Showing posts with label Learning Disability. Show all posts
Showing posts with label Learning Disability. Show all posts

Friday, 5 April 2013

Shameless Mick

I guess I can't put it off any longer. I've read as much as I can and watched both hour-long tv documentaries, which incidentally varied enormously in quality with the BBC Panorama special easily trumping the ITV effort. It's the subject of conversation in every pub, and generally across the length and breadth of the Nation, if not the wider world. 

The absolutely tragic Philpott case involving the death of six children in Derby has shocked us all and lifted the lid on some very uncomfortable issues. Try as I might, it's hard to find any redeeming features in Mick Philpott, the self-styled 'shameless Mick', despite his defence counsel describing him as a 'caring father'.

I think such a statement in mitigation enormously irritated HH Mrs Justice Thirlwell who was quick to dispel that particular myth. As the vast brood of kids in this very unorthodox domestic situation grew older, I'm fairly sure huge amounts of trouble were being stored up that could only lead to great unhappiness at the hands of this 'enormously dangerous' bully. 

It was no great surprise that Mr Philpott received a discretionary life sentence with a 15 year tariff. Interestingly, had the Crown decided to continue with charges of murder, upon conviction the tariff starting point would have been whole life. As always the sentencing remarks are worth reading in full and it's abundantly clear that Mrs Justice Thirlwell got the measure of the man completely. What sweet irony that it fell to a female judge to deal with this case. One can only speculate how irritating Mr Philpott must have found this. 

Apart from the children obviously, I have to say my sympathy lies with the long-suffering wife Mairead who was undoubtedly chosen by Philpott because of her vulnerability and susceptibility to manipulation and control. We didn't hear her speak much due to the control exercised over her, but I suspect she is of limited ability and possibly has a learning disability. I think the jury's majority verdict in her case might indicate a degree of concern by at least some jurors.  

In cases such as this, I believe there is a view by some judges that adjourning for full probation reports prior to sentencing is unnecessary because long custodial sentences are inevitable. I remain firmly of the view that PSR's should be prepared in order to highlight issues that might not have received a great deal of attention during the trial. I can't help thinking that the judge would have found a psychology report for Mairhead both helpful and enlightening before passing sentence on her.

As is usual with all those receiving a life sentence, a probation officer in Derby will be starting the process of preparing a Post Life Sentence Report on Mick Philpott and that will form the basis of future sentence planning. It won't be easy challenging his distorted views of relationships, but someone, somewhere will have that task over the coming years.  

Thankfully for us all, Mick Philpott can no longer be a danger to further women and children for a long time to come, but the timing of this case couldn't be more cruel coming as it does right at the very moment when attention is focused on the level of state benefits. For critics of the system you'd be hard-pressed to find a better example to illustrate your case than that of Mick Philpott and the estimated £70,000 that flowed through his bank account in benefits.

Even ever-smug-looking Chancellor George Osborne can't resist the opportunity to make mischief with the Philpott case for political ends, no matter how extreme or unusual it might be. Unfortunately it's for this that the deeply obnoxious Mick Philpott will be remembered, as much as being responsible for the deaths of six very normal-looking children and who sadly didn't seem to have overly-benefited from the state's largess.                              

Friday, 13 January 2012

Coppers

I'm sorry if it seems like this blog is turning into the electronic version of the tv or radio times, but there just seems to be so much being broadcast about criminal justice at the moment. Maybe it's always been like this and I just hadn't noticed, but now I have blank blog pages to fill.

'Coppers' is a Channel 4 documentary series following various branches within the police as they go about their daily work. I never caught any of series one broadcast in 2010 and the new series started on Monday this week, featuring CID based in Mansfield, Nottinghamshire. The subject matter is of interest to probation officers because of course those being dealt with will almost certainly come our way at some point. Watching this first programme just served to remind me once again for the need of something similar, following our work with offenders, but maybe the tv people just don't think it's exciting enough.

First off, I have to say it's reassuring to see that the officers based in Mansfield appear so 'normal' to me. So professional, so human and well, like us in many respects. I knew that before of course, but we have different jobs to do and of necessity we view the clientele somewhat differently. Once again I recognised all the characters and try as I might I found it hard not to be either mentally writing their PSR's, pondering a supervision plan or just seeking an explanation. At the same time, ringing in my ears, was a particularly irritating political soundbite I've heard recently along the lines of 'we should try and understand less and condemn more.' Errr no, and tv programmes like this highlight for me the stupidity of such sentiments.

The young, cocky, suspected burglar who feels that the police are 'stupid' and villains much smarter will be all too familiar to most PO's. Such distorted thinking is sadly so very typical. Having failed miserably at school, probably the product of unstable parenting and negative role models, he will almost certainly be involved in either heavy drinking or drug usage. The look of those eyes and the profuse sweating during interview looked very familiar to me. The future for him, and sadly the community that he resides within and is no doubt pestered by him, is quite bleak. Currently unemployable, one can only hope that either the passage of time and maturing process, coupled with a rather more sensible girlfriend, may in the end effect some positive change. 

Of course probation will do it's best. He'll no doubt find himself on a Thinking Skills Programme at some point. A referral to a drug project and a spell of Unpaid Work, but when he either fails or breaches it will be ever-lengthening spells in custody, which he made plain were no great hardship at all. What he and his ilk need is something radical. Do you remember that tv series a few years back called 'Bad Lads Army?' A brilliant example of how the combination of external interest, structure and discipline can change someon'e life for the better. A period away from your normal environment, a broadening of horizons and the chance to have some responsibility. All quite well-known techniques behind organisations like Scouts, Youth Clubs, Sail Training Association, Intermediate Treatment and Prince's Trust, but as a society generally we seem to have forgotten the lessons and no longer have the range of opportunities we once did. 

