Thursday, 1 April 2010


I was contacted first thing one Monday morning by our Criminal Justice Liaison Worker. Part of her job is to liaise with the police and the courts and to identify and assist with mentally disordered offenders.

She was ringing from Charwood Magistrates’ Court. There was a 15 year old boy in the cells, waiting to be charged with robbery and aggravated vehicle taking. The more she told me about the circumstances, the more appalled I became.

Shane had been a perfectly unremarkable boy until a terrible thing happened to him when he was 14. He was seduced and sexually abused by the mother of one of his friends. Since then he had become increasingly depressed and suicidal. He began to self harm. Three months before, he had cut his wrists quite badly and was assessed under the Mental Health Act and detained in a children’s psychiatric ward for about two months. He was a patient of the Child & Adolescent Mental Health Service (CAMHS).

A week previously Shane had taken a serious overdose and received medical treatment at the local Accident & Emergency Department. He had then run off, taken his parents’ car and was arrested and charged with aggravated vehicle taking. He was on bail when he was arrested again late on the Friday evening. He had stolen a car from a woman at knifepoint and had then crashed it, with the explicit intention of crashing it into a tree and killing himself. It was only the car’s insistence, through an annoying and persistent warning noise, to put on his seat belt that had saved him from serious injury. He was found by police wandering down the road in a very distressed condition, and had asked to be arrested. The police duly obliged.

What should then have happened:
The police, knowing his previous record of attempted suicide and self harm, should have arranged for a formal assessment under the Mental Health Act without delay. He could then have been detained under the Mental Health Act and admitted to a children’s ward for appropriate treatment.

What actually happened:
He was seen by a Forensic Medical Examiner, who unaccountably decided that he was fit to be interviewed. He was then interviewed, cautioned and remanded in custody until the next available court. Which was on the Monday. A suicidal, severely mentally ill child had been held in the cells for over 60 hours.

We attempted to retrieve the situation as much as possible. A social worker from the Youth Justice Team came to the court. We contacted the CAMHS consultant psychiatrist who also came to the court. His parents were already there with him, understandably extremely anxious and distressed about the entire situation.

We interviewed Shane. He presented with a range of symptoms of depression and Post Traumatic Stress Disorder, including nightmares and flashbacks relating to the abuse, loss of appetite and weight loss, and severe sleep disturbance. He was experiencing auditory hallucinations. He told us that he kept hearing an external male voice telling him to do things he didn’t want to do, such as cutting his wrists, taking tablets, and crashing the car. He said he had tried to use distraction techniques, but these did not always work. He cried. He wanted to die. He wanted it all to end. It was very clear from this interview that Shane was genuinely mental ill, and desperately needed to be in a safe environment.

In conjunction with the clerk of the court and Shane’s solicitor, we devised a plan. It was too late to use Part II of the Mental Health Act (Sec.2, Sec.3 etc), but we could use Part III of the Act, relating to the powers of the courts to detain mentally disordered patients. A bed was found in a secure children’s psychiatric unit. The Consultant gave evidence of Shane’s mental state to the magistrates. The Court agreed to detain Shane under Sec.35 for assessment. The police duly took him to the unit. Justice, at last, was done.


  1. Oh poor boy. That is such a sad story. I really hope things improve for him.

  2. How sad, the world really does contain some truly awful people. I hope that things improved for Shane and the woman was brought to justice.

  3. I can't agree with your interpretation here. I've read your (excellent) blog with interest for some while. As a serving police officer, this is the first time I've felt compelled to comment: I have a particular interest and experience in policing / mental health issues ... and in short, there is NO WAY that any offender who has stolen a vehicle in a knifepoint robbery and against whom there is sufficient evidence to charge would be diverted from my police station under any provision of Part II MHA.

    There is no legal obligation (or moral obligation) on the police to ensure that every person with a history of mental illness is assessed under the Mental Health Act. That may well have been necessary in this particular case, the FME (police doctor) may well have err'd, but it's not correct to say it should always happen. Someone having been arrested for an offence, the obligation when someone appears to be mentally disordered (awful legal termiology, I think?), is to ensure he is assessed by a FME who is the at liberty to order assessment under the MHA if s/he thinks it appropriate.

