Friday, May 03, 2013


I wrote some time ago about a regular customer whom I have been seeing on and off for almost two decades. He was back yesterday, for the usual pain-in-the-arse misbehaviour. As luck would have it our duty psychiatrist was at court, so he examined Daniel, and addressed us about what he had found.
The years have not been kind to the old man, and he is more confused than ever, but still has the capacity to flare up.
The system is not very good at handling mental illness, although it afflicts quite a high proportion of the people we deal with. We remanded him for reports, in the hope that he will be transferred swiftly from a prison environment to an NHS one.


  1. I hope that is a misrepresentation. Surely there are strict rules on when you remand someone and "hoping" that it is a route to NHS services is surely not one of them. If he needs held for mental health reasons then there are processes but remand in not one of them.

    1. The court was addressed by a consultant psychiatrist and we accepted his advice. NHS resources are so stretched that we cannot automatically assume that a bed might be available.

    2. So consultant psychiatrists are effectively making sentencing decisions - wow! And the reasoning was because the NHS might not have space for him - double wow! If I break my leg tonight I might see if I can get lifted in the process - cut out the NHS and get to a prison medic!

    3. Don't be silly.
      This was not a sentence, it was a remand decision.
      We were faced with an obviously troubled man. The court needs a professional report on his condition to inform its decision, and that will now be prepared. The doctor told us that if we remanded our man into custody, a transfer from the prison hospital to an NHS one might be possible.
      I cannot say any more about this case, except that I am sure that he will be treated justly and compassionately.

  2. Crimminal justice system person7 May 2013 at 09:58

    @ anonymous. The bench decides but is given indpendant advice from registered mental health professionals. In this case a Consultant, who incidentally, has the power to request the court to section somebody. In practical terms where there is a mental health issue and a bail decision, benches are in a difficult position. they must protect the public but don't have the ability to secarch around for a secure hospital there and then. Prisons have hospital wings and in the case of remands, in order to protect the public, sometimes that the best that can be arranged at short notice.

  3. Bystander - sorry but the prospect of him being transferred from a prison to a hospital is non existent. I used to believe that I would be able to get this arranged for clients but only once in many years practice have I ever managed it. It is terribly sad but there is no hope of him being transferred. You have not said exactly what the psychiatrist said but I expect that to arrange the transfer you will need a report from a second mental health professional as well. That tends to be when it all comes unstuck because it is the second psychiatrist who has to confirm that a bed is available. Because of the pressures on the NHS that you rightly refer to, even getting a second report, especially when the court order it, is sometimes a hopeless task. The reason I mention the court ordering the report is because if I remember correctly, there are strict limits on the amount the court can pay and psychiatrists won't provide a report for the sum that you can spend. To add to the fun, the way round this - i.e. getting the defence to organize the report and incur it as a legal aid disbursement is also difficult now that the LAA have reduced the amount that they will pay.

    I do hope that I am wrong about all this and your chap gets the treatment and help that he obviously needs. Keep us updated please.


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