Thursday, June 28, 2007

“Mad” or “Bad”?

In my new (and so far neglected) blog “Do I Look Like I Care?” I received a comment from a reader who calls herself Kim. Kim said, in part:

“Ann* is very unwell; she is a paranoid schizophrenic, and has not had her depot injection for 8 weeks. She is a real danger to herself and others, and is getting rather aggressive. She assaulted 2 nurses up at the local unit last week, they called the police, and the unit said they couldn’t have her as she was being violent and the police wouldn’t have her as she was mentally unstable, so sent her home. Now we (her friends) take turns looking after her, it’s one crisis after another, and we are all starting to fear for our own safety. We have contacted all the relevant people and no one will take any notice of us as we are patients under the same team. We are at our wits end, and getting unwell ourselves.

They won’t do anything until she puts an axe in someone else’s head or her own, by which time it’s too late. They will spend millions on a public enquiry, where if they had done their job properly no one would get hurt and would save lots of money.”

*Not her real name.

I feel this experience highlights two major problems which I have written about previously: the difficulty in accessing services for people with mental health problems - even for those who are familiar with how the system works; and also the fact that the responsibility for caring for such ones often falls on those who are neither equipped nor qualified to do so. But also, I can’t help but wonder if Ann will end up in a similar situation to Justin.

Justin is a young man suffering from mental health problems. He set fire to his flat and as a result was given a discretionary life sentence.

Slurry tells us regarding Justin:

“It was his mental illness which led up to the event. He was not being looked after by the CMHT very well at all. We (his friends) knew something big was going to happen so we rang the CPN many times in the week leading up to it. Never did they come and visit Justin or speak to him like they promised, then it was too late.

He does not do well in the prison system, as it’s the wrong place for a mentally ill person, and I am so bitter at the system which failed him and so many others.”

Now don’t get me wrong; I’m sure that there are people with mental health problems who are just as capable of breaking the law as someone without these problems, and being ill isn’t necessarily the cause of someone breaking the law. But in both of these cases, and many like them, the deterioration of the person’s symptoms were obvious to others, to the extent that friends feared that at some point the individual would take extreme action which would usually be completely out of character for them.

This point is important for two reasons:

Firstly, the general public wrongly presume that people with mental health problems are unpredictable and could go off on a murdering spree at any moment. The two cases above clearly show that if people bother to take notice, the warning signs are there.

Secondly, the CMHT were obviously unable or unwilling to act on the concerns of others. This is either because their resources are desperately lacking or because they don’t take the concerns of others seriously. My guess is that it is a combination of both.

So the question is: how many people are in prison because they have been failed by the Mental Health System? I know we often hear in the news about people on trial who have had a psychiatric assessment, and I’m sure that this is often an attempt to avoid the full penalty for their actions. But what about those who are genuinely ill, and who were well known to their local CMHT before the incident? And even neglected by their CMHT before the incident?

“Service users” are often seen as faceless objects.

"Faceless Care" by Philippa King


R2K said...


Mr Mans Wife said...

Hi there R2K, thanks for visiting my blog.

That's a lovely little bunny, but going by your picture you don't look like the sort of person who would appreciate such cute things. It just goes to show that you can never judge a book by it's cover.

I've looked at your blogs, and I love the zoomed in photography. The bathroom website is facsinating and very original too!

Thanks again for popping over. Leave a comment next time!

uphilldowndale said...

r2k, do you eat rabbits?

It's not good enough is it, we set people up with mental health to fail.
you must feel like you are screaming in the wind.

Mr Mans Wife said...

Screaming in the wind is a very good description Uphilldowndale. Remember the blog by a woman who's brother was a sufferer of Schizophrenia? He ended up in prison as well, although she didn't say what he had done. Her blog seemed to disappear, which was a shame.

We used to eat rabbits when we were kids. Or rather, it was served up for dinner and we went hungry. It tastes awful.

slurry said...

eating rabbits yuk! yes the system is failing people all the time, sad but true.

Anonymous said...

i blame the government. as we all know not enough staff or resources in the places that matter.

can you really put an axe in your own head?

only asking from a curious scientific point of view as opposed to a "go on then, bet you cant" stand point....

