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The Daily Shame | April 24, 2014

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Nicola Edgington and Hannah Bonser – neglected by the NHS Mental Health Services

Nicola Edgington and Hannah Bonser – neglected by the NHS Mental Health Services

| On 07, Mar 2013

32 year old Nicola Edgington was known for killing her own mother and having profound mental issues.

Even so, she was given the freedom and the opportunity to kill an innocent bystander, and very badly injure another.  These were two complete strangers.  She had no personal hatred for either…just a compulsion to kill.  That’s not normal.  To do something as terrible as that, you really have to have something very wrong with your brain.

No?

What do you mean the judge says she’s only got a borderline personality disorder?  What the fuck’s that when it’s at home?  Don’t be using the word ‘borderline’ for someone like Nicola Edgington.  She tried to decapitate another human being in a very public place!

It had been made clear, by those who had worked with Nicola and knew of her tragic past, she was to be admitted without question if she presented herself for admission at a hospital.  These people knew what she was capable of and wanted to make sure she would be given adequate support in future.  Sounds great, but still nowhere near the close and careful monitoring she should have been afforded in the meantime.

She had killed her own mother, served time for it and been let out.  That’s quite bad, isn’t it?  More recently, she’d had a miscarriage and was at rock bottom with no family support.  Hardly surprising her brother cannot bear to be near her, seeing as she killed their mother. He even told her in a Facebook message he was glad she’d miscarried and urged her to kill herself.

So, who WAS looking after her?  How did the mental health department responsible for her welfare fail to keep her stable?  Where were they when she decided to stop taking her medication?  Where were they when she was desperately trying to alert anybody she could find that she felt seriously compelled to kill someone…anyone.

Yes, the Police cocked up.  A check into her criminal history would have thrown up the killing of her mother and she very probably would have been guarded at the hospital they took her to until a psychiatric team became available to attend to her, but they didn’t check Police records and, sadly, they can’t go back and change that.

Even so…when someone calls 999 and says, “I’m dangerous. I need to go to a mental hospital. The last time I felt like this I killed my mum.”, alarm bells should already be going off…very loudly.

Similarly, the mental health team, who should have been monitoring Nicola more closely, cannot go back and change the way they woefully let her down during the time leading up to the attacks.

After handing Nicola Edgington over the hospital, the Police were called by her again and again with requests for help and were reassured by hospital staff Nicola was NOT in need of Police assistance.  She was begging anyone who would listen to lock her up.

Where were the mental health team while she was making these calls?  Where was anyone?  Had anybody at the hospital actually checked her records to ensure she was being held in a secure enough environment?

Nicola Edgington’s case isn’t an altogether isolated one where lack of mental health care is concerned and it really fucks me off to read this over and over in reports about her.

Her case has only been highlighted because she actually went ahead and did what she told everyone she was going to do…what she felt an intense compulsion to do!  She killed someone!   58 year old Sally Hodkin was killed by a woman who, by her own admission, should not have even been allowed to walk the streets.  22 year old Kerry Clark was also very badly injured.

These were two perfect strangers to Nicola and the attacks took place in full view of on-lookers in a public place.  That’s a serious mental issue, not a borderline disorder.

Situations like hers arise due to lack of support from a slack mental health team.

The very fact the judge, who has put her away for 37 years, brushed her aside as having a borderline personality disorder just goes to show how people are still viewing mental illness as something sufferers can easily control if they put their minds to it.

I’m still struggling with Judge Brian Barker’s words, “She used the weapon forcefully and purposefully in each attack. She was controlled and she was rational.”

Not being funny, but I have my own ideas about the definition of the word ‘rational’ and it is very clearly NOT killing your own mother and NOT trying to cut someone’s head off in broad daylight!

Again…Nicola Edgington tried to cut someone’s head off in the middle of a park.  What’s borderline about that?

