“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