Dennis Sterling was detained to Broadmoor Hospital almost sixteen years ago and in early 2021 was already subject to a restricted hospital order after a series of violent and sexual attacks, which includes a violent sexual assault on a Broadmoor nurse in 2012. In February 2021, there was an incident which led to further prosecution which was recently finalised at Reading Crown Court.
Mr Sterling was accused of racial abuse towards staff which then led to him excreting on the hospital floor and causing £7,000 of damage to the hospital itself. Most concerningly, he was charged with occasioning actual bodily harm after he slashed a staff member’s face using a piece of plastic. The outcome of the legal proceedings was an absolute discharge which means guilt is established but there is no further consequence beyond that conviction and the impact of the process itself.
The Crown Court judge, Amjad Nawaz decided upon this course of action due to Sterling already having an indefinite hospital order for the much earlier offending.
WHAT’S THE POINT?
You might wonder what the point of a prosecution would be for someone who is already detained indefinitely or what the point of an absolute discharge would be, given it means nothing happens beyond the process itself? – they are perfectly fair questions and we need to think about the short-term impacts (ie, in the hospital itself) as well as the longer-term potential.
In the short-term, there may be something to be argued about an immediate consequence for actions. £7,000 is a lot of damage that you and I are now paying for and if we caused that damage in our street or our local A&E department, we would probably expect prosecution for that conduct. There is also something to be said for deterrence: demonstrating to that patient and others (whose circumstances will not be identical, no two people’s are) there will be consequences if your assault NHS staff and caused broader, disgusting disorder which potential compromises health. Also, it can’t have been known at the decision-making stage that an absolute discharge would be the outcome. In other situations where inpatients are prosecuted, we see the imposition of fines by the courts, subject obviously to the financial circumstances of the defendant. Some Mental Health Act patients are in receipt of benefits whilst detained and have been fined substantial sums to compensate the hospital, as victim, for the repairs costs for damage – compensation has sometimes been ordered to individual victims, like other patients or staff.
In the longer-term, where offending is more than trivial, there are other reasons to take seriously complaints of criminal conduct like this. Firstly, a new conviction in 2023 will be relevant to decisions take about how the patient is managed (ie, high or medium security, etc.) or to the decision by the Secretary of State’s Mental Health Unit about authorisation of leave from hospital or conditional discharge. Prosecution is never done for the sole purpose of influencing risk assessments of this kind, but where further offences have been committed by patients, they are relevant to risk-based decisions. Behaviour in hospital indicating risk can be taken into consideration anyway, but where it has been necessary to prosecute arising from that behaviour and has led to criminal conviction, it can be taken more seriously still as indicating further risk to the staff or the public. There are also considerations around how further offending influences Multi-Agency Public Protection Arrangements.
MENTAL HEALTH AND CRIME
Due to this year’s emphasis on the police role in mental health, I’ve been thinking a lot about crime and mental health. As a consequence of the 2018 HMIC report Picking Up The Pieces and the first National Strategy on Policing and Mental Health (2020), the Right Care, Right Person initiative has focussed on the police role in what I might call “crisis care” situations, ie, mental health matters unrelated to crime. But the 2020 strategy aimed to highlight two problems: yes, the crisis care stuff, but also, the crime related demand the police service sees. The argument put was the police are over-involved in crisis care, but they can be under-involved in mental health related crime. We see this in research on those of us who with mental health problems who were victims as well as with those accused of offending.
One concern voiced by charities like Mind about this year’s discussion, are reports the police increasingly see all mental health demand as something for “health”, as if all offending by those of us affected by our mental health is explained by our mental health. We know this is not true – sometimes mental health issues are causal in driving offending behaviours but often they are at best, contributory and often, coincidental to the offending. Nothing in law, prevents the investigation or arrest and the prosecution and conviction of someone who is mentally ill to such a degree they require hospital detention under the MHA, as Mr Sterling obviously does in the example, above. Whether you investigate and arrest or prosecute and convict are quite separate matters.
Public policy on this is relatively simple and I summarise here: the more serious the offending or the risk, the less relevant someone’s mental health problems are to the decision to prosecute. Yes, an offender’s mental health and the potential impact upon them are factors tending away from prosecution, but that needs careful consideration against the public interest which includes for example, victims who are serving the public, the use of weapons, the offender’s background of offending and the need to impact on behaviour which is prevelant in that area, etc. Mental health and crime is complicated: it needs careful consideration with an open mind and knowledge about what the value may be of allowing courts to decide these issues in possession of the full information.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2023
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 