I read a throw-away remark on Twitter this week, about mental health professionals – specifically psychiatrists – being the experts to determine whether or not someone’s mental health condition has caused offending behaviour or whether it was quite coincidental. This self-evidently obvious statement is, in fact, quite wrong! It is, ultimately, a matter for courts, not psychiatrists to determine such things. Specifically, it is a matter for inexpert juries of lay people who may have to wade through complex, contradictory material relating to psychiatric diagnosis and reach a view about what was going on inside someone’s head at the time of an offence.
We’ve seen this in several fairly high-profile trials over the last year or so – here are just a couple of examples –
1. Nicola EDGINGTON – prosecuted for murder and attempted murder whose offer to plead guilty to manslaughter on the grounds of diminished responsibility was rejected and a full murder trial held. The jury rejected her argument and convicted her of murder.
2. Aras HUSSEIN – prosecuted and tried for murder, also having offered plead guilty to manslaughter on the grounds of diminished responsibility. The jury found him guilty of murder and he was sentenced to prison despite acceptance that he had serious mental health problems.
Meanwhile, the Appeal Courts also have a role to play in getting this right. It has been known that following convictions for murder, defendants return to the higher courts to present new evidence. In the infamous case of farmer, Tony MARTIN – the man who shot a burglar in Norfolk – the Court of (Criminal) Appeal substituted a conviction of manslaughter on the grounds of diminished responsibility after hearing new evidence. This was also true of James PETROLINI, who was convicted of murder along with another man. The irony of this latter case, is that upon the Appeal succeeding, his prison sentence was replaced by a restricted hospital order. The timing meant that as his accomplice was released from 18yrs in prison, he was moved onto an order which guaranteed his indefinite detention until the psychiatrists in charge of his care and the Ministry of Justice were satisfied it was safe and appropriate for him to be released!
GRADES OF RESPONSIBILITY
So the law has a suite of checks and balances to keep challenging outcomes and a range of verdicts to suit different kinds of relationship that some defendant’s mental health has to their offending. We saw during 2013 that the man who attacked PC Adam KOCH in a Birmingham mosque was found not guilty of attempted murder by reason of insanity. This occured relatively soon after another attack against police officers in London led to the conviction of Christopher HAUGHTON for the same offence of attempted murder, despite the fact that he was so unwell that he was eligible for detention under the Mental Health Act from the point of the committing the offence, right through to sentencing. In other words there are three kinds of relationship between offending behaviour and mental health, according to the law —
- Not guilty by reason of insanity – a defendant is not criminally convicted for their actions.
- Guilty on the grounds of diminished responsibility (alternative only to a charge of murder) – responsible for actions, although liability is diminished because of mental ill-health.
- Guilty as charged – fully responsible for actions, notwithstanding evidence of mental ill-health.
It is a feature of law, however, that whichever of the outcomes is reached, there is just one likely outcome: a restricted hospital order. This outcome is also likely if the prosecution case did not get as far as a trial because of a defendant having been found unfit to plead or stand trial. It remains a likely outcome for convicted defendants, too – only those convicted of murder will be sentenced to a mandatory prison sentence and even then: there is still provision within the Mental Health Act to transfer such prisoners to hospital, if required.
The point of this short post is twofold — to ram home again and again, that all of these complex decisions are legal issues for juries, courts and legal officers, not medical issues for psychiatrists. Of course, it is right and proper that those providing care for vulnerable people have a say in the process but we also know that psychiatric opinion can differ and that the resolution of all of this is the trial process and the ultimate arbiter: a jury. The second purpose is to show that when trusted to get on with it, juries sometimes go with the flow, the sometimes forge their own path through the evidence and regardless of which, the higher courts exist to challenge outcomes or hear new evidence.
I rather like our legal system in this respect – I’d even say I’m very proud of it and we should remember: it is the basis for the mental health and criminal justice interface the world over.
Winner of the Mind Digital Media Award.