Guest post: Mental Health and Dangerousness by Professor Paul Crawford, author of The Wonders of Doctor Bent
The deaths of Barnaby Webber and Grace O’Malley-Kumar, both 19, alongside Ian Coates, 65, and serious injury of other members of the public at the hands of Valdo Calocane in Nottingham caused much soul-searching about the state of mental health services to support mentally challenged individuals and keep the public safe. Debates were reignited about whether those who kill with diminished responsibility should serve indefinite hospital orders or be sent to prison for murder. Also thrown into the mix was understandable concern about how these extreme tragedies risk stigmatising the non-violent majority of people living with mental health conditions.
We are all nonplussed about how to respond to such tragic events. What motivates individuals to behave in horrifying, despicable ways? Who is responsible for preventing such catastrophes in the first place? How should such individuals be treated or dealt with? On the back of the NHS England’s (Midlands) full independent investigation into the care and treatment of Valdo Calocane in the months leading up to 13 June 2023, Mind, one of the leading mental health charities, rightly expressed heartfelt condolences to the families of those affected and then stated:
“It is all too clear there were a series of missed opportunities alongside systemic failures. Under-resourced services, poor communications, a failure to properly listen to and involve Valdo Calocane’s family all meant he fell through the cracks in the system, with devastating consequences.” [1]
How we react to such horrendous and tragic killings will depend on where we stand. Some may wish for punishment with long prison sentences and the clarity of a verdict of murder. This may seem acceptable, for example, in cases where the individual is clearly able to take responsibility and is motivated to do harm, as in acts of terrorism or wilful assaults on others.
However, others may consider perpetrators with a serious mental health condition as compromised in their actions and requiring treatment not punishment. In the case of Valdo Calocane, diagnosed with paranoid schizophrenia, the then Attorney General, Victoria Prentis KC MP, deemed the sentence of an indefinite hospital order “unduly lenient” and referred it to the Court of Appeal, pursuing a hospital and limitation direction or “hybrid order” of treatment first followed by punishment. However, the Court of Appeal upheld the original sentence.
In the days following the tragedy, like so many others across the UK, I felt shocked and saddened over the needless loss of life, imagining the grief of the families of the victims. There was also a chill in knowing that my colleagues and our many students may well have crossed paths with Valdo on campus, as he was also, like Barnaby and Grace, studying for a time at the University of Nottingham.
Having experienced a serious attack on my own life while working in an acute psychiatric treatment setting, caring for people struggling with serious mental health problems, I know how things can suddenly change for the worse. One day, a patient and I were enjoying a conversation about poetry. The next day, I was subject to a storm of violence from that same person. When asked by the psychiatrist as to his motivation, the patient answered baldly, “I was trying to kill him!”
This lived experience and my concern for finding a balance between public safety and the rights of people living with a serious mental illness, between treatment and punishment, between prison and hospital settings, predates the Calocane case. Such tension features in my new novel, The Wonders of Doctor Bent (out 18th March, 2025). The novel focuses on Dr Bent, who seeks to humanise the prisonlike environment of Foston Hall, a high-security psychiatric hospital. The question is, are his reforms, his ‘wonders’, warranted and do they work, and in whose favour?
While any of us may immediately struggle to empathise with those who are mentally ill and violently kill others, we need to acknowledge first how uncommon this is. Although I had once been subject to an attack, and traumatised by it, this was a rare event. When tragedies do occur, we need to consider the ethics of punishing people who kill others acting with proven diminished responsibility on the same terms as those with full mental capacity. Finally, we need to avoid stigmatising the great majority of people with mental health challenges as potentially violent. We all know that the greater, everyday violence in our society does not come from such individuals. The charity Mind concluded:
“People with mental illness must be held accountable when they commit serious crime. But when people are unwell, they need to be treated with respect, and able to access adequately funded mental health services which can intervene early and provide ongoing support. Strong local partnerships between services that include carers and communities are critical to ensure the right decisions around someone’s care are taken at the right time. This is especially true for people from racialised communities who are more likely to experience poor care and worse outcomes.” [1]
The Wonders of Doctor Bent is available at Amazon, WHSmith, Cranthorpe Millner, Waterstones, and Foyles.
Reference
[1] Mind (2025) Mind responds to NHSE investigation into treatment of Valdo Calocane. Wednesday 05 February. https://www.mind.org.uk/news-campaigns/news/mind-responds-to-nhse-investigation-into-treatment-of-valdo-calocane/
About Professor Paul Crawford:
His recent non-fiction work, Florence Nightingale at Home, won Best Achievement in The People’s Book Prize 2022. He also led the recent animated series with Aardman, What’s Up With Everyone, supporting young people’s mental health, which won Best Design and content in the 2021 Design Week Awards, multiple categories in the 2021 PR Week Pride Awards and reached over 17m people within four months of launch alone. He is Joint Editor-in-Chief for The Palgrave Encyclopaedia of Health Humanities and Commissioning Editor for two book series, Arts for Health (Emerald), and Routledge Studies in Literature and Health Humanities.
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