Hackney’s John Howard Centre medium secure unit makes ‘massive strides’ in safety following escape and absconsions
PUBLISHED: 17:25 09 November 2016 | UPDATED: 17:48 09 November 2016
Emma Bartholomew visits the medium secure John Howard Centre to find out what is being done to keep neighbours and patients safe in the wake of a string of high-profile security incidents
Not so long ago the John Howard Centre medium secure unit was making headlines for all the wrong reasons.
A litany of problems plagued the centre in Kenworthy Road, which strives to rehabilitate mentally ill patients – many of whom display violent tendencies while some are convicted criminals.
It first came under the spotlight when convicted murderer Lerone Boye escaped from inside three years ago. Boye was found hiding under a bed in a friend’s house three months later after a huge police operation to track him down.
“October 16, 2013 – I will never forget it as long as I live,” Paul Gilluley, the consultant forensic psychiatrist who heads the unit, tells the Gazette at the centre this week. “You never want an escape to happen on your watch.”
MPs Meg Hillier and Diane Abbott then called for safety to be the “highest priority” after a spate of high-profile offenders – including a violent rapist, child snatcher and the man dubbed “Britain’s most prolific burglar” – went on the run while on escorted leave.
And last July five patients lay siege to the centre, arming themselves with broken glass, trapping six staff members in an office until police – who were later commended for their bravery – managed to defuse the situation with no injuries.
In May last year, after three patients went missing in the space of three months – including one locked up for attempting to kidnap a stranger – the centre bowed to pressure and agreed to trial tags for patients granted leave.
It’s not an ideal solution – the point of allowing patients out into the community is to build up trust with an eye to their eventual release. All the same, police have heralded the pilot scheme a success.
The two patients who have since absconded whilst on leave have both been found within an hour.
Another coup d’état has been the relationship developed between the centre and the police’s anti-social behaviour and mental health team which was set up in January.
While centre staff used to make their own judgements about patients, police now give their perspective on the potential risk to the public at monthly meetings. Police meanwhile learn about the type of patients the centre treats, and the type of recovery work they undergo to reduce their offending behaviour.
“Most places in London and across the country will have a model where the mental health services get on with their work and the police get on with their work,” said Dr Gilluley. “We are communicating much more and discussing whether there is a way to deal with this a wee bit differently, and we have found it has worked more effectively. If we had an abscond police would go ahead and investigate, but sharing things before is important to try and prevent things from happening instead of waiting until it happens.”
Ian Simpkins, the Partnerships Inspector who heads the police team, believes they have made ‘massive strides’ by working in partnership.
The daily presence of Pc Jonny Flint on the wards has also been beneficial in building up trust with patients. So far he is the only hospital officer in the whole of the Met.
Pc Flint explained: “Mental health can affect people’s behaviour in a criminal way, but it doesn’t mean people should be excused from criminal behaviour. I’m quite big on pointing out that prosecuting someone can sometimes be the biggest beneficiary for them.
You can’t keep saying: ‘No you can’t keep on hitting people – you are going to get into trouble,’ but never get that person into trouble. There are numerous cases when the person goes before a magistrate and gets a small fine but it means their behaviour improves remarkably, which means they can be on a pathway to discharge much quicker.
“There’s still a lot of stigma around mental health, but with mental illness the clue is in the title - illnesses can be treated.”
While the centre has one nationally recognised personality disorder ward for 16 patients, it mainly treats men with mental illnesses such as schizophrenia, depression and bipolar affective disorder.
Patients are only allowed to leave with the permission of the Ministry of Justice or the independent Mental Health Tribunal, who carry out their own risk assessments.
Layers of security are threefold at the medium secure unit – which essentially means no one should be able to escape from it.
Facts and figures:
139: Number of beds for patients and detainees
550: Staff tally including consultants, nurses, social workers
3.7% of patients reoffend after conditional discharge from similar centres, while....
59% of prisoners in UK jailed for less than a year go on to reoffend
18 months: Average length of stay for patients – but can be a lot longer
Procedural security includes the electronic tags and making sure no visitors enter with things like mobile phones that could help people escape. Physical security covers details like the 5.2m fences surrounding the unit.
But most important is “relational security” – how patients are feeling and their interactions with others. Staff continually check the patients’ mental state to get an overall picture and meet weekly.
Dr Gilluley said: “They might say, ‘He’s fine this week,’ or they might say, ‘He’s been a bit funny because he’s not sleeping at night; he’s walking up and down, he’s hearing voices and he’s started to think again that the next door neighbour’s possessed by the devil.’.Then you start to wonder he’s getting ill again. So we build up that picture the whole time and tailor the treatment for the individual to meet their needs.”
Dr Gilluley, who inspects other centres around the country for the Care Quality Commission, said: “When people are unwell they expose to you an intimate side of themselves.
“It’s quite a profound relationship you build up, particularly in forensics because we have people here for prolonged periods of time.
“Day-to-day it can be really hard work. Seeing people who had really improved, then when you see them they are very, very ill, can be quite awful – it’s quite traumatic.
“But to see people getting better and having a better quality of life with their family is very rewarding.
“It’s not a job you are going to do for the thanks. You are detaining people and taking away their freedom so people don’t send you Christmas cards and say ‘thank-you, doctor’. But you do get an odd one now and again.”