Finally, equal protection for all vulnerable psychiatric patients

Posted by Emma Norton on 08 February 2012

One of the biggest concerns for anyone who loves or cares for someone with a mental illness must surely be the fear that if and when their loved one asks for help, help might not be there. That at the time when their loved one most needs to be kept safe, those whose job it is to keep them safe, may let them down.

The parents of Melanie Rabone have suffered every parent’s worst nightmare. Their daughter Melanie developed depression in her late teens and from time to time she could become suicidal.  It was for this very reason that she was persuaded to be admitted to hospital in the spring of 2005. Melanie agreed to be admitted so it was not necessary to section her - however a note on her medical file stated that if she attempted to leave the hospital, she should be assessed for detention under the Mental Health Act. Melanie’s family believed that she was somewhere safe where she would be kept from harm.

After 3 weeks Melanie asked to be allowed out. Her parents strongly objected but in a bizarre decision - later admitted by the hospital trust to have been negligent -  her doctor granted her home leave. Despite her family’s best efforts to protect her, Melanie managed to take her own life in a local park. She was just 24 years old.

The Rabones lodged a complaint at the trust and started litigation. They argued that the hospital had failed to protect their daughter and in so doing, had violated her right to life. They were shocked and devastated to discover that the hospital denied that it owed a duty under the Human Rights Act to stop Melanie from taking her own life at all - and the law at the time appeared to support this position. There seemed to be no recognition of the anguish suffered by Melanie’s parents who desperately wanted the hospital to acknowledge its grave error and the importance of its obligations towards vulnerable patients.  With extraordinary determination, the Rabones fought the case all the way to the Supreme Court.

Alongside Mind, Justice and INQUEST, Liberty intervened in this case. It was clear to us that patients on psychiatric wards were at a particularly significant risk of suicide - for many it is the very reason for their admission. This is the case whether or not they are formally detained.  And in any case our research has shown that many patients who are technically ‘voluntary’ are in fact nothing of the sort, being held on locked wards, needing permission to leave and being treated exactly the same way to all intents and purposes as those who are detained.

In a case called Savage v South Essex Partnership NHS Trust back in 2008, the House of Lords held that the hospital authorities owed a duty to a patient detained under section to prevent her from committing suicide.  Liberty, Mind, Justice and Inquest intervened in that case, too.

Today’s Supreme Court judgment takes the law an important step further. It means that hospitals must take reasonable steps – no more, no less – to safeguard the right to life of mental health patients in their care, regardless of whether or not they are detained, in circumstances where the hospital knows, or ought to know, of a real and immediate risk to life.

The agony of losing a child is something most of us will thankfully never have to face. But despite their heart-breaking loss, the Rabone family have achieved something truly remarkable today - a landmark judgment which will protect some of the most vulnerable members of our society.


Emma Norton

Emma Norton

Head of Legal Casework