....i think the handle would have to be short. if it was too long you would go right over the top & the axe would land in your bum.

can you die from an axe wound to your bum? seems to me that a bum is perfectly equipped to handle an axe.

i think it would look like a wooden squirrels tale if it was stuck in you bum after coming over from above.

now there is an irony there. squirrel & axe in the same sentence. i mean i wonder how many squirrels have had there homes destroyed by an axe.

i think we need a campaign for better health care. obviously the government would have to raise more money to fund the extra care so i think i will go with this for a campaign slogan

"more taxes less axes"

Mr Mans Wife said...


...*quite a while later*


I couldn't stop laughing from the second sentence onwards! Reading it out loud to Mr Man was virtually impossible! You make some very valid points though Grannys.Myth.Peeler!

slurry said...

That comment really was funny!

Mr Mans Wife said...

Slurry you should check out his blog! Everything that man says is funny!

Anonymous said...

i thank you, mrs man

so are so kind, as always.

however i must add that not all my blog is funny. its just the funny parts that are funny, the serious parts serve as a supporting element to the funny parts, unless of course they are supposed to be serious in their own right. which would be funny if it wasnt so serious. now thats ironic. oh god dont get me started there. i mean, well, isnt irony ironic, what are the chances of that.

Mr Mans Wife said...

LOL he's off again!

Inspector Gadget said...

Sorry to hijack this but I really need to leave a comment on your other Blog about the child being hit in the street and I can't for technical reasons. Can you email me? Thanks IG

freedom said...

yepo ...

a friend of mine got life last week for killing someone on a drunken drug fulelled rampage.

at the start of last year he asked for psychotherapy specifically to help deal with his violence issues.

he wasn't taken seriously so he was given some rather under-strength "counselling" for the task at hand.

he didn't attend for long.

now the state will be feeding him for the next 18 years or so.

on a brighter note: grannys.myth.peeler .. thanks for existing yr hillarious :)

Mr Mans Wife said...

Thank you for your comment Freedom, although when I wrote this post I had in mind people suffering from serious mental health problems, such as psychosis, which would cause the person to become detached from reality and could cause them to commit an act which would normally be regarded as out of character for them.

Obviously I am not in full possession of all the facts in this case, but it is well known that drugs and alcohol can make a person behave in an unpredictable way, so it’s debateable whether psychotherapy could have prevented this incident.

Anonymous said...

it's estimated that 70% of the prison population have mental health problems - i don't know how many of these had been in contact with their CMHT beforehand.

i work in a medium secure unit - i'd estimate that the majority of service users were in touch with a community team before they committed their index offence and were badly let down by them.

what should be happening in ann's case is a referral to the local/regional forensic team, or at the very least she could be transferred to a PICU - dumping her back on her friends/family at a potential risk to both them and to ann is awful :o(

Mr Mans Wife said...

Hi there Survivorworker, thanks for your comment. You provide some valuable information there.

I'm interested to know what role a forensic team would play in this case. Could you enlighten me?

Anonymous said...

hi MMW,

the role of the forensic team would be to assess how the violent behaviour could best be managed - as there have been no criminal charges (i assume?) it is unlikely that she would be admitted to a forensic unit (either medium or low secure), however they may be able to offer an outpatient service or something to supplement the current service from the CMHT. it all depends on what is available in the area - some CMHTs have specialist forensic nurses to act as a link between services, but many don't. in the circumstances, i am *very* surprised that ann wasn't transferred to the local PICU (psychiatric intensive care unit) as this would seem to be the most appropriate place for her. in some ways, in terms of getting the appropriate treatment, it might actually be beneficial for criminal charges to be brought against her for assault, although obviously this would be distressing for all concerned - swings and roundabouts :o/

Mr Mans Wife said...

Thank you for explaining that Survivorworker. I was just a bit confused because when I see the word "forensic" I automatically think "CSI"!

Like you, I am surprised that she wasn't admitted into a PICU, after all isn't that what they're for? But maybe (like everywhere else) there were no beds available.

Anonymous said...

lol - that's a common reaction when i tell people about the speciality i work in!

btw - from my experience, the PICU is usually the one place that *does* have beds ... sounds more like they couldn't be arsed to me!