Restricted patients Restricted powers Personal reflections Stuart Brown Q. C.
By way of background l Limited experience – – 7 or 8 years 10 -15 days p. a. “Usual” Training Not my usual area BUT THIS IS NORM This jurisdiction Generally
Strictly personal!! l l Chatham House ! Designed to provoke Culled over coffee But usual disclaimer
Some Statistics of which I confess to being unaware previously l Total numbers of restricted patients – – l 1997 2007 2, 650 of whom 292 female 3, 448 of whom 458 female High security – – 2007 608 male 35 female Statistics do not allow earlier comparison
And…. . l New admissions – – l 1, 092 of whom only 218 subject to s 37/41 1, 458 - 333 Numbers transferred from prison (60% in total; ) – – l 1997 2007 Large numbers whilst awaiting sentence trial After sentence 1997 -251 / 2007 -394 Recalled after CD 106 / 210
Legal category /type of disorder Historical interest only? ? l In 1997 of the total of 1, 092 – – – l 975 mental illness 38 psychopathic disorder 28 mental impairment (4 severe) Of the 1458 in 2007 – – – 1215 mental illness 117 psychopathic disorder (highest ever) 40 mental impairment (5 severe)
Discharges l Absolute – l Conditional – – l l Real rarity –a handful each year By Secretary of State 29 / 80 By Tribunal 163 / 288 Most “ leave” through operation of criminal courts And a significant number die (49 in 2007)
Reconvictions A real shock upon first reading l l And a favourable comparison with prison /probation Two year follow up – – Over 1999 -2005 1% reconvicted of grave offences (2% all sex & violence) 7% all offences Slightly better figures if look at Sec. of State alone l 0% / 3%
Initial thoughts l l l Growing numbers Females a tiny portion Major movement between prison & hospital – l l But a tiny percentage of those with mental health problems Small numbers of discharges each year A conservative approach – Dictated by public / political opinion
Limited (restricted) legal function l l To discharge or not to Somewhat wider powers in non-restricted cases – l S. 72(3) –recommend leave / transfer and further consider if ignored 90% (? ) of cases actually / realistically (? ) pressing for informal, non-statutory recommendation
And…is anybody listening ? l Weight –parliamentary answer – – No feedback No monitoring More likely to listen to R. C. Even next tribunal may not know BUT IT SHOULD A relationship of “constructive tension” Silber J. SHOULD WE BOTHER ? SHOULD WE DO MORE ?
A strict (restricted) legal test l l l Snapshot on a day Mental illness –not even concerned with category Nature or degree –i. e may well have been stable long period Appropriate –a weasel word? Treatment –widely defined
The real problem Is there anything else ? l l Where can we discharge to –Hospital? Shortage of community resources – – l Hostels Placements A strict commitment to a stepped down approach Security – Leave THE CAUTIOUS APPROACH (apparently) PREVAILS –
Compounded by…. l The composition of the tribunal ? – l A challenged administration – l Criminal practitioner/ past or present RC/ the expert “lay” Listing / papers / clerks The nature of the proceedings – Adversarial /inquisitorial
And. . l The quality and presentation of evidence – – History predominates –is this justified? Not always those with the best knowledge Not always focussed Not always the best time l l Stress Clinical regime -CPA
And… l The influence of the Ministry – – – Stereotyped comments (Unjustified? ) insistence on right to comment Delays to progression l l – Leave Transfer Readiness to Review
Legal representation l l l Grossly underpaid The best are deserting No scope / funding for the independent expert Playing second fiddle to the would be advocates on the Panel But. . – – A lack of ambition – e. g. HRA / JR Inadequate preparation l l Notes Alternatives
Vested interests l l Pecuniary advantage? Social workers know best BUT REALLY A CINDERELLA SERVICE FOR PATIENTS WHO LACK PUBLIC SYMPATHY
An upbeat ending l l The Tribunals Service The new appeal regime The use of the deferred discharge The interest and importance of the jurisdiction
Any questions
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