My Lords, I draw attention to my relevant interests as outlined in the register. I support Amendments 8, 12 and 19, which seek to ensure that people who have suffered as a result of a crime committed by a patient with a mental health disorder who is detained in hospital under a restriction order are afforded the same rights under the victims’ code as victims of offenders who are held in the prison estate. This is not the case presently.
The amendments seek to extend the principle that all victims have a right to be heard in the justice process and to include the NHS and His Majesty’s Courts & Tribunals Service in the list of responsible agencies. This would bring mental health tribunal processes in line with the rest of the criminal justice system and remove a long-standing and unfair disparity in treatment for people who have experienced these crimes. The principle that everyone who experiences a crime should have the opportunity to make their voice heard in the criminal justice process is at the heart of why these amendments are necessary. Those who have experienced crimes committed by patients with a diagnosed mental health illness deserve parity of treatment with all other people who have experienced crimes.
Under the victims’ code, people have the right to make a victim personal statement before the Parole Board when the person who has offended is being considered for release. Anyone who is directly affected by violent crime should have the right to be heard, but, as the victims’ code does not extend to mental health tribunals, victims of an offence caused by somebody held under a mental health restriction order cannot make any personal statement in writing, or in person, to the mental health tribunal panel.
The VPS is the single key entitlement which allows people to explain the impact of the crime committed against them, and there is a widespread consensus that the opportunity to submit a VPS is beneficial for all victims. It can offer some catharsis, which is essential in assisting the recovery from the trauma of a crime. In addition to this being beneficial to people who have experienced crime, this process may offer the opportunity for patients with a mental health disorder to gain further understanding of the impact of their actions on other people. This is particularly important when these people return to the community and sometimes feel that it would be better not to take their medication. Understanding the risk of not doing so might be beneficial for the proportion who are able to leave hospital.
The anticipated number of victims wishing to speak directly to the mental health tribunal is likely to be small. I understand that in cases of people wishing to address the Parole Board in person, it is currently fewer than one in 10. The majority are likely to submit a written statement to the panel that explains the impact that the actions of the patient has made on their lives.
The practice of allowing statements to be made to the tribunal is established in other jurisdictions, such as Scotland and Australia. In research undertaken by the Victims’ Commissioner in 2019, a family in Scotland discussed their experience addressing a mental health panel. They attended a separate hearing where the patient was not present but a legal representative attended on their behalf instead. The family did not get the outcome from the hearing they had hoped for but, crucially, they felt acknowledged and a party to the process despite that. They said:
“We … did feel given a voice, and one of the few occasions in the whole process we felt we had a voice and able to articulate our position”.
Clearly, it should be possible to balance the rights of patients.
Of course, as a nurse, I cannot overemphasise the need to maintain the confidentiality of medical records in tribunals. None of this needs to be shared with the victim making the representation and those impacted by crimes, so why is there such a different process in England and Wales, even just north of the border? As victims of crime are not currently able to address mental health panels in writing, by video link or in person, we are left with a two-tier system in which a distinction is made based on whether somebody is detained in a prison or in a mental health hospital. It is those who have suffered from the crime who lose out in terms of being heard.
I have worked closely with the Victims’ Commissioner, who has long called for this change. I hope that the Government will look favourably on these amendments and identify any changes to mental health tribunals that may be necessary.