Without Limit of Time

Not an untypical story on BBC News of a guy with schizophrenia being sentenced to “be held under the Mental Health Act, without limit of time.” That is very very scary – not just for the person concerned, but for us.
“Without limit of time” means he is very probably detained under Sections 37 and 41 of the 1983 MHA. Basically, he has to live in a hospital, and only the Home Secretary can release him. Yup, his future is directly in the hands of a politician.
Several years ago, around late summer / early autumn, a person with mental health problems committed a serious crime (I worked with detained clients for several years). It’s about that time of year that the applications go in from patients to be allowed home for Christmas Day – they all got refused. The Home Secretary didn’t listen to the doctors, he didn’t consider the human benefits to patients and their families – he thought only of his job. I was lucky – the client realised it wasn’t our fault, but it was still a poor situation.

Now look again at that story – and this quote “Psychiatrists deemed him a risk to the public if he failed to respond to treatment.” IF IF. But they’ve not just locked him up in case, they have also thrown away the key. How would the public react to a Dr who said “Well, the infection may fail to respond to treatment” and then started hacking limbs off ? This sentence is just as permanent – it really is.
I’m not saying that punishment is not deserved – it is – but that the punishment and treatment should be balanced, in proportion, humane. This sentence is none of them.

If a person detained under 37/41 is ever ‘released’, it is done on licence. The sentence never ever gets removed. A few years ago, a person who had been released on licence, with an index offence involving rape, had a visit from a Community Nurse. The Nurse noticed a book he was reading, and subsequently found out the book contained a rape scene. She had no knowledge of whether he was fantasising about this, but the guy had his licence revoked straight away and was immediately arrested and taken back to a secure hospital. I have many books, and I have no idea how many of them contain sexual scenes. This, remember, is Community Care.

Two clients under 37/41 I recall very clearly. One eventually worked her way through the system to Rampton Hospital – one of the most secure hospitals in the country, and part of that was due to frustration. She told me once that she saw her Psychiatrist and he gave her more meds as she didn’t seem very happy. So the next week she looked happy, and he gave her even more. She wasn’t bad – she was trapped in a system which didn’t care. The other guy has not set foot out of the ward I used to work on (I left 4 years ago), and he hadn’t gone out for the 2 years before that. Over 6 years in one building. And the powers that be wondered why he was ill ??

As part of my training as an RNMH, we were plonked in front of a TV one day and the film “One Flew over the Cuckoos Nest” was played.The environments may be different, the laws may be different, and time has moved on….
But the attitudes remain exactly the same.

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