    Clearly they did not think it appropriate in this case, which may have been right or wrong. But I must add, that had the FME ordered MHA assessmet which may have concluded with a recommendation of admission under s2 or s3, I'd have still proceeded to order consideratios of charges, denial of bail and have made a recommendation to the court, that because of the recommendations being made by AMHP / DR for admission under Part 2, they should consider the provisions of Part 3 in court.

    Either way, whether or not he is assessed MHA for potential admission under Part II of the Act, the police (and CPS) are legally responsible for determining whether or not he is would be charged with the offence and there is NO WAY on earth I would EVER allow someone against whom there was sufficient evidence of knifepoint robbery to be 'diverted' under any provision of Part II MHA without charge. It is an 'indictable-only' offence, there is a victim, there are broader public safety considerations. The offender's mental health, whilst important, is only one factor to take into consideration, amongst very many relevant factors. Let's imagine Shane is diverted from the police station without charge under s2 or s3 to a MH ... he goes missing and further offends or he assaults nursig staff in the unit, I think there would be quite legitimate questions asked about why he wasn't prosecuted for this serious crime. This is not a minor offence where Shane's interests are at the forefront - they need to be balanced against other interests.

    If the FME err'd by not arranging formal assessment under the MHA, that is a fair enough point, I know that FMEs have varying degrees of knowledge (and interest, frankly) in MH, but it should also be borne in mind that the consistency of psychiatric diagnosis and assessment (about paritcular conditions as well as about fitness to be interviewed, etc.) is a much a problem by specialist and forensic psychiatrists as it is with FMEs.

    There is no doubt in my mind - notwithstanding your point about what the FME did / didn't do or what should have happened - that this man should have been charged with the offence(s) (bear in mind, he'd stolen a vehicle previously and driven it dangerously, this offence represents an escalation of his alleged offending) and the full consideration of the court, with proper psychiatric reports and evaluation, can then be given to whether he is fit for trial, whether there is a trial of facts, or whether there is a full criminal hearing concluding with acquittal, criminal justice disposals or Part III Mental Health Act disposals are appropriate.

  4. I'm conscious that some will observed I've referred to Shane as a man in my above post whe I did know he was 15. I just wanted to state for the record, that the fact he is 15 doesn't alter my respose at all. Sorry. The right place to trash this all out is court.

    Also, I'm not deliberately trying to be anonymous, I just haven't worked out how to register on this thing as it's a different blog format to others I use ... my name is Michael.

  5. Thanks for your comments, Michael. I would agree that the FME was probably deficient -- in fact, we've had quite a lot of problems with FME's in our area lately. However, it would have been perfectly possible for Shane to have been detained under Part II MHA, in spite of the ostensible seriousness of the offence. In fact, I am aware within our constabulary area of at least one case where an adult murderer was detained under Sec.3 following his arrest, and having been assessed in the police station under the MHA, and admitted to the regional secure unit without a court appearance.

    I do think that a serious issue in this case was the length of time a 15 year old, with or without a known history of mental illness, was held in custody without being brought before a magistrate. At the very least, Social Services could have been made aware of the situation so that they could have investigated the possibility of remand to a children's secure unit. Another issue would have been his fitness to plead.

  6. There's plenty wrong with the system and I find actually, that the main problem is communication between AMHPs and Police Officers ... as long as there's a mutual understanding of how both organisations priorities and responsibilities are balanced and discharged, no problem. Michael.

  7. As an AMHP working in a busy inner city, I think the bottom line is how low down MH is on the govt agenda, as it is always the frontline workers who deal with the wider issues. But thats an argument all on its own.

    We have two brilliant mental health police liasion officers in the borough, and know from colleagues this has made a great difference in recent years, following joint training on mental health issues. Especially when requesting police checks, and negotiating on complex MHA assessments.