It seems the story of Hannah Bonser has recently resurfaced too.  Another similar case.  You only have to read a few stories about her situation to realize that, even if you’ve been in and out of mental institutions and had constant intervention since childhood…once you’re an adult you can just piss off and snap out of it.

Don’t go thinking Hannah Bonser’s case is an isolated one either.  Again, it’s just been highlighted because she actually ended up doing what she’d been telling psychiatrists she wanted to do for years.  She killed someone…an innocent 13 year old girl called Casey Kearney.   No motive, no personal involvement with her victim…she just sated her need to kill people.  Nothing mental about that, is there?

By the way…I love the way the NHS have spent a lot of time and effort explaining to us on their website how important it is to ensure people with mental problems are promptly seen to and helped.  They even tell us about the terrible things that can happen to adults with mental issues if their illness isn’t dealt with.

I searched through their information and nowhere do they mention it’s very often several months or years…YES YEARS…before a formal diagnosis is even made and correct medication is prescribed.  Well done to the NHS for knowing what should happen in a perfect world, but this isn’t one and the UK’s adult mental health services are very often quite shit.

So many vulnerable adults are left to fend for themselves while mental health professinals pass them back and forth, pouring lip service on to their families while everything falls apart.

It’s okay, though, because a hospital’s A&E department are fully equipped to accept emergency patients who find themselves unable to cope.

Yes…they will welcome anyone who needs urgent psychiatric help.

Hmmm…then what?  Is it like on TV, where a mentally unstable person is given a hospital bed and a psychiatrist is quickly called to assist them?  Even better, are they taken straight to a psychiatric ward where they can receive immediate appropriate care?

Ever tried calling an ambulance to assist mentally disturbed adult who is going off their head in your home?

No?  Well, forget what you see on TV…it’s not real.  No…honestly, it’s made up…much like the NHS information on the great service you can expect from your local adult mental health team.

You see…if you request emergency treatment for mental issues, it’s very likely you’ll end up with a paramedic ambulance, a Police car and a huge motorway crash-sized ambulance outside your house by the end of it all.

You think I’m joking?  I’ve seen it!

Great waste of resources there and all because that ONE person’s mental health team are not doing what the NHS website keeps trying to convince us they are.

And…do you know what really makes me sick?  The instant blame aimed at the Police for their mishandling of Nicola’s case.  Where is the speculation about why a known killer and mentally unstable individual was left so poorly supported she ended up in the state she did?

Looks like nobody wants to point the finger at the NHS and their crap adult mental health system.  Looks like they want to carry on ignoring the fact attitudes need to change.

I know, in this instance, the Police should have done more, but, in most cases, they do what they can.  They really do.

On the whole, the Police are very helpful and, despite the fact they’re not qualified mental health experts, their aim is to help a distressed individual get to hospital to receive specialist input as soon as possible.  So, prior to the arrival of an ambulance, they will offer to take them to the hospital and retain responsibility for their welfare until they’re handed over to the relevant people.  Oh yes, they will.

The thing is, are they really the relevant people, or are they people who can say the words, “It’s okay, you can leave them with us until the psychiatric team are available”.  Hmmm…sounds more like it.

You know…an A&E department will tell you a psychiatric assessment team is on hand when, really…and this is just horrendous…they may actually be nowhere near the hospital and unable to assist for a very long time.

Meanwhile, the distressed individual is ushered into a room to sit by themselves and wait…and wait…and wait.  Unless they’re causing a disruption, they’ll be ignored.

So, we’re talking about a person whose mind is in such turmoil, they’ve requested urgent medical attention by phoning 999.

Even so, what a waste of time they are!  Their situation surely isn’t an immediate emergency because they look okay.  Who cares what’s going on in their heads?  They’re walking and talking and appear to be in perfect physical health!

Hey everyone, the clue is in the word ‘MENTAL’.  You notice I did not say ‘physical’.  I said ‘MENTAL’.  Their MIND is going crazy, NOT their body.  However, after possibly hours of their MIND being left to gallop away quite merrily in all the wrong directions, who knows what they might suddenly get up and do?   They might even walk straight out of the hospital and kill someone.

