I have not read the whole thread, sorry. I have worked as a consultant psychiatrist for many years and I don’t believe he has a mental illness as such. He most likely has a very disordered personality, with antisocial traits. In my view, he is more ‘bad’ than ‘mad’. If he had an illness like schizophrenia I’m sure that would have been put forward by his defence by now.
The problem with people who have severe antisocial personality disorder, is that treatment options are very limited. Medication has no real role, and any kind of therapy would require engagement and reflection from the individual. I doubt this person is capable of that.
It is very difficult to balance detention with liberty. The Mental Health Act allows detention of mentally unwell people but with safeguards. People can rightfully appeal their section and there is a high threshold for detention. There have been multiple calls for the MHA to be amended. Many want it to be more lenient for want of a better word. They feel the act is too restrictive. Mental health advocates are campaigning for a higher threshold to get people detained, thus making it harder in general to hold people against their will.
These reforms of the act were put on pause after the Nottingham killings. Because in that case there was a mentally unwell man who was able to kill others whilst sick and untreated. So it would have been v poor timing to reduce the powers of the act at that point.
It is very hard to get it right when on the one hand you want to lock up potentially dangerous people, whilst on the other hand people’s liberty needs protecting.
There was a move many years ago to try and manage people with what they called ‘dangerous and severe personality disorder’. This was after the Michael Stone killings. However, it became apparent that this had not been thought through properly. This was not a medical diagnosis. Where would these people be managed, in hospitals, in jail? And what kind of treatment would this involve anyway? When would they be safe to be released? Liberty groups campaigned to say that it was an infringement of rights to lock people up when they had not actually committed a crime.
I am not sure mental health services could have made much difference in this case. I think a more robust reaction by criminal justice services to the crimes he committed as a teenager was needed. The hope would then be that in custodial detention, he could have some kind of rehabilitation work before his full personality was established as an adult.
I think there are some very dangerous individuals around, and I don’t think we have the answers how to manage them. Especially if they don’t have a treatable mental illness or have committed a significant crime. The period before they have actually committed a serious crime is the most dangerous.
It is all unbelievably tragic. I can’t fully hold any one institution responsible because we don’t have the mechanisms to deal with these situations. And the parents may have been absolutely terrified of him. We don’t exactly know what their role was in all this.
I would be wary of putting this down to a treatable mental illness or ASD etc. Some people just are ‘evil’. We are not meant to say that in MH services but I believe they are.