Minister seizes on study to bolster reform plans

A five-year study into homicides and suicides by psychiatric patients has been seized upon by the government to justify its mental health law reforms.

The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness found that more than 50 homicides and 1,300 suicides are committed in England and Wales each year by mental health patients – figures that have remained static.

Speaking about the report, health minister Rosie Winterton told the BBC a key issue was the fact the government could not force discharged patients to take medication. Such powers are included in the Mental Health Bill in the form of community treatment orders.

The inquiry itself, which was led by the government’s mental health “tsar”, Louis Appleby, said it had “no reliable way” of calculating how many suicides or homicides would have been prevented by the community treatment orders proposed in the bill. But it said 25 per cent of homicide cases and 14 per cent of suicides were preceded by non-compliance with treatment.

Paul Corry, director of public affairs at mental health charity Rethink, said he was “disturbed by the spin” the Department of Health had chosen to put on the report.

He pointed out that the report did not recommend legislative change but called instead for improved care planning, more services for patients with dual diagnosis services and better transitional arrangements between wards and the community.

Corry said people were not running away from services but were seeking help only to be turned away because services were not available or they were not deemed eligible.

Mental Health Alliance chair Andy Bell said the study did not back the idea that “people who cannot benefit from mental health treatment should be detained nor that extending compulsion in the community would make any difference”

Key findings
In the week prior to their suicide 49 per cent of patients were seen by mental health services but only 14 per cent were thought to be at risk of suicide.

In the week prior to homicide, 29 per cent of patients were seen by services but only 9 per cent were thought to be of short-term moderate or high risk of violent behaviour.

Stranger homicides have remained at five per year, indicating that community care has not increased the risk to the public.

● Avoidable Deaths