nothing has changed.

The man charged with Dean Clark's murder is a 38 year old patient who Dean had known for years. Dean took him in because the man had been sleeping rough and on friends' couches,and had needed somewhere to live. Dean had a spare room and needed a flatmate. Five days later Dean was dead, stabbed to death in his bed.

A recently retired mental health worker told the media  there are “gaping holes” in the mental health system that needed  to be fixed. Dean's mother received a visit from some person from the mental health system, which she found “utterly useless”. The mother asked  her visitor the questions you would expect: when was the man last seen by the authorities? What steps were being taken to ensure he was adequately monitored?

As usual, for “legal reasons”, a mother's anguished questions could not be answered. This is indeed a very difficult legal area. By definition, the criminally insane – as they were once called –  confined in an institution like the Mason Clinic,  are patients and not prisoners. The doctors treating them are in a doctor-patient relationship, and are not their jailers. Such patients have rights of privacy even greater than those of ordinary prisoners.

But the community has rights too. Dean Clark and Colin Moyle had the right to live their lives without unmonitored dangerous psychiatric patients roaming around their neighbourhoods listening to voices in their heads, voices  often urging them to kill someone. Each time such a tragedy happens there is the usual hand wringing, offers of sincere condolences – and ducking for cover. But nothing changes.

The “three strikes” law which I helped to put in place,  and other changes to sentencing and parole laws, came about in large part because enough people got sick enough of violent thugs being continually released from prison to make sufficient  noise for politicians to take notice. Poll driven politicians on both sides of the -wing divide listened, and the laws gradually changed. Five years on from Colin Moyle's horrific death  clearly nothing has changed regarding the criminally insane, and Dean Clark paid the penalty for that political torpor.

There is an added tragedy in every such case. Two months on, in a secure forensic environment where he is compulsorily medicated, Dean's killer is probably  as “sane” as he will ever be, and  now has to live with the horror of what he has done. Living with that will be a burden he must bear for the rest of his life, regardless of what the courts eventually do with him. That alone may make him go off medication in the future –  so he can return to a more comfortable world of the voices and delusions –  unless he is properly monitored when he is again released.

It is time the same level of public pressure that eventually resulted in “three strikes” was brought to bear on the mental health system. It is simply not acceptable for learned pointy heads to nod wisely and say “this is all a very difficult balancing exercise”, or utter similar platitudes every time such a tragedy happens.  The mental health system has a long history of covering its backside, stretching back at least to whistle blower Neil Pugmire, who warned the public in the 1990's  about the imminent release of a dangerous sex offender, and paid a heavy price for doing so. Eventually though, as a result of public pressure, the Protected Disclosures Act was passed to protect the Neil Pugmires of the future.

Whether  changes  to the way we deal with dangerous psychiatric patients happen  now is, in the first instance, up to the public. The National government changed its plans to mine Schedule 4 of the Conservation Estate because enough people objected to the plan, and the reflected that level of objection. People need to wake up to the danger of inadequately monitored, dangerously ill mental patients in their midst under non existent “community care”,  and make just as much noise. Otherwise you or your son's next flatmate may be a mental patient in the incompetent  hands of those supposed to be monitoring them. And listening to the voices.

Thanks to David for the guest post.

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