Leading article: One tragedy that testifies to a decade of neglect

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The Independent Online

The history of James Green, who is in Gloucester prison awaiting sentencing, would be tragic under any circumstances. Here is a young man who has shown symptoms of mental illness since his mid-teens, habitually harmed himself, set fires, and attempted suicide. It is well known to the authorities that he harbours murderous tendencies; threatening to kill is the crime for which he will be sentenced.

But the case of Mr Green is more than tragic. It is one small piece in a great national disgrace. His family have watched his deterioration year by year. They have tried repeatedly to solicit help from the relevant specialists. But it was not until he was in prison on remand for his first arson attack that he was finally diagnosed with Severe Personality Disorder. Until that point, his condition had been put down to learning difficulties.

The belated diagnosis, however, offered no respite either to Mr Green or his family. For his SPD is judged untreatable, so he will not be sectioned, nor will any psychiatric unit accept him. What is more, he has so far done nothing that is deemed serious enough to warrant confinement either in hospital or in prison: his family have been advised that he can expect his sentence to take the form of a community order.

What this means is that Mr Green will be back living at home or in bed and breakfast accommodation, in the very circumstances that prompted his increasingly desperate cries for help: the self-harming, the fire-setting and the threats to kill. All that anyone can hope is that the threats remain just that - threats.

If James Green's were an isolated case, it would be bad enough. But it is not. Someone else diagnosed with SPD who translated his threats into action was Michael Stone, who was found guilty of bludgeoning Lin Russell and her young daughter to death on a towpath in Kent. Those particularly horrifying murders led to changes in the law to permit "untreatable" patients to be detained. The amendments are still making their way through Parliament.

It is not for us to second-guess the specialists who have examined James Green. Nor do we dismiss lightly the human rights questions that are posed by the compulsory detention of the mentally ill. The old system of asylums stunted many lives and created lasting injustices. And it must not be assumed that Mr Green is a killer in the making. But provision for the mentally ill has surely gone too far in the opposite direction.

If any definite conclusion can be drawn from Mr Green's story, it is that prison is not the place for such individuals. The number of mentally ill people who are in prison essentially because there is nowhere else for them to go is a scandal that needs to be urgently addressed. It also places a burden on the prison system, with which it is not equipped to deal.

The greater failure, however, is that the alternative - "care in the community" - is rarely much better. Satisfactory outpatient care requires the one thing that successive NHS and social service reforms have failed to deliver: co-ordination of different agencies tailored to the individual need. When something goes wrong - whether with battered children, foreign offenders or mental patients - invariably it is because the seamless provision that was promised has not transpired.

This may require more money, but it also requires political will and clear lines of managerial responsibility. Outrageously, the last time that James Green left prison, with a suspended sentence for arson, it was two days before Christmas and without medication, social support or housing. How much more desperate must the cries of help become before mental illness starts to rank much higher among the Government's priorities?