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Caring for the mentally ill : you get what you pay for



Well-known member
Aug 12, 2008
Southend on sea
Caring for the mentally ill : you get what you pay for

posted by Dr John Crippen at 10:22 AM

His desperate plea for help was ignored : click to enlarge

Sad news today about Daniel Gonzales. Daniel suffered from schizophrenia. Unlike most schizophrenics, he was violent and dangerous. I want to stress that last point. Most schizophrenics are sad, isolated, friendless people who are incapable of violence. Most schizophrenics are like my friend Emily

I still miss her. I still feel angry about the appalling lack of psychiatric care she received from the NHS.

So what happened to Daniel Gonzales? Four murders, two attempted murders and then, alone in his room in Broadmoor, he committed suicide. How could this happen? It seems he begged for help but was ignored. Why was he not sectioned and removed to a place of safety earlier? And what sort of complacent, indolent incompetence allowed this poor, sad man to take his own life whilst he was in a psychiatric hospital? Where were the staff? Having a coffee break? Filling in forms about the latest government targets?

Despite nearly 60 appointments with doctors and psychiatrists and his own pleas to be admitted to a hospital, Gonzales was free to fulfil his ambition of becoming a serial killer resembling the film character Freddy Krueger, from the Nightmare on Elm Street series.

The Times
How can this happen? Well, the facts of this specific case are not yet in the public domain, but I can tell you how it happens in the area in which I work. It is no longer possible for GPs who are worried about patients with severe mental illness to get their patients assessed by trained psychiatrists. The psychiatrists will not even read our referral letters. Our referral letters go to a pot pourrii of dumbed down mental health care workers who decide what should be done. Collectively, they are known as the Community Mental Health Team (as described in Shocking Psychiatry) The word “Team” is, as NHS BLOG DOCTOR readers know, a favourite NHS word used to dilute repsonsibily. The “Team” only speaks in the passive tense. “It was decided that….” and so on. The passive tense is the grammatical refuge of all who wish to avoid putting their name to a decision.

Make no mistake, it is not easy to decide if and when a mental health patient is safe to be released into the community or, conversely, to decide if and when he is so dangerous that he should be removed from the community. The latter decision is particularly challenging. Even if these decisions were to be made by outstanding psychiatrists (and there are not many of those, for the speciality, with one or two notable exceptions, does not attract la crème de la crème of the medical profession) there would be mistakes. But the decisions are not made by psychiatrists. They may be rubber stamped by them, but the face-to-face, front line assessments are often made by people who have not even been to medical school.

You probably think you could have done a better job assessing Daniel Gonzales. You are probably right. So why don't you have a go? A career in mental health is open to all. You don't have to worry about having been to medical school. Or anywhere else for that matter. You don't beleive it? It's true. Any old fool can apply.

If mental health and a stable, happy life are important to you, then you probably value these same aspects in the lives of other people. One interesting career choice you might want to investigate is working as a community mental health worker. The career itself is a broad term that spans many different educational pathways and jobs that all focus on improving a person's mental health, which ultimately improves their personal happiness and participation in society.

The job classification of community mental health worker is such a varied one and it can be used to represent virtually any career that has a focus on the improvement of a person's mental health. The title may be used to mean many different things from one organisation to another. The career itself can be based in a hospital, client's home, agency workplace, private practice or a health clinic.

a career in mental health
Is it any wonder that there are tragedies.


quality factor

Very good read, thanks once again, firemonkey.
Very poignant.


Well-known member
Founding Member
Jan 7, 2008
I suspect they offered the guy meds, offered to dope him silly, but he refused,

I wish i didn't have to put up with off meds neighbours, they're a real pain and i've got enough problems of my own, i wonder how they can't be aware of the upset their antisocial behaviour creates
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