Jim MacKeith was a remarkable forensic psychiatrist who convinced the judiciary of the frailties of confession evidence and demonstrated clear connections between indefinite imprisonment without trial and mental breakdown. He displayed a lifelong determination to place his own psychiatric professionalism in a moral and humane context.
His father was a doctor who was anxious that his son, James, the eldest of six children, born in 1938, follow the family profession. But at Epsom College, Jim failed to shine at either O- or A-level and found most medical schools closed to him; so he went to Trinity College, Dublin, to study literature on a flexible degree course that enabled him to study medicine there later.
His early life in Dublin turned out to be a welcome escape from his Calvinist pedigree. It shaped his character and nurtured radical instincts; he gained early forensic experience when he sued the Dublin police after being arrested and bitten by a police dog during a demonstration against the 1961 "Bay of Pigs" invasion of Cuba; and after he had returned to England and completed his psychiatric qualifications, he opted for five years' solid practical work at the interface between custody and mental illness - first in Brixton Prison and then in Broadmoor maximum security hospital.
This proved valuable grounding for putting policy into practice when he became a consultant at the Maudsley Hospital, London in 1977. The Home Office and the health ministry were looking for a half-way house between maximum security special hospitals like Broadmoor and regular mental hospitals where patients and visitors mingled freely. Setting up these "medium secure units" was a delicate task at a time when unions were powerful and Whitehall was unaccustomed to innovation. So the task of implementation was handed over to doctors. MacKeith and his colleagues spent day after day working out compromises between security and therapeutic solutions to develop an environment in which staff could work effectively and patients could be properly treated.
While engaged in this project, he began a long and creative relationship at the Institute of Psychiatry (the partner research unit of the Maudsley) with a young Icelandic researcher, Gisli Gudjonsson, which would, over time, transform the way in which the courts approached confession evidence.
In 1980 when they met, legislation was already being drawn up to reverse the burden of proof in court: under the Police and Criminal Evidence Act (1984), the defence no longer had to disprove police accounts of what the defendant was alleged to have admitted; for the first time the prosecution had to prove that confessions were reliable.
The research of MacKeith and Gudjonsson helped underpin this procedural change by demonstrating to judges why some confessions were so unreliable. At the time many courts were still treating psychiatric evidence with something approaching contempt and clinging to outdated concepts of mental incapacity - a condition which in the 19th century had been defined by pseudo-scientific words like "idiot" and "imbecile" and in the 20th by equally meaningless IQ scores. The research partnership - and especially the empirical measurement of "suggestibility" developed by Gudjonsson - swept all that aside not just in England but worldwide. As judges became more sceptical about confessions, police fabrication of them diminished.
During the 1980s it slowly dawned on the British public (though much more slowly on its government and its courts) that …