Last nightâ€™s episode was a belter wasnâ€™t it? â€¦ see Channel 4 â€˜catch upâ€™ on the internet, if you missed it: 10pm on 25th June. Â It was right up my alley â€“ Nyaar St Juste rang the police telling them to come with shovels because there was a body in a garden. Upon arrival officers arrested him because he had failed to turn up to Luton Crown Court the day before and whilst he was in custody he was interviewed, not as a suspect, about the call he made regarding the body in the garden. Police were making enquiries in to it all, which started to suggest he may have been the one to dig the hole and nothing was found to suggest a crime. He was taken to court, released by the judge on bail and stabbed his mother causing his brother to ring the police and report the whole thing.
Thus an attempted murder investigation began. Because of the way he was presenting with limited communication, whispers and unusual demeanour, the custody nurse quite rightly sought a mental health assessment, for which he had to be taken to A&E due to delays in custody that started to affect the investigative â€œPACE clockâ€, which governs the amount of time the police have to hold someone under investigation without charging them with any offence. The mental health assessment â€“ implied to have been a Mental Health Act assessment for potential admission to hospital, but this wasnâ€™t precisely clear â€“ concluded, according to the officers that he wasnâ€™t unwell but that in any event, if he were, that they didnâ€™t have any secure beds anyway, which would have been the type required.
By this point, we now have the mental health and criminal justice systems bumping up against each other: the inability of Bedfordshire Police to secure assessment within timescales which fit the investigative framework and I was now also starting to wonder about the mental health response. At the risk of appearing to jump to the end of this story, Nyaar does ends up â€˜sectionedâ€™ (in the words of the programme) by a criminal court after being found not guilty by reason of insanity. Precisely, this means he was given a restricted hospital order, known sometimes as a â€œsection 37/41â€ order â€“ detention in hospital for treatment and unable to be released, granted leave or transferred between mental health hospitals without the authorisation of the Secretary of State for Justice because he poses â€œa risk of serious harm to the publicâ€. And his â€˜insanityâ€™ relates to his mental state at the time of the offence, not his mental state at the time of trial. He was in custody immediately after the incident, so it seems likely to me he would have been â€˜sectionableâ€™ at that point. But what do I know?!
What I do know is, it wouldnâ€™t be the first time we see mental health services assessing someone who could be admitted to hospital under the MHA and concluding that they canâ€™t be. And this episode shows an example of what I call the criminalisation contingency â€“ you need X kind of mental health care but you canâ€™t have it unless the police prosecute you. Think parity of esteem: imagine the police response to a drink driver who crashed his car in to a brick wall, breaking his legs and smashing his head off the interior, causing a serious head injury. Imagine if either ambulance or police said, â€œWell, he obviously needs A&E, orthopaedic operations and a head injury assessment but he canâ€™t have any of that until the police prosecute him.â€ Weâ€™d all be up in arms and the police and paramedics sacked for gross negligence. Different in mental health, though â€“ isnâ€™t it?!
And the episode shows what can go wrong, if this is what happened â€¦ because the initial CPS assessment was, â€œthere is insufficient evidence to charge.â€ Which means he should be released. So what if it were true, as seems possible, if not likely â€“ that he could have been sectioned but they chose not to do so because it was assumed the police will be able to prosecute him and then the police couldnâ€™t gather sufficient evidence?! You could hear the anxiety in the words of the officers as they contemplated all of this â€“ it got so worrying that we even heard an Assistant Chief Constable asking if the police couldnâ€™t just â€œemergency charge himâ€, which they canâ€™t. Thatâ€™s not a thing once youâ€™ve taken CPS advice. No doubt, all due to the horror of releasing someone.
A brief word on hearsay evidence, for those who donâ€™t know what that means. Charlie, Dave and Steve are in a pub one evening: Steve asserts that the football World Cup is beneath his contempt, full of cheats who are diving all over the pitch making any attempt to watch it entirely unbearable and that rugby is a far superior game. Ardent football fan Dave punches Steve to reinforce a stereotype and teach him a lesson for his candid insights. Charlie then rings the police and says, â€œDave just punched Steveâ€. Whether Dave is still on hand to hear this and react or challenge the assertion, as he sees fit, will determine whether or not it is admissible evidence against him. If Dave legged it as soon as he knocked Steve out, as Charlie was making the 999 call and was down the road towards the taxi rank before that allegation was verbalised, will determine whether itâ€™s hearsay evidence which is not normally admissible in a criminal court. Same applies when the police or paramedics turn up to treat Steve: if he comes round and says, â€œDave punched me after failing to understand how rugby is a far superior gameâ€, this will not be directly admissible against Dave if he had already left the scene.
So in this case, Nyaar is alleged to have stabbed his mother, his brother makes the call to the police (hearsay) and the victim and brother repeat the allegation to paramedics (hearsay) â€“ you can see how it starts to become problematic as direct evidence. Itâ€™s useful information, but not direct evidence. Then they find a knife in the property that has blood and DNA on it â€“ well, if you DNA tested all the knives in my kitchen, youâ€™d find two or three traces of DNA on there, albeit hopefully no human blood. Doesnâ€™t prove anything, of itself, though. If you found my DNA on one of my knives and human blood, it doesnâ€™t mean that I stabbed anyone â€“ it could have been my wife or son who did it and youâ€™d still expect to find my DNA.
So we have police hoping MH services might be able to â€˜sectionâ€™ Nyaar; and mental health services potentially assuming the police will be able to charge him â€“ if the latter is not true, MH services having said heâ€™s not sectionable and in any event they didnâ€™t have a bed, creates something of a problem doesnâ€™t it?!
Imagine if the police had NOT won their appeal against the CPSâ€™s original decision not to prosecute?! Release â€¦
This kind of case is not isolated â€“ we hear all the time of serious crime allegations where MH services really want the person prosecuted immediately, regardless of mental state or any care needs identified during a mental health (Act) assessment. I wrote about this only recently after some questions arose following a talk I did to Approved Mental Health Professionals about MHA assessments in police custody. The punchline being â€”
What I didnâ€™t see on #TwentyFourHoursInPoliceCustodyÂ was evidence of close communication between whoever it was that did the mental health assessment at hospital and investigators and in any event, why would police investigators challenge and how could police investigators challenge any decision made, if they werenâ€™t there to discuss matters? Â They may not be able to work out whether it is a genuine clinical view that thresholds for admission are not satisfied, or whether assumptions are being made about â€˜going down the forensic routeâ€™.
So, some brief advice for investigators and custody sergeants who are faced with the potential situation that MH services may be implicitly relying upon the idea that the police will prosecute someone for something â€”
And then just bear in mind, and Iâ€™m not sorry for repeating this as police officers are told this very routinely â€”
All comes back down to three things â€”
Winner of the Presidentâ€™s Medal from
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award.