Isn’t it sad that, although we all joke about the stereotypical psychiatrists with their obsessions with each patient’s relationship with their mother or other family members, it’s often all that’s delved into and anything else deeply ingrained into a person’s psyche on an irreversible level is ignored.

Psychiatry should be about preventing seriously disturbed human beings from crimes that nobody with just a borderline personality disorder would even dream about.  It should not be about trying to reduce caseloads and passing the buck at every opportunity.

More importantly…just because a person looks okay, talks in an articulate manner and can tell you coherently what they’re feeling…it does NOT mean their head isn’t full to bursting with the most dangerous and damaging thoughts you could ever possibly imagine.

Intelligence and ability to communicate in a clear and concise manner, does NOT automatically prove a person’s sanity.

Where mental illness is concerned…it’s what you CAN’T see that’s the problem…not what you can.

As children, no end of help, support and medication would have been available for Nicola and Hannah, but after having being turfed out into the ADULT mental health system…they were left to flounder.

Mental health departments…get your fingers out.  Deal with your caseloads and stop palming vulnerable people off on the already overstretched emergency services.

Comments

  1. Hannah

    Great article. I also have serious concerns about those convictions. Just one point of clarification, the “Borderline” in Borderline Personality disorder doesn’t mean almost or partially a personality disorder- a common misconception- it’s from the old- now defunct- psychoanalytical concept of being on the borderline between “neurosis” and “psychosis”:

    http://bpd.about.com/od/faqs/f/BPDname.htm
    http://en.wikipedia.org/wiki/Borderline_personality_disorder#History

    It’s now often referred to as Emotionally Unstable Personality Disorder. I have a friend with BPD, and she goes through episodes which can come on in a matter of minutes which I can only describe as being “hyped up” or manic, when there’s no getting through to her. She’s never hurt anyone and I don’t believe ever would, but she’s threatened too kill herself before and had to be sectioned. When she’s acutely unwell, she’s not really responsible for her actions which often involves serious risk taking. It’s terrible that it’s not considered a “proper” mental illness, even if that was what Nicola Edgington and Hannah Bonser had (and both had reputable psychiatrists prepared to testify that they had schizophrenia).

  2. smackintheface

    Thank you so much for your comment, Hannah. I was originally planning to go into more detail about various mental disorders, but you’ve done it brilliantly and better than I could have.

    I’m still so gobsmacked the judge forced his own, personal, conclusion on the jury and, in so doing, very probably swayed their decision. To feel it was appropriate to form his own diagnosis of Nicola’s mental state, when he had the opinions of far better-informed specialists on hand to work with, was so arrogant.

  3. Strawbear

    The NHS policy with the mentally ill seems to be ‘we can’t afford it, so what can we do?’

    Demanding that the NHS deal with the problem when they don’t have the budget to do so is the reaction of a child asking why they can’t have another biscuit because the packet is empty.

    You can stick a pin in any NHS area and I’m sure you’ll find lots of similar cases, especially when BPD is involved. When men have it, they’re usually jailed, when women get it, they’re referred to their GP, referred onto a mental health team who spend most of their time trying to prevent the worst case scenarios happening. Suicide, child neglect, self harm and murders.

    BTW, BPD seems to be short hand for ‘no fucking clue’. That’s pretty much paraphrased from a Dr who worked with BPD patients.

    If you want the NHS to deal properly with mental health care, then their over all budget would need to be a lot higher. What we have now is only slightly better than Bedlam.

  4. smackintheface

    Thanks for your comment, Strawbear. The government are stifling the NHS and you can’t get blood out of a stone. I agree with that, but there are individuals who just don’t do their jobs adequately and I’ve met too many of those on many different levels. A lot of the time the emotional support isn’t there between referrals and that’s so important in a lot of cases.

