Tuesday, September 16, 2008

Reporting of mental health stories "horrifying"

Not a revelation, I guess.

There were two important mental health stories on the BBC News website last week. One was a report from the Healthcare Commission on the treatment of people with mental illness, much of which was rather damning. Another was about how people with mental ill health were being routinely detained in police cells instead of being taken to hospital for assessment. But the only one that made a big headline – the lead story one morning – was a story entitled Mental care escapes 'horrifying'

Using the Freedom of Information Act, the Today programme had uncovered that 94 people had escaped from medium and low secure psychiatric hospitals during 2007. The word horrifying comes from Sir David Ramsbottom, former chief inspector of prisons. Not sure quite why he was asked about this subject, but he said;
"It is a horrifying figure of course, but not one that surprises me because the medium and low secure units in the NHS do not have same degree of security a prison does."
No, that's quite right. That's because secure psychiatric units do not serve the same purpose as a prison.

Your psycho-killers of myth and legend, your serious criminals with mental health problems end up in high security hospitals, such as Broadmoor or Carstairs. Of course, criminality is not the only reason why someone is detained in such circumstances, but those are the places for people who are considered highly dangerous. I don't know how many people escaped from high secure psychiatric units in 2007. Probably none at all.

The vast majority of people who wind up in secure units do so for their own protection. The purpose is not incarceration so much as constant supervision. Prison, on the other hand, is primarily about punishment. People in prison have broken the social contract and have forfeited their liberty. Most people detained because of their mental health haven't committed any crime. They need protecting. The general public do not need protecting from them.

Sometimes this goes wrong. Last year, a young man with autism escaped from hospital and went on to rape a young girl. This is a terrible story, a terrible crime. However, most people who commit rape are considered mentally healthy and neurotypical; just because a crime is committed by a person with mental illness, autism or an intellectual impairment, that doesn't mean that other people should have seen it coming a mile off. I mean, they maybe should have done for all I know, but this tragic case is not evidence that thousands of people need locking up.

And so, a few days later when there are concerns about people with mental illness being put in police cells rather than being taken to hospital, we wonder why police officers feel that it is appropriate to treat innocent and highly vulnerable people like criminals. Cause and effect, anyone? And how many people were subject to this horrifying experience in a year, compared to the 94 that got away? 11,500.


Anonymous said...

Sorry to hear about the bots- nasty !
Since I work in mental health I have to say people need to be more concerned about their neighbors who appear "normal" than anyone with a diagnosed illness of any kind! It's what is unknown that gets you and denial not illness. I also heard some bad stuff re: Canada's policies in MI as well. When times get tough the politics gets to red herrings away from the economy! Thanks for stopping by!

Maddy said...

I get 'best of today' from the Today Programme via BBC America.

I forget the name of the chap they interviewed [as they couldn't get any of the big wigs to co-operate] but although his message was crystal clear to me, the interviewer kept on the tack of 'safety of the general public.'

So yes, that was me, yesterday, shouting at the interviewer as I walked down the street in public with my i-pod!

seahorse said...

You sum it up nicely. It is the horrors going on within low to medium secure units that need highlighting, not the fact that some people have the guts to successfully escape.

A doctor friend of mine was describing a scene at his hospital where a woman was found crouching by a car park bleeding. He felt dutybound to deliver basic first aid (put a thumb over the cut) until a MH nurse arrived. He described the incident as "One of your inmates has escaped". I questioned our friendship for sometime after that, but did pick him up on it and he apologised.