Lousia Ovington independent investigation report ... - NHS North East

More documents

Recommendations

Info

CHAPTER 8 – USE OF THE MENTAL HEALTH ACT AND COMPLIANCE WITH THE CODE OF PRACTICE 128 Louisa Ovington spent living in the community after the lifting of this detention the authorities remained under a specific duty to provide her with care, in addition to their general duties under community care legislation and under the CPA. It appears from the records that a CPA meeting was held on 21 February 1996 to plan for Louisa Ovington’s discharge, although the panel has not seen the record of the meeting itself. Despite several short admissions to hospital, the Mental Health Act was not used again until June 1998. On 30 May 1998 Louisa Ovington was remanded to Low Newton Prison, Durham, on charges of theft, threats to kill, possession of a bladed article and criminal damage. Serious concerns were expressed about her mental state and on 5 June 1998 she was transferred to the Tony White Unit at the County Hospital Durham under the care of Consultant 5, under Section 35 of the Act, to enable a report to be prepared on her mental condition and a recommendation as to sentence. Section 35 enables a court to remand a person to hospital, for up to 28 days, for a report to be prepared. The period can be renewed, for 28 days each time, to a maximum of 12 weeks. COMMENT This seems to have been an appropriate use of Section 35 and properly implemented. There must have been one renewal as the matter did not come back to court for sentence until 17 July 1998. Consultant 5 expressed his view that Louisa Ovington was suffering from a mental illness and personality disorder and recommended that the court should make an order under Section 37 of the Act ( often known as a ‘hospital order’) so that she could receive treatment in hospital. Section 37 provides that a court can, on conviction for an imprisonable offence, authorise an admission to and detention in hospital provided certain criteria (as to the existence of mental disorder and appropriateness of the admission) are met. On 17 July 1998 an order was made under Section 37 and Louisa Ovington returned to the Tony White Unit for treatment. She remained under Section 37 until she was transferred to St Nicholas’ Hospital in January 1999. COMMENT Again, this seemed to be an appropriate use of Section 37, properly implemented. Section 37 is often accompanied by a ‘restriction order’ under Section 41- an order made by the court restricting the patient’s discharge, transfer, or leave from hospital without the consent of the Home Office. The order can only be made where it is
CHAPTER 8 – USE OF THE MENTAL HEALTH ACT AND COMPLIANCE WITH THE CODE OF PRACTICE necessary to protect the public from serious harm. This was not thought appropriate at the time. Section 37 is not a time limited order, but carries safeguards (not available under Section 35), including an ability to apply both to the Hospital Managers and to a Mental Health Review Tribunal for the detention to be reviewed. Additionally the responsible psychiatrist must discharge the patient when the criteria are no longer met. Louisa Ovington did apply to the managers, but her detention was upheld. She also wrote to the Mental Health Act Commission, who at the time had responsibility for monitoring the conditions of detained patients. While at the Tony White Unit Louisa Ovington’s behaviour had been extremely disturbed and she was charged with assault occasioning actual bodily harm on a member of staff. It was apparent that the Tony White Unit was not the right place for her and lengthy discussions took place between Consultant 5 and Consultant 9 at St Nicholas’ Hospital. Consultant 9 agreed to take Louisa Ovington into the forensic secure unit at St Nicholas. However his view was that rather than transfer her under Section 37 (a ‘Hospital Order’), the court should be asked, when the matter of the Assault Occasioning Actual Bodily Harm came before them, to impose a Section 38 ‘Interim Hospital Order’ under which a person who has been convicted may be detained in hospital to allow further examination and consideration of the need for a hospital order’ The order must be renewed by the court every month and can only last for a maximum of 12 months. On 13 January 1999, the Section 37 order was discharged, a Section 38 order imposed by the court and Louisa Ovington was transferred to St Nicholas’ Hospital. COMMENT Initially this seemed illogical to the panel - normally Section 38 would precede Section 37, not follow it. The provision was apparently included in the Act to enable doctors who may only have had a brief time to examine