Public Policy Editor
Christopher Clunis, John Rous, Paul Gordon, Alan Boland, Stephen Laudat are just some of the names of the mentally ill who have killed in recent years. Ten days ago those of Wayne Hutchinson, a paranoid schizophrenic who killed two people and seriously wounded three others, and of Martin Mursell, who knifed his stepfather to death and almost killed his mother, were added to them.
But despite the catalogue of recent inquiries into homicides by the mentally ill it is far from clear whether the policy of Care in the Community has increased the number of homicides, or the risk to the public.
According to the Audit Commission's report on mental health services, "in the last two decades of the community care policy, the number of homicides committed by mentally ill people has not increased, while the number committed by others has more than doubled".
Its conclusion is based on Home Office statistics which record all murder convictionsand those for "section 2 manslaughter" - where the charge is reduced due to diminished responsibility.
Because of the high clear-up rate for murder, the Home Office believes the figures are a fair representation of trends. After rising from 1957 when the plea first became available, numbers have remained broadly constant since the early 1970s as the run-down in long-stay beds has accelerated, fluctuating between 60 and something over 100 a year. In the most recent years numbers have declined.
But not all homicides by the mentally ill produce a verdict of diminished responsibility - Mursell did not enter such a plea. Diminished responsibility also covers the mentally handicapped, as well as the mentally ill. And some people convicted of murder also receive psychiatric treatment. Dr William Boyd, director of the Royal College of Psychiatrists inquiry into homicides and suicides, said the figures are "a quagmire" although "there are no figures which suggest there is an increase in homicides".
Dr Geoff Searle, a consultant in Bournemouth who is also a spokesman for the Royal College, suspects greater publicity has heightened the sense that the risk is higher. "In the past, some of these homicides will have been of one patient by another in long-stay hospitals. When I was at Tooting Bec in south-west London, one long-stay patient murdered another . . . but it did not receive much publicity."
But even when there were more long-stay beds, murders still occurred outside hospital. "The vast majority of the mentally ill have always been cared for outside hospital. Even if we locked up everyone who suffers from psychosis, these things would still happen because we don't know everyone who suffers from psychotic illness."
Most schizophrenics, he argues, are withdrawn, frightened individuals who are at far greater risk of suicide than of violence towards others. "You are far more likely to be killed by lightning than by a wandering lunatic - but we don't go round with lightning conductors bolted to our heads."
Schizophrenics who fell through the net while living out in the community
Christopher Clunis: Sent to Rampton after stabbing to death Jonathan Zito at Finsbury Park Tube station, north London, in 1993.
Ben Silcock: A schizophrenic who was seriously mauled by a male lion after he climbed into the lions' enclosure at London Zoo.
Wayne Hutchinson: Convicted of manslaughter earlier this month after killing two people and wounding three others during a six-day rampage.
Martin Mursell: Jailed for life earlier this month after murdering his stepfather and attacking his mother, almost killing her.