‘Our mental health system has not been invested in’ – mental health consultant on Nottingham attacks

We spoke to Julian Hendy, the founder of the Hundred Families charity which supports and advocates for those affected by mental health homicides. His own father, Philip, was murdered in 2007.

We’re also joined in the studio by Dr Colin King – he’s a mental health survivor who’s become a practitioner himself.

Matt Frei: Julian, first of all, I’m very sorry about what happened to your father. This must bring some terrible parallels back to you. Tell us about what happened to Philip, and then, has anything since then at all, as far as you can tell, changed in the system?

Julian Hendy: My father went out to pay his paper bill one Sunday morning in Bristol in 2007, and as he was leaving this shop, he met a man who had a long history of schizophrenia, drug abuse and violence, who was untreated at the time. The man went and proceeded to stab him in the neck and stab him in the back and he died seven days later as I was holding his hand. I am a documentary maker by profession. I ended up making a film about what happened to my dad and four other people around the country. I found that there had been 20 other cases in Bristol at that time. There had been four other inquiries, they had made recommendations and findings that found very similar problems. Problems to manage the risk properly, problems to look after the care properly, problems to treat drug and alcohol problems, problems about discharge, problems to listen to the families. These are repeated problems that have all been highlighted in inquiry reports over the last 30 years, and it seems that nobody’s actually learning from them effectively.

Matt Frei: Why do you think that is?

Julian Hendy: I hope this is a landmark case which will actually spur on some proper change.

Matt Frei: Why do you think people aren’t learning from these cases?

Julian Hendy: I think mental health services are in crisis. I think there’s a focus on wellness. There’s a lack of focus on people with serious mental illness. Most of the cases I see, I’ve dealt with 300 families, all been bereaved by patient or mental health related homicide. Most of the cases I see are of seriously unwell people who are unable or unwilling to access good care and treatment. The vast majority of people with mental illnesses are never violent if they are in treatment and accepting their medication. The problem is of people who don’t or aren’t able to get treatment, who don’t think they’re ill. Those are the cases that need more assertive care and follow up, and that doesn’t seem to be happening at the moment. In Leeds, where I am, we’ve got an assertive outreach team which has proven to reduce the suicide rate. This has kept people engaged in services and that has kept them, their families and the general public safe. Problem is, is those assertive outreach teams have been disbanded around the country, and so the people who don’t need it aren’t getting timely care and treatment.

Matt Frei: Dr King, you heard what he had to say there, and of course the numbers are actually quite astonishing. 300, so this is not a very, very rare case. Tell us about your own case, you were sectioned four times, I gather?

Colin King: I was sectioned under the Mental Health Act at 17, I’ve been sectioned four times with a diagnosis of schizophrenia. I’ve been incarcerated, misdiagnosed, illegally treated, subject to coercive practices. The mental health system is almost a criminalisation of mental health needs. It doesn’t address individuals. I’ve got to send a big apology to those people that have lost their lives in this case as well. The health and safety issues need to be considered much more intensively.

Matt Frei: But what you’re saying is that when you were sectioned, it was more a form of incarceration than a form of treatment.

Colin King: Yeah, it’s incarceration because our mental health systems have not been invested in since the Poor Laws, and that’s the 1600s. Our Mental Health Act is completely out of sync, our way of working multi-disciplinary, from clinicians, to nurses, to psychologists, the multi-disciplinary practice is flawed and we are in a dangerous situation where people are being badly treated in mental health systems.

Matt Frei: And when you were released into the community, when you were discharged, having been sectioned, what was that based on? What were the decisions around that?

Colin King: They were economic and political. We need your bed, you need to get out. You need to be moved to the community. Even though we haven’t got a sustainable care plan to support you, we need that bed. So the decisions are business decisions. They’re not based upon person centred, individualised holistic approaches to people’s needs. And that’s where we are in 2024.

Matt Frei: So when the health secretary, Wes Streeting, said in the King’s Speech, there was this line about ‘We need to reform the system, more rights for individual patients’. Is that about basically dealing with backlogs, that they need to make space, a bit like in the prison system?

Colin King: They need to make space. You consider that from my community, we’re 11 times more likely to have been given a diagnosis of schizophrenia, we’re more likely to be given medication, we’re more likely to be mistreated. And so the mental health doesn’t recognise the need to invest in community resources so people can be discharged properly and effectively with clear safety plans that are multi-disciplinary orientated.

Matt Frei: Julian, if I can turn back to you, to do this properly, to look at individual cases requires a huge amount of manpower, but also money, doesn’t it?

Julian Hendy: In my view, it’s a question of resources, but also cultural change. I think there’s, as I said, there’s an emphasis on looking at wellness and wellbeing and not sufficiently looking at serious mental illness. In 1970, we had 120,000 psychiatric beds. At the moment we’ve got less than 18,000. So the psychiatric institutions are not safe places. It seems to me that had we had more places where it could actually be a proper place of safety, asylum in the old sense of the word, where people could cope and recover from their illness and be helped to do that. We don’t have those systems, we need a cultural change, it seems to me, to have more assertive care and treatment for those who need it, and we need more transparency around these sorts of cases so we can talk about it easier.

Matt Frei: And is there a problem also about the fact that mental health is still stigmatised? It’s something that people don’t want to talk about. They don’t want to confront it, and it’s everywhere.

Julian Hendy: I think there’s more mental health awareness around. But I think the problem is, is that cases like these violent acts by people who are untreated cause massive amounts of stigma. So the only way, in my view, to counter the stigma problem is by treating the violence and giving preventative care so people don’t go into crisis and commit terrible acts against themselves, their families or the general public.

Matt Frei: Colin, do you agree with that? Again, it seems to be about individual cases, assessing individual cases, but at the same time having a sort of more holistic approach with society as a whole to teach them about mental health, and what it means.

Colin King: We need to educate people about mental health, it’s something that starts with good practices, good wellbeing practices. We need to elevate that safeguarding procedures and duty of care to people in mental health settings. We need to make sure that we invest, not from a business model, from an individual model. My good friend Ajibola Lewis, who lost her son in 2010, had a legislation called the Mental Health Use of Forces Act. She’s now struggling to ensure that we have good, comprehensive support from peer support, lived experienced practitioners and community oriented practice.

Matt Frei: You’ve had an amazing recovery yourself. The treatment has worked, you’re now Doctor King. You are actually sectioning people into the system when you have to. But how stigmatised were you? How much was that a burden on you?

Colin King: It is a massive burden and it is still a massive burden. When I walk and I talk to you in the studio today, my name is Colin King, an individual with status, with prestige, with a history of achievement. When I’m given my diagnosis, I’m reduced to somebody who has that diagnosis, and we need to look beyond, to the person inside the diagnosis and begin to work with people so they retain their humanistic status.

Matt Frei: And what can government do quickly now in order to fix that?

Colin King: I know that Tim Kendall [NHS England’s National Clinical Director for Mental Health] is now activating a community orientated project that can be activated on a 74 hour basis throughout the community. They need to actually employ people, like myself, as lived experience advisors to restructure and dismantle the whole mental health system.

Matt Frei: Julian, final word to you briefly, what do you think should be done right now in order to make sure that the kind of suffering that you went through, your father went through, is not repeated?

Julian Hendy: I think there needs to be wholesale change. I think we need to focus on assertive care for those who need it. We need a lot more transparency around it. We need reform in the way mental health is dealt with. We need a focus on serious mental illness. Not well being and awareness.