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Care In The Community - One Size Does Not Fit All

ProfilePosted byOptionsPost Date

OneFootInTheGrave

OneFootInTheGrave Report 4 Mar 2013 12:48

A psychiatric patient who virtually decapitated a woman during a stabbing in a London street was found guilty of murder and she will be sentenced today.

Six years after killing her own mother, Nicola Edgington, 32, of Greenwich, killed Sally Hodkin, 58, in Bexleyheath in 2011.

The move to providing "Care in the Community" for psychiatric patients was in many ways a good idea as a lot of people were locked away when they should not have been. However the way it has been implemented by successive governments is one of the long list of "one size fits all" scenarios.

What happened to Sally Hodkin should have never have happened and those charged with the safety of the public from the Prime Minster downwards must take steps to ensure such an incident never happens again.

The public has a right to be protected from those who are known to be capable of this sort of action and those who are known to be capable of this sort of action have to be protected themselves to stop them from being able to carry out such actions.

My view and you may not like it, is that where a person who has a psychiatric problem and it is known they could be a serious danger to others or to themselves then they have to be put in a place of safety.

RolloTheRed

RolloTheRed Report 4 Mar 2013 13:31

Yeah, but that's the trouble nobody knows for sure.

The old habit of locking away anybody loopy was obviously wrong - nearly everybody goes off the rails a bit from time time. Modern treatment for the huge range of mental problems quite properly keeps people in the community as far as possible. Two big advantages are that people do not become institutionalized, brutalized and recovery is more likely. When residential care is deemed necessary then results can be very mixed.

So what about people who may do harm ?
It is not so easy as the Daily Wail and its seems to think.

Lots of people seriously harm and kill other people - bad drivers in a temper, drunk, texting or not paying attention, care home and health staff who neglect their duties, utterly sane people with agressive tendencies. Often times there is plenty of warning of lethal behaviour to come but they are not held in preventative custody just in case.

OK, let's say that being killed or maimed by somebody who has had and may still have mental problems is somehow worse than an attack by somebody sane. That is to say that being killed by a deranged woman with kitchen knives is worse than having your throat cut by a drunk with a smashed beer bottle. Dead is dead.

What can be done about it ?

Well the Daily Wail would say let's go back to locking up lots of people. Hmm - very expensive and uncertain. Attacks by people with mental problems will still happen. So lock up some more. And so on ad infinitum.

OK, incarceration won't work what else ?

Maybe if they are closely monitored and tracked it would help? Maybe, but who would do the monitoring ? An expensive psychiatrist ? That brings us back to the cost issue. Group4 et al ? They already dabble in this sort of thing with scant success. In any case tracking criminals with foor bracelets has been far from the panacea expected.

So nothing can be done ?

Not really with current knowledge unless you wish to go back to having a significant part of the population back under lock and key with all the expense entailed. Life is full of hard problems with no easy answers.

"
I been Norman Mailered, Maxwell Taylored.
I been John O'Hara'd, McNamara'd.
I been Rolling Stoned and Beatled till I'm blind.
I been Ayn Randed, nearly branded
Communist, 'cause I'm left-handed.
That's the hand I use, well, never mind!

I been Phil Spectored, resurrected.
I been Lou Adlered, Barry Sadlered.
Well, I paid all the dues I want to pay.
And I learned the truth from Lenny Bruce,
And all my wealth won't buy me health,
So I smoke a pint of tea a day.

I knew a man, his brain so small,
He couldn't think of nothin' at all.
He's not the same as you and me.
He doesn't dig poetry. He's so unhip that
When you say Dylan, he thinks you're talkin' about Dylan Thomas,
Whoever he was.
The man ain't got no culture,
But its alright, ma,
Everybody must get stoned.

I been Mick Jaggered, been silver daggered.
Andy Warhol, won't you please come home?
I been mothered, fathered, aunt and uncled,
Been Roy Halee'd and Art Garfunkel'd.
I just discovered somebody's tapped my phone.
"

Silly Sausage

Silly Sausage Report 4 Mar 2013 13:34

I have to agree with you, surely who ever decided that Nicola should live in the community hadnt taken on board the duty of care to the genral public more so that the poor girl had killed her own mother, she obvioulsy wasnt supervised correctly probably by some overworked social worker, but thats me assumming.

AnnCardiff

AnnCardiff Report 4 Mar 2013 13:56

she should never ever have been released after she killed her own mother

OneFootInTheGrave

OneFootInTheGrave Report 4 Mar 2013 14:30

Hayley Empress of Drama, your comment "obviously wasn't supervised correctly probably by some overworked social worker" could have a lot of bearing on the issue.

I know from a friend who was a community psychiatric nurse that she felt that she had an impossible case load to deal with. She packed it in a few months ago as her workload had reached the point that she could no longer provide the level of care that her patients needed, she went back to work in a general hospital.

To few resources and to little time appears to be a common occurring in relation to many, social workers, community nurses/health workers, care workers, and home helps, not enough hours in the day to do their job properly, and to many targets to meet.

If care in the community is to work then it has to be properly resourced to ensure that each individual receives the full care and attention that their particular problem requires.

As the nurse I know said, to often it is a, quick hello, how are you today, goodbye, see you tomorrow, and don't forget to take your medicine :-(

AnnCardiff

AnnCardiff Report 4 Mar 2013 14:54

the NHS - too many chiefs and not enough Indians - always has been the way and always will be until someone with some common sense steps in and sorts it out - all these departmental heads with their own little empires - assistants with assistants

OneFootInTheGrave

OneFootInTheGrave Report 4 Mar 2013 15:02

AnnCardiff - don't forget their clipboards and expenses, they would be lost without them :-D :-D :-D

ChrisofWessex

ChrisofWessex Report 4 Mar 2013 15:35

Mental Health has always been the poor relation in NHS. Closest friend was a mental health Social Worker who always worked in Mental Hospitals. She had to retire in her mid fifties having been told that she was 'burnt out'. She always said she found her work very interesting but exhausting.

The medical staff in this field fought against all being returned to live in the community.

AnnCardiff

AnnCardiff Report 4 Mar 2013 16:15

too true - I worked in our local psychiatric hospital for nigh on thirty years - always bottom of the pile when it comes to spending money - things were not too bad unil we went Trust with the largest teaching hospital in Wales - they were broke - we had plenty of money having always had a good accountant - the minute we went Trust the University Hospital of Wales, flat broke at the time, took all our money to cover their backs and left us in debt. No longer do long term mental health patients get birthday presents or taken on outings - the mini buses bought by the Friends of the hospital have long gone - I could go on and on and on

+++DetEcTive+++

+++DetEcTive+++ Report 4 Mar 2013 16:31

Nicola Edgington has paranoid schizophrenic with a personality disorder. She was treated successfully in a secure psychiatric NHS hospital after murdering her mother. She was released when it was deemed that her condition was stable and controlled with medication. Community support workers were in place.

The system let her down.

The day before she committed the second murder, she knew that her condition was deteriorating. She tried to contact her support workers. When that failed, she tried to get herself admitted to the Psychiatric ward of a local hospital in Greenwhich. She was left alone while staff discussed her request/tried to get hold of her medical history. During this time, she walked out.

Like many NHS Trusts, Oxleys where she was previously treated, are shedding staff. They have already wasted a lot of money trying but failing to merge with a neighbouring one. It’s the front line staff and those depending on them who suffer.

Care in Community can work. Patients can also ‘work the system’ to the extent that the Staff on the wards strongly suspect that they will probably reoffend but the patients have ticked the right boxes. Unfortunately, you can’t incarcerate an NHS patient indefinitely just in case they might do so.