Shane

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.