Judge warns ongoing failure to get suicidal girl care risks ‘blood on our hands’

The president of the family courts has warned the state will have “blood on our hands” if an appropriate care placement is not found within days for a girl who has made repeated attempts to take her own life while in youth custody.

In a judgment published today, Sir James Munby said he was “ashamed” by the ongoing failure to find an appropriate placement for the 17-year-old to move to, despite her being due to leave youth custody in 11 days time.

Munby was told six low secure units could provide the care and supervision she needed but they were all full and not due to have any beds free for months.

He said the girl’s case exposed the “disgraceful and utterly shaming lack of proper provision” of the services needed. Munby sent his judgment to the chief executive of NHS England, the home secretary and the secretaries of state for education, health and justice and scheduled another hearing for Monday.

NHS England said since the judgment was made public, beds had been found in three appropriate care settings. Assessments are now ongoing to ensure the correct package of support is in place.

‘Disgrace’

The girl, referred to in the judgment as X, has lived in the residential unit in youth custody under a care order while Cumbria council and partner agencies tried to find her appropriate care. In an earlier judgment, Munby stressed the importance of her having a placement to move to when she left the unit.

During her time in the unit – which experts all agreed was not suitable for her – restraints had to be used on 117 occasions, there had been 102 “significant” acts of self-harm, 70 successful and attempted assaults on adults and 16 incidents of significant property damage.

Munby said there was a “substantial body of professional opinion” that X needed therapy in an appropriate clinical setting. Staff at her current unit felt any plan to send her for care in the community would be “a suicide mission on a catastrophic level.”

“Staff do not think it will take more than 24 to 48 hours before they received a phone call stating that X has made a successful attempt on her life,” Munby heard.

Despite the efforts of the council and commissioners no bed had been found. Munby said the failure to find a place for X was not the fault of those working on the case, who were not responsible for resource provision.

He said the circumstances were a “disgrace” for “any country with pretensions to civilisation, compassion and, dare one say it, basic human decency, that a judge in 2017 should be faced with the problems thrown up by this case”.

“If this is the best we can do for X, and others in similar crisis, what right do we, what right do the system, our society and indeed the State itself, have to call ourselves civilised?

‘Blood on our hands’

“The honest answer to this question should make us all feel ashamed. For my own part, acutely conscious of my powerlessness – of my inability to do more for X – I feel shame and embarrassment; shame, as a human being, as a citizen and as an agent of the State, embarrassment as President of the Family Division, and, as such, Head of Family Justice, that I can do no more for X.”

He added: “If, when in eleven days’ time she is released from ZX, we, the system, society, the state, are unable to provide X with the supportive and safe placement she so desperately needs, and if, in consequence, she is enabled to make another attempt on her life, then I can only say, with bleak emphasis: we will have blood on our hands.”

Mike Prentice, medical director for the NHS North Region, said: “The judge is quite right that the relevant agencies need to ensure a safe, new care placement for this young woman, which is suitable given the great complexities of her situation. That’s what’s now happening, and a number of options have now been identified, with detailed clinical and social assessments taking place tomorrow to ensure the right package of care can be put in place before her release date.”

The UK number for the Samaritans help services is – 116 123.

This story was updated on Friday 4 August.