the offender to have ‘the response in hospital evaluated without any irrevocable commitment either side to this manner of dealing with the offender should it prove unsuitable’ 93 . The panel asked both Consultant 5 and Consultant 9 why it had been done, as it would have been straightforward to transfer Louisa Ovington under Section 37. Consultant 5 told the panel that he would have preferred Louisa Ovington to continue under Section 37, or ask the court to make a Section 37 order with a Section 41 restriction. Consultant 9 told the panel that he favoured the use of Section 38, as it would, he told the panel, have kept Louisa Ovington in hospital and obliged the court to remain involved. If she had remained detained under Section 37 and the proceedings against her had been discontinued, there was a chance she could have successfully appealed against the Section 37 and been discharged by a Mental Health Review Tribunal. There was no such appeal possible against Section 38. His clear view was that the matter should ultimately be disposed of with a Section 37/41. 93 Home Office Circular No 71/1984 129
Page 1:
REPORT TO THE NORTH EAST STRATEGIC
Page 5 and 6:
Contents CONTENTS Page Preamble 6 I
Page 7 and 8:
Introduction and terms of reference
Page 9 and 10:
The panel met on 14 occasions, tota
Page 11 and 12:
CHAPTER 1 - NARRATIVE OF KEY DATES
Page 13 and 14:
This opinion was referred to by man
Page 15 and 16:
Page 17 and 18:
20 May 1998 to 12 January 1999 CHAP
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
60. As was common in 1998, there we
Page 25 and 26:
Page 27 and 28:
women. Registrar 1 prepared a very
Page 29 and 30:
77. One of the major components of
Page 31 and 32:
visit to see him. A little later, o
Page 33 and 34:
93. The final report from the psych
Page 35 and 36:
Page 37 and 38:
surprised and told the panel that h
Page 39 and 40:
• Consultant 9,in his evidence to
Page 41 and 42:
Page 43 and 44:
129. Although Louisa Ovington conti
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
there was “some latitude” in th
Page 53 and 54:
61 14th offence 62 15th offence 63
Page 55 and 56:
176. Social Service staff did respo
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
78 21st offence 204. However Louisa
Page 63 and 64:
hours. They did not have access to
Page 65 and 66:
210. CPN 2 also completed a risk as
Page 67 and 68:
Chapter 2 - Evaluation of the healt
Page 69 and 70:
CHAPTER 2 - EVALUATION OF THE HEALT
Page 71 and 72:
During Louisa Ovington’s first ad
Page 73 and 74:
Kneesworth House Louisa Ovington co
Page 75 and 76:
The conclusion drawn by the psychol
Page 77 and 78: On 10 July 2001 Louisa Ovington att
Page 79 and 80: take part in several sessions of a
Page 81 and 82: COMMENT CHAPTER 2 - EVALUATION OF T
Page 83 and 84: CHAPTER 2 - EVALUATION OF THE HEALT
Page 85 and 86: CHAPTER 3 - OUTLINE OF MENTAL ILLNE
Page 87 and 88: CHAPTER 3 - OUTLINE OF MENTAL ILLNE
Page 89 and 90: CHAPTER 4 - THE CARE PROGRAMME APPR
Page 97 and 98: The essence of CPA is to ensure car
Page 99 and 100: Chapter 5 - Involvement with police
Page 101 and 102: 89 ibid The guidance states that th
Page 103 and 104: DS1 told the panel bluntly that, in
Page 105 and 106: and social care agencies. The panel
Page 107 and 108: CRO with a condition of psychiatric
Page 109 and 110: COMMENT The probation officer estab
Page 111 and 112: CHAPTER 5 - INVOLVEMENT WITH POLICE
Page 113 and 114: COMMENT CHAPTER 5 - INVOLVEMENT WIT
Page 115 and 116: CHAPTER 6 - RISK ASSESSMENT AND MAN
Page 117 and 118: CHAPTER 6 - RISK ASSESSMENT AND MAN
Page 119 and 120: • South West Durham Mental Health
Page 121 and 122: CHAPTER 7 - PROVISION OF MENTAL HEA
Page 123 and 124: The policy changes were driven by t
Page 125 and 126: • Past psychiatric history; • S
Page 127: CHAPTER 8 - USE OF THE MENTAL HEALT
Page 131 and 132: CHAPTER 8 - USE OF THE MENTAL HEALT
Page 133 and 134: Given the multiplicity of agencies
Page 135 and 136: CHAPTER 9 - CONCLUSIONS AND RECOMME
Page 139 and 140: Some of the risk assessments from a
Page 143 and 144: • Recommendation 16. Trusts shoul
Page 145 and 146: f) Use of “talking therapies” C
Page 147 and 148: professional who had seen her withi
Page 149 and 150: i) Joint working CHAPTER 9 - CONCLU
Page 151 and 152: their procedures for formal contact
Page 155 and 156: LIST OF RECOMMENDATIONS • Recomme
Page 157 and 158: LIST OF RECOMMENDATIONS • Recomme
Page 159 and 160: LIST OF RECOMMENDATIONS • The pol
Page 161 and 162: Bibliography 1. Effective Care Coor
Page 164: INTRODUCTION 28 North East Strategi
show all

Lousia Ovington independent investigation report ... - NHS North East

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?