Mental Health through Institutional Bias

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Mr B’s story stands as one of the United Kingdom’s most significant miscarriages of justice. Together with his younger brother, Mr B faced conviction—he for manslaughter on grounds of diminished responsibility, and his brother for murder.

Medical History and Early Life

In the late 1980s and early 1990s, Mr B experienced drug-induced psychosis, a consequence of his participation in the rave culture. He received treatment with various medications, including Procyclidine, and generally managed his condition well, suffering only occasional relapses.

The Index Offence

On the evening of 11 March 1998, Mr B and his brother attended their local pub in Essex. A physical altercation erupted, prompting five individuals to flee and leaving only Mr B and his brother at the scene—allegedly after their drinks were tampered with. While awaiting trial in remand, Mr B’s antipsychotic medication was abruptly stopped.

Legal Proceedings

Mr B’s younger brother received a murder conviction and a 14-year prison sentence. On the advice of his barrister, Mr B pleaded guilty to manslaughter due to diminished responsibility, believing this would hasten access to his required medication.

The family’s solicitor instructed their GP to provide original medical records, specifically prohibiting photocopies. This unusual request raised concerns, particularly as reliance on samples cast doubt on whether it was a grave oversight or a calculated move to secure conviction and aid the defence. Despite never being diagnosed with Paranoid Schizophrenia, Mr B was compelled to accept the label to access treatment for his worsening mental health—a decline likely intensified by prison-induced psychosis and the overwhelming stress of the allegations.

Imprisonment and Subsequent Life

Mr B ultimately spent twelve years in custody, nine of which were in a secure mental health institution. During his incarceration, he faced punitive measures, such as loss of parole and increased medication, simply for refusing to admit guilt.

Upon release, Mr B resumed his career as a qualified carpenter and joiner, eventually establishing a limited company. He was not subject to any legal restrictions but continued to take Clozapine, monitored by the Community Mental Health Team (CMHT) through mandatory monthly blood tests, with no consideration given to reducing this frequency.

Advocacy and Pursuit of Improved Treatment

Seeking reform, Mr B requested a review of his ongoing treatment regime. The team consulted a leading Clozapine specialist, whose research demonstrated that blood testing could safely be reduced to every twelve weeks, or even annually. This was supported by a forensic report.

When this evidence was presented to the CMHT, their response was slow and failed to address the critical concerns. Instead of resolving the issue, they advised escalating the complaint to the Parliamentary and Health Service Ombudsman (PHSO), effectively sidestepping responsibility.

CMHT’s Response and Ongoing Advocacy

The CMHT’s official stance remained that monthly blood tests were compulsory for life, with no allowance for flexibility or unlicensed alternatives. Yet, armed with forensic backing, Mr B attended an annual meeting to challenge the necessity of regular mental health appointments. The CMHT provided no answers or explanations to the complaint, nor did they respond to the recommendations put forth by the forensic expert, despite previously asserting, ‘we have experts’.

Resolution and Looking Ahead

Thanks to persistent advocacy and ongoing dialogue, a compromise was achieved: Mr B would move to six-weekly blood tests for two cycles, followed by an immediate shift to twelve-weekly tests. Additionally, annual mental health reviews could now be scheduled every eighteen months, with the possibility of further extending them to two years or beyond.

Justice on Appeal remains steadfast in its mission to confront injustice. It continues to advocate for individuals affected by institutional shortcomings, standing up to organisations and their associates—including the NHS—who sometimes use their expertise to the detriment of those they ought to serve.

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