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Care Less in the Community - Why Care in the Community isn't working (7 March 2011)

By Rubin Italia

We in crime, continue to deal at ever increasing rates with individuals who have mental health difficulties but are living within the community. Regrettably the support systems that are supposed to be a primary care point for them appear to be failing everyone.

There are a number of real examples that illustrate the point more clearly. An individual is arrested for a minor criminal offence. He suffers from Paranoid Schizophrenia, has no recollection of the offence. The facts are that he is alleged to have thrown an empty bottle at a stranger, which lands on the complainants arm and smashes. The defendant has a mother and father but does not live with them due to his psychiatric difficulties.

After charge we raise the issue with his psychiatric team. They are reluctant to assist at all. In the interim the client over different dates continues to offend and again his recollection is hazy at best. The client is assessed as to whether or not he is fit to plead and stand trial. Although the independent psychiatrist confirms that the client is not fit to plead he has problems obtaining information from his psychiatric team His mental health social worker and doctor both confirm that they do not believe he is unfit to plead, a clinical judgment. However more offending occurs. His mother a mental health nurse is so concerned; she writes a letter to the court on one of the matters.

The client fails to attend 2 hearings for 2 separate matters, unsurprisingly despite us writing and even speaking to him. He is then arrested and due to the number of offences, is placed in custody. He is again assessed. His condition has deteriorated to such a level that he is not fit to stand trial. This is not an isolated case, there are others all that appear to have the community care team either not assessing the client at all or trying to assess him. In another case the client lived in a mental health hostel opposite the mental health unit. His condition was chronic yet no member of staff was able to assist as to why an assessment was not being conducted.

The list goes on. A recent client has 5 matters outstanding at different courts all for similar matters but his doctor has only now tried to see him, as he is now in custody.
The situation is as frustrating for the clients as it is for those defending them. The Crown Courts deal with such matters in a better way; partly due to legislation, which is better placed for mental health offenders but sadly the Magistrates Courts have often been slow to appreciate the complex rules relating to such offenders.

What can the defence do when they are met with such situations that can affect both the progress as well as the health of the client?

Not being afraid to report what we perceive is inappropriate behaviour on the part of health care professionals is sometimes an approach that can reap benefits to the client and further his case, supervisors and partners are can help the rest of the team in making this judgement.

The only thing we, as criminal defence lawyers, can do is be as knowledgeable in an area where, a thorough appreciation of the legislation and procedure cannot be underestimated as well as ensuring that particularly vulnerable clients receive the correct treatment in the end. It can be frustrating as you often feel that you are not dealing with the prosecuting authority but also a mental health team, which are sometimes found wanting a client who is as vulnerable as they come.