Yesterday's report on the case of John Barrett, the paranoid schizophrenic who killed a stranger two years ago, has once again thrust the question of how we should deal with the mentally ill into the spotlight. Barrett, who had a history of violence, absconded from a secure unit in a south London psychiatric hospital, where he was a voluntary patient, in September 2004. The next day he travelled to Richmond Park where he stabbed to death a passing cyclist, Denis Finnegan. Barrett afterwards claimed that voices in his head had instructed him to kill.
The randomness, brutality and unprovoked nature of such killings tend to increase public sympathy for draconian action against the mentally ill. Calls to section first and ask questions later inevitably follow. This certainly appears to be the Government's attitude. The Mental Health Bill unveiled today will propose a much greater element of compulsion in the treatment of the mentally ill. Yesterday the health minister, Rosie Winterton, claimed that the new Bill will help prevent such tragedies happening again.
Yet the idea that our response should be to lock up more of the mentally ill is wrong. The conclusion of the latest report is worth reading. It states very clearly that the root of this tragedy was not a lack of legislation. The killing, it argues, could have been avoided had better decisions been made by health professionals over the treatment of Barrett and a better evaluation made of the threat he posed to the public. There was insufficient monitoring of the patient and poor communication between the various authorities responsible for him right down the line. Barrett had been locked up for the safety of others after nearly killing a man in 2002. The problem was that he was given a conditional discharge by a mental health review tribunal the very next year. As the report points out, this was fatally premature. Previous reports into killings by mentally ill patients have demonstrated similar failings in the system. And it usually emerges that warnings from relatives - and even patients themselves - go ignored.
The problem goes deeper than advocates of instant legislation imagine. Its roots lie in the 1980s when the asylums were closed down and a policy of care in the community was introduced. This new system was an improvement, but it was seriously under-funded. And a lack of resources has bedevilled it ever since. It has also been dangerously under-scrutinised. The present Government's prisons policy is compounding the problem. Though a large proportion of the UK's prisoners is mentally ill, few receive any treatment inside. And when they are released they are given no help either. According to a survey in 2002, three-quarters of mentally ill prisoners were allowed back into the community without an appointment to see a doctor.
Treatment for the mentally ill has long been a neglected outpost of our public services. But sweeping new powers for doctors to lock up the mentally ill are not the solution. As well as being illiberal, they could prove counterproductive. Many of those who work with the mentally ill predict it will scare people from coming forward for treatment.
Horrific as cases such as the death of Mr Finnegan are, the number of killings by mentally ill patients has not risen in recent years. And the proportion of mentally ill patients who are violent is extremely low. The vast majority need compassionate treatment, not detention. But the mentally ill, whether violent or not, do have something in common. They need proper care when their symptoms first emerge, rather than when a crisis occurs. At the moment we have a system that only seems able to rouse itself to intervene when it is already too late.Reuse content