    Sorry to say, I’ve seen too many cases where individuals working in the Mental Health Services are flouting their responsibilities. Things they are paid to do are not being done. Even top consultants are assessing patients, passing them to relevant centres for extensive therapy, only to find their recommendations have not been carried out and the patient has been turfed back out of the system after a half-hour consultation.

    That’s a waste of the consultant’s time and the NHS’s money right there. They may be assessing patients to their full ability, but people at the next stage of treatment are ignorantly casting their own opinions within half an hour without a single reference to the recommendations in the referral. Yes…half an hour.

    I’m not a child asking for biscuits. I’m an adult asking for the system to be tightened up. It’s not a case of money every time…sometimes it’s a case of individuals not doing their job and not bothering about the potential harm that can come to vulnerable patients or those around them.

    If a child presents with difficulties, a paediatrician, a GP, a child psychologist, a child psychiatrist and a social worker will work together to help them…QUICKLY. The whole family is dragged in and assessed thoroughly before you can blink. Any adults and children involved with that child are grilled extensively. The whole family have an enormous amount of time and money spent on them…FOR ONE CHILD. Parents who have experienced this are wowed by the whole experience.

    Equate this to a one hour assessment of an adult with a top consultant and half an hour with a psychologist who has decided not to follow the recommendations of that top consultant, which was to give six weeks of intense therapy. It’s not right and the patient cannot then go back to the top consultant because they’ve already been referred on. It’s very often a quick and vicious circle of GP, consultant, therapist, out, GP, consultant, therapist, out.

    Better still, equate this to an adult with a whole host of mental issues being referred by that top consultant to the Maudsley in London and having to wait one or two years for an apppointment. In the meantime. NOBODY, not even that top consultant, will take responsibility for them because the all important Maudesley assessment is the only thing that can determine what medication or treatment is necessary. Bizarre and not at all responsible.

    Ironically, if I was a child asking the NHS for biscuits, I would most certainly get them. As an adult…yes…the packet is most definitely empty.

    Thanks again for your comment. I totally get where you’re coming from.

  5. Hannah

    “I’m still so gobsmacked the judge forced his own, personal, conclusion on the jury and, in so doing, very probably swayed their decision.”

    Sadly, I think it was likely the other way around. The public in general can be very ignorant and the same thing happened in the Hannah Bonser case, with a seemingly more sympathetic judge:

    http://www.judiciary.gov.uk/Resources/JCO/Documents/Judgments/sentence-bonser.pdf

    Alternatively, they may simply not have trusted the MH system to manage her safely and protect the public and, given the history of the case, perhaps that’s understandable.

    “BTW, BPD seems to be short hand for ‘no fucking clue’. That’s pretty much paraphrased from a Dr who worked with BPD patients.”

    I’ve suspected the same, knowing several people with BPD diagnoses, or rather the translation is “you’re female, acting crazily, and we don’t know what else is wrong with you.”

  6. biomed

    BPD is by many accounts an extremely severe personality disorder, far exceeding the mortality rate of psychiatric disorders like major depression and generalized anxiety disorder. While I work with mental health patients frequently, whenever I’ve worked with a patients with BPD it presents with a much more difficult and relatively dangerous (mainly to the patients themselves) set of issues. I agree with the premise of this article, and indeed your conclusions about the mental health services today, but the other physicians and researchers I know wouldn’t characterize BPD as some kind of catch-all, but rather a diagnosis only to bestow when absolutely necessary, because the implications are so severe. They certainly, certainly, wouldn’t cite crimes that someone with “just” BPD couldn’t commit: it is just, if not more severe, as schizophrenia, and the subtle distinctions– hallucinations/delusions of persecution, etc.– in schizophrenia in no way make one more serious than the other, or patients with one disorder more likely to commit a horrific crime than the other. It, obviously, shouldn’t have mattered what her diagnosis was, as her actions speak for themselves. I just felt the need to clarify that BPD is equally severe, and could just as well account for her actions as another diagnosis.

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