NHS must protect lives of all psychiatric patients at risk

Psychiatric hospitals risk breaching human rights law if they do not take action to protect the lives of patients admitted informally, the Supreme Court has ruled in a landmark judgement today.

Previously the courts had ruled that only patients detained under the Mental Health Act 1983 were owed a positive duty by the state to protect their lives in line with Article 2 of the European Convention of Human Rights, which guarantees the right to life.

However, the Supreme Court ruled today that this applied equally to patients admitted informally to mental health hospitals, in a verdict that was greeted by mental health charities.

“Now it is clear that in times of crisis everyone will have the strongest protection that the law can offer,” said Mind chief executive Paul Farmer.

The case concerned a patient, Melanie Rabone, who took her life in April 2005 after being allowed home on two days’ leave from Stepping Hill Hospital, a facility run by Pennine Care NHS Trust where she was a voluntary patient.

She was allowed home leave despite the fact she was suffering from severe depression, had been admitted to the hospital after several suicide attempts, and the hospital judged that she was a moderate to high suicide risk. Rabone’s parents had brought the case against the trust.

The court ruled that she was at immediate risk of suicide and under the trust’s responsibility and control, meaning its duty under Article 2 was engaged; any distinction between Rabone and a detained patient was “one of form, not substance”.

“As the decision to allow home leave was one that no reasonable psychiatric practitioner would have made, the trust failed to do all that could reasonably have been expected to prevent the real and immediate risk of Melanie’s suicide and it breached its operational duty,” it said.

Rabone’s parents have been awarded £5,000 each in damages. 

In a statement, the trust said: “All those involved in this litigation have had the deepest sympathy for the Rabone family and the tragic circumstances surrounding Melanie’s death in 2005.

“The trust acknowledged that it did not manage Melanie’s care as it should have and has apologised to the Rabone family. We also paid full compensation to her estate in 2009. “

More on inpatient psychiatric care

Staff cuts and overcrowding blight care for detained patients

How providers are failings mental health inpatients

Guide to the Mental Health Act