In 2004, Mrs Carol Savage was one of 165 who took their own life while receiving treatment as a psychiatric in-patient.1 With the trial yet to take place, few facts are presently known. The day after voluntarily attending Runwell Hospital, she was detained for treatment under section 3 of the Mental Health Act 1983 (‘the 1983 Act’) with a diagnosis of paranoid schizophrenia. Having made a number of attempts to leave the open acute psychiatric ward, checks on her whereabouts were prescribed for every 30 minutes. Believed to be at low risk of suicide, Mrs Savage was allegedly left unsupervised on hospital grounds from which she was able to flee, walking 2 miles to Wickford railway station before fatally jumping in front of a train. A coroner's jury concluded that the preventive precautions in place were ‘inadequate’. And her daughter, Ms Anna Savage, claimed that the hospital had breached her mother's right to life by allowing her to escape.
The issue in this case is not uncommon. P is an adult who has an unresolved medical condition, in this case epilepsy. His primary carer, however well motivated, does not accept the diagnosis nor the treatment proposals. P may object to treatment (whether his own view or prompted by his carer). In order to determine what is in P's best interests, since he cannot decide for himself, it is necessary to observe him, and not to rely upon what is relayed about his condition by his carer. To that end, a period in hospital for assessment and treatment is necessary.