Improve Standards of Care or the Deaths Will Continue; (1) AS MENTAL HEALTH CRISIS DEEPENS, AN URGENT WARNING FROM PSYCHIATRISTS (2) Violent Loners and Their Families Who Live in Fear

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SEVERELY ill mental patients will continue to kill in the community unless they urgently receive improved care, an inquiry will warn today.

More and better-trained medical staff, as well as extensive and higher-quality accommodation, are needed to prevent a deepening crisis in mental health services, says the Royal College of Psychiatrists.

The report, commissioned by the Department of Health, attacks the current care in the community programme and blames 13 of the 39 killings by released psychiatric patients on a failure to supervise them after their release because of inadequate staffing levels.

Staffing was so low that, in some cases, doctors had become `inured to inadequate conditions of practice and do not complain through disillusionment'.

The report, ordered after the killing of an 11-year old girl in Doncaster by a mental patient in 1991, will warn that only more resources for looking after the mentally ill can reduce the risk to the public and to patients themselves.

A shortage of of beds in secure units meant that often patients known to be potentially violent had to be sent back into the community.

Clarification of the role of consultants and other carers for the mentally ill are also essential to improve care and supervision of severe cases, says the report.

Clinicians particularly should be better trained in assessing the risk of patients becoming violent - many often felt that homicide had been `totally unpredictable'.

They should also be trained in the use of legal powers available under the Mental Health Act, which include detaining patients against their will.

Many patients who killed or committed suicide had lost contact with the mental health services or were refusing to comply with treatment, the inquiry found.

The team, composed of leading psychiatrists and health officials, notes: `We are left with an uncomfortable feeling that more strenuous efforts to insist on maintenance of contact might have been rewarded with fewer deaths.'

Chairman Professor Andrew Sims says there `is no particular culprit for this sorry state of affairs but there are grave lessons for the Department of Health, clinicians and health authorities in our findings'.

Responding to the report - based on a study of 39 homicides and 240 suicides - Health Minister John Bowis said there was `no evidence' that the number of killings or suicides by patients from psychiatric hospitals was increasing. …