Until 1992, when mental health provision was reorganised under the misleading title of "care in the community", there existed in the village of Banks, just to the north of my home town, Southport, an institution for the care of what were called the "mentally handicapped". The full name was Greaves Hall Hospital, but us locals always referred to it as Greaves Hall. It was an old country house that had been a private residence, a school, a convalescent home for TB sufferers and, from 1948, a hospital for people with mental health issues. Initially for patients from Liverpool, it expanded to become a regional centre.The mental health unit had wards and ancillary buildings in the leisure grounds of the old house. It was demolished in 2009.
We in Southport saw little of the inmates of Greaves Hall. Sometimes, a few would escape to be recaptured, but, usually, they were confined to the hospital limits. If they were referred to at all, it was often in mocking, disparaging terms. And the inmates saw little of the outside world, not even of their own families. Staff whom I knew said that they had patients from Southport who had not received visits for more than 10 years, despite the fact that a bus ride from Southport town centre to the hospital was a mere 25 minutes. The staff also told me that, if they encountered patients' relations when shopping, walking or socialising in Southport, the relatives would usually ask questions such as: "Oh - how's our so-and-so getting on?" - and leave it at that. Seriously ill mental health patients and people with learning difficulties were regarded as an embarrassment to be hidden away, and it is no disrespect to the ex-staff of Greaves Hall or any similar institution in Britain to say that is what happened.
Things began to change in the 1980s. A strange alliance of mental health campaigners and right-wing politicians worked to bring about the closure of places like Greaves Hall. The former group wanted to break down the stigma of separating mental health patients from the wider community; the politicians simply saw an opportunity to cut public spending. "Care in the Community" was born.
Almost immediately, things began to go wrong. Many released patients simply could not cope with life in the outside world. Support for them was erratic, as the whole venture was given insufficient resources. A large number became homeless, suffered violence, turned to crime or committed suicide. They still do; the institutions may be gone, but the prisons and homeless shelters are full of people with mental health problems.
Equally worrying was the fact that many disturbed patients, when released, became murderously violent. To spare regular readers, I will confine myself to saying that I have written about a number of murders by released mental health patients. At the risk of appearing obsessive, yet another of these appalling killings has happened. Many features are common to all these slayings, but each has something uniquely horrible about them.
The unique horror in this case is that a man has murdered his own grandmother in Mitcham, south-west London, weeks after being released from a psychiatric unit. Kordian Filmanowicz, a 21-year old paranoid schizophrenic, stabbed his grandmother, IIona Czuper 60 times in the throat and killed the family pets with a paving slab. As might be expected, he admitted manslaughter on the grounds of diminished responsibility. He had been released in March of last year after six months of psychiatric care, only to kill his grandmother on the 8th May, 2017.
One depressingly familiar fact - complacent misdiagnosis - emerged during the trial. As the BBC says:
"During his stay at a unit in Croydon in 2016, he threatened a staff member "in an aggressive way" with a plastic teaspoon, saying he would remove her eyes with it, Mr Mulholland (Prosecutor) said. But senior psychiatrists released him into the community on medication after deciding he had made a "huge improvement", the prosecutor said."
According to "The Bolton News", the judge:
"..advised against medical experts taking his progress at face value, saying they should take great care "bearing in mind the decisions taken in the months leading up to his offending".
Suffice it for me to say that such advice should be obvious to the mental health professionals who deal with people like Filmanowicz. It would save a great many innocent lives. We are a long way from the era of Greaves Hall. Care in the Community has kept most of the mentally ill and mentally handicapped in the wider community, but has not received the necessary resources to be completely successful. As a social experiment, it has had mixed fortunes. Too many of both groups have simply swapped one institution for another: prison (or homelessness). A minority of the former group, as has been seen, have killed hundreds of innocent people, such as IIona Czuper, since the 1980s. Still, you can't make an omelette without breaking eggs, and the powers that be seem to regard these deaths as collateral damage.
'Dumping in the community' is how I viewed the policy when it was introduced.
ReplyDeleteThat is 100% correct. As I said, the "released" mentally ill and handicapped were not given the care and support they needed to cope in normal society. In the first couple of years after Care in the Community was implemented, about 50 committed suicide and the murderous minority killed about the same number.
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