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Tuesday, June 15, 1999 Published at 07:36 GMT 08:36 UK


Case for compulsory medication 'overstated'

Community care deaths have been blamed on failure to take medication

Failure by homicidal patients to take their medication is not one of the five most important risk factors, says the mental health charity Mind.

BBC News' Niall Dickson reports from Highroyds hospital on mixed reactions to the idea of forced medication
It has rejected calls for mentally ill patients to be forced to take medication.

Mind says the case for compulsory medication, backed by reports that the problem has contributed to deaths, has been "overstated".

The charity conducted an independent review into 14 homicides by mentally ill people in the past 10 years.

It found that in only one or two cases failure to take medication was a clear factor in the death.

The main problems were poor risk assessment, communication failures between different agencies and inadequate care planning.

Opposed to compulsory treatment

Mind is opposed to a government advisory body's draft proposals to issue compulsory treatment orders against vulnerable community care patients.

The orders would mean they would have to take their medication or be forced back into hospital.

The proposals are part of a review of mental health legislation.

They are backed by the Zito Trust, which was set up after the murder of Jonathan Zito by community care patient Christopher Clunis.

Mr Zito was stabbed in the eye by Clunis, a complete stranger, as he stood on the platform at Finsbury Park underground station in north London.

It says failure to take medication has been a significant factor in homicides in recent years.

The Clunis case is one of the 14 major cases studied by Mind, which is opposed to compulsion.


The authors of the Mind report, Camilla Parker and Dr Andrew McCulloch, said: "While non-compliance is clearly an issue in homicide inquiries, it appears that it is being overemphasised in current policy.

"Non-compliance does not exist in a vacuum, but occurs because of a combination of service users' wishes and attitudes, based on past experiences and the support and information offered by services."

Non-compliance comes ninth on a list of 12 key issues identified by the report, which is supported by organisations such as the Royal College of Nursing and public service union Unison.

[ image: Christopher Clunis: killed complete stranger]
Christopher Clunis: killed complete stranger
It is below substance misuse, lack of suitable accommodation and lack of resources and above involvement of carers, ethnic minority issues and the need to reform mental health legislation.

The report's authors also question the value of the current inquiry system and say one individual inquiry cannot be used to draw overall conclusions about the success or failure of community care.

Mind's report will feed into the current review of mental health legislation.

The charity has previously expressed disappointment and regret that the government appears to be continuing with plans for compulsory treatment orders.

Other charities are also opposed to compulsion. The National Schizophrenia Fellowship says it believes it will discourage mentally ill people from coming forward for help.

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