ABSTRACT
At the time of writing, an unprecedentedly broad alliance of mental health professionals, voluntary organisations and service-users/survivors has been campaigning against draconian proposals for increased coercion set out in the UK government’s draft mental health bill. These proposals seem set to provide for the compulsory treatment of people living in their own homes with prescribed drugs that may have serious adverse effects, and for the preventive incarceration of individuals solely on the basis of a diagnostic category newly formulated by politicians and civil servants.1 Although the proportion of homicides committed by people deemed to have a mental disorder relevant to the offence declined significantly between 1957 and 1995 (by an average of 3 per cent annually), high-profile campaigns by pressure groups such as SANE, aided and abetted by media representations erroneously linking ‘schizophrenia’ and voice-hearing with violence, have presented community care as a grossly irresponsible failure. This has fuelled the
pervasive and damaging stereotyping of psychiatric patients, especially those who happen to be young black men, as dangerous, yet male psychiatric patients are very much more likely to take their own lives than to kill someone else, particularly a stranger (Taylor and Gunn, 1999; Beresford and Croft, 2001; Fernando et al., 1998; Crepaz-Keay, 1996; Leudar and Thomas, 2000). Challenging such prejudice is an essential prerequisite to ensuring that political, policy and service responses to the needs of a small minority of male service-users who really are threatening as well as vulnerable are both considered and appropriate.2 Yet the political clamour surrounding a small number of high-profile tragedies in which psychiatric patients have either killed, or spectacularly ended their own lives, has been accompanied by a resounding silence on the significance of violence as a cause rather than consequence of distress (Rogers and Pilgrim, 2003). Moreover, the number of psychiatric patient deaths associated with neuroleptic drugs-possibly as many as one a week in the UK, or four times the rate of ‘mad’ homicides-and the greater exposure of black patients to higher doses of potentially harmful medication has attracted far less interest and concern (Sayce, 1995; Littlewood and Lipsedge, 1982/1997 pp. 259-60).
