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England and Wales High Court (Administrative Court) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Secretary of State for the Home Department, R (on the application of) v Mental Health Review Tribunal & Ors [2004] EWHC 1029 (Admin) (07 April 2004) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2004/1029.html Cite as: [2004] EWHC 1029 (Admin) |
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QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
Strand London WC2 |
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B e f o r e :
____________________
THE QUEEN ON THE APPLICATION OF SECRETARY OF STATE FOR THE HOME DEPARTMENT | (CLAIMANT) | |
-v- | ||
MENTAL HEALTH REVIEW TRIBUNAL | (DEFENDANT) | |
VICTOR WILSON | ||
NOTTINGHAMSHIRE HEALTHCARE NHS TRUST | (INTERESTED PARTIES) |
____________________
Smith Bernal Wordwave Limited
190 Fleet Street London EC4A 2AG
Tel No: 020 7404 1400 Fax No: 020 7831 8838
(Official Shorthand Writers to the Court)
MR STEPHEN KNAPP (instructed by Peter Edwards Law) appeared on behalf of the DEFENDANT
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Crown Copyright ©
"An application for admission for treatment may be made in respect of a patient on the grounds that-
(a) he is suffering from mental illness, severe mental impairment, psychopathic disorder or mental impairment and his mental disorder is of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital; and
(b) in the case of psychopathic disorder or mental impairment such treatment is likely to alleviate or prevent a deterioration of his condition; and
(c) it is necessary for the health or safety of the patient, or for the protection of other persons, that he should receive such treatment and it cannot be provided unless he is detained under this section."
"Where an application to a Mental Health Review Tribunal is made by a restricted patient who is subject to a restriction order, or where the case of such a patient is referred to such a tribunal, the tribunal should direct the absolute discharge of the patient if-
(a) the tribunal are not satisfied as to the matters mentioned in paragraph (b), (i) or (ii) of section 72(1) above; and
(b) the tribunal are satisfied that it is not appropriate for the patient to remain liable to be recalled to hospital for further treatment.
(2) Where in the case of any such patient as is mentioned in subsection (1) above-
(a) paragraph (a) of that subsection applies; but
(b) paragraph (b) of that subsection does not apply,
the tribunal shall direct the conditional discharge of the patient."
" ... the tribunal shall direct the discharge of a patient liable to be detained otherwise than under section 2 above if they are not satisfied-
(i) that he is then suffering from mental illness, psychopathic disorder, severe mental impairment or mental impairment or from any of those forms of disorder of a nature or degree which makes it appropriate for him to be liable to be detained in a hospital for medical treatment; or
(ii) that it is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment."
"The Tribunal is/is not satisfied that it is necessary for the health or safety of the patient or for the protection of other persons that he/she should receive such treatment."
It is significant to note in the instant case it also drew a line through "(c)" which reads:
"The Tribunal is/is not satisfied that it is appropriate for the patient to remain liable to be recalled to hospital for further treatment."
"His apparent lack of remorse or distress when apprehended is, in my view, likely to be a dissociative reaction, that is neurotic rather than psychotic in origin. His pleasant and uncomplaining persona could also be seen as dissociation in painful reality. Since he has not been formally assessed, I cannot refute the diagnosis of personality disorder and his classification of psychopathy. It is clear that he is adamant in his refusal to engage in treatment and is highly unlikely to make any progress in this direction whilst in the hospital system. Since no work has been done on the index offence or relationships in general, one must assume that Victor Wilson remains a danger to woman were he to be released into the community. I anticipate that he will be granted the opportunity of a trial and, in my opinion, he is fit to plead. Meanwhile, he is, in my opinion, appropriately detained under section 46 of the Mental Health Act 1993 in order to prevent a deterioration in his condition and subsequent risk to the general public."
"In her oral evidence she said that she would come down on the side of personality disorder, because of the length of the dissociative reaction. She later stated that she was satisfied that there was a personality disorder although there was very little to back this up, but that on balance she was satisfied."
"We have considered this evidence carefully, as well as the full RMO report [which I have cited], and have looked for other substantive evidence. We have not found such evidence and we conclude that the evidence before us is not sufficient to satisfy us that the diagnosis of psychopathic disorder within the meaning of the Mental Health Act 1983 is made out. The argument made on behalf of the patient was that the issue was borderline, and that while it was understandable that the RMO was able to draw her conclusions, the opposite conclusion could also be reached, but nevertheless, because of the borderline issue, did not argue that the patient did not fit into the psychopathic disorder category.
We have explained the reasons why we have reached our conclusion that we are not satisfied about categorisation, but there are also further determinative points even if we had concluded differently with regard to diagnosis. They proceed on that alternative basis."
The Tribunal then went on to consider an alternative basis.
" ... he is highly dangerous, and that the prospect of his discharge into the community would be terrifying, but that the hospital cannot give him treatment; the hospital could prevent deterioration by continuing his custody but that he does not need to be in hospital although he does need to be detained. This prevention of deterioration was simply by detaining him and allowing him to continue his coping strategy. We agree that, given an acceptance of mental disorder, this situation does not met(sic) the statutory requirement that we should be satisfied that he needs to be detained in hospital for treatment. We find that it is the fact that he has not been detained in hospital for treatment because the medical opinion is that he is not treatable. It is appropriate to note here with regard to the RMO's concern about release to the community the further adverse points that the patient has not engaged in any work in relation to his offences and the relevance of this to risk in the community, and the RMO's concerns about the upsetting effect of release into the community after so many years in detention.
The result of the above reasoning is that we conclude that the patient should be discharged."
" ... also wide enough to include treatment which alleviates or prevents a deterioration of the symptoms of the mental disorder, not the disorder itself which gives rise to them."
Earlier, Lord Hope had said:
"If the sheriff is satisfied that medical treatment in a hospital is not likely to alleviate or prevent a deterioration of the patient's condition, he must direct the patient's absolute discharge."
"Given the clear danger of release into the community, our decision that the patient be absolutely discharged, conditions having no valid part to play in the circumstances of this case, and the patient's own wish to stand trial and plead guilty, we find it appropriate that discharge should not take place until 12 weeks from today in order to allow the Home Secretary to review his position in these changed circumstances."