At the other end of the spectrum, and the first episode of this new series of 'Coppers', was the learning-disabled sex offender. We don't know all the details, but it seems he was being accommodated in a hostel of some kind and was the subject of certain restrictions in terms of movement. Basically an ill-judged decision to allow him out into the community unescorted now means that he has been sentenced to indefinite detention in prison (no doubt IPP) with a judges recommendation that he never be released.

I find this absolutely shocking, but highlights the plight of this very difficult group of offenders. Not bad, or mad in terms of being appropriate for detention in Special Hospital, this sad man will now be inappropriately the responsibility of HM Prison Service with little chance of release. Due to his learning disability he will be deemed unsuitable for sex offender groupwork programmes within prison and his future is even more bleak than the young suspect burglar. I always find these cases very upsetting and his probation officer will find that their scope to assist is sadly severely restricted. Without doubt, the learning-disabled remain very much misunderstood by the Criminal Justice system and get a very raw deal as a result.     

     

Monday, 28 February 2011

Cautionary Tale 3

From time to time it's not unheard of for the workload to increase to such an extent that help has to be summoned from neighbouring offices. It was just such a situation a few years ago that found me visiting a young black guy on remand in order to prepare a PSR for Crown Court. Living as he did in the big multi-cultural city it gave me the rare opportunity of getting involved with someone from a very different culture and background to my usual overwhelmingly white clientele. As such I recall vividly being somewhat more tense than usual when approaching the prison gates, I suppose just because of all the accumulated race awareness training that up till that point had been mostly of academic interest only.

The guy was in his early twenties, physically large and fit looking with a broad smile. He was facing serious charges of possession with intent to supply heroin for the third time and as such was looking at an extended sentence of up to seven years. The interview proved to be one of the most difficult I have ever encountered. No matter how I seemed to approach the questioning I didn't seem to get any answers that made a great deal of sense. It was difficult to hear him despite us being in a semi-enclosed glass booth, but amid the loud din of family visits taking place in the adjacent visits area. He seemed to be constantly distracted and alternately 'laid back.' I remember concluding the interview and driving home thinking it had been a disaster and that the cultural challenges being posed by this case were simply too much for me too deal with. I was quite depressed by this and mulled it over for most of the evening and indeed till I got back to the office in the morning.

A forensic examination of the file and a telephone call to another officer who had previously supervised the young man elucidated the astonishing statement 'well you know he's got a learning disability don't you?' Suddenly all became much clearer. Here was a young guy who was attempting to survive in a very big bad world by trying to hide his disability and just appearing to be more cool and laid back than most. He probably hadn't understood anything I had been discussing with him and I'd been so tense and thick that I hadn't spotted his disability.

A further reading of the file also made clear the nature of his offending. He was being regularly and cynically used by the local drug barons who knew all too well the nature of his disability and simply manipulated him into standing on the street corner to hand out bags of powder to anyone who approached with ten pounds.

Clearly this was not going to be a simple PSR after all. To cut a very long story short, I managed to convince the Court of the need for a full psychological assessment that concluded that this guy's disability effectively meant that he could be persuaded to do anything and he did not have the intellectual capacity to understand the possible consequences. It was one of the saddest reports I've ever read as it didn't take a lot of imagination to see what kind of future lay ahead for this guy, and indeed what kind of a life he had experienced to date being the 'patsy' to all and sundry in return for what he felt was friendship. 

It was immensely satisfying that on the day of eventual sentence the judge agreed to take verbal evidence from myself and a worker from a learning disability advocacy project. He not only resisted the prosecution application for an extended custodial sentence but instead imposed the maximum period of probation supervision of three years and endorsed a condition of residence at a probation hostel. All a very satisfying end to a challenging case I felt, but of course only the beginning of some very hard work for the officer who eventually got to supervise the order.

I'd really love to say that this story had a happy ending, but it doesn't. A sneaky look at CRAMS some time later showed that the guy had been excluded from the hostel for possession of cannabis, had returned to his old haunts and is currently serving that seven years we so successfully managed to avoid him getting. Clearly there's much to learn from this, not least how heartless and callous some criminally-inclined people are and what a devastating handicap a learning disability can be. It also begs the question as to how somebody can reach the age of 23, have a major learning disability and there be no definitive assessment and diagnosis until a probation officer requests one.      

Saturday, 26 February 2011

More on PSR's

The starting point for virtually all our work with clients is at the stage of a request for a Pre Sentence Report from either the Magistrates or Crown Court. There will have either been a guilty plea or finding of guilt and before passing sentence the court feels that more information about the defendant would be appropriate. The days have long gone when we routinely prepared reports for Crown on not guilty pleas.

As I have previously bemoaned, the PSR situation has changed dramatically in recent years with the introduction of so called Fast Delivery Reports prepared by unqualified Probation Services Officers, together with the introduction of OASys which computer-generates reports from data input in the form of answers to questions. Nevertheless, the PSR or Standard Delivery Report as it is now termed, even in it's current debased format, is still a key part of the Criminal Justice System in ensuring fair outcomes and the laying of sound foundations for rehabilitation. 

At the PSR interview stage the probation officer will be gaining as much information about the person as possible, making assessments about the reasons for their offending, identifying areas where they might require guidance or practical assistance and begin to develop a plan of action in order to assist rehabilitation and hopefully an end to offending. All this in addition to being mindful of the requirement to address the need for punishment. To me this has always been one of the best bits of the job. Identifying what's wrong, what needs doing and how it can be sorted, all explained in about three pages of A4. If done properly, not only will the sentencing bench go along with it because it makes eminent sense, but it sets out neatly to any subsequent colleague who might pick up the case what needs doing and why.

As a result of skilfull and attentive interviewing, it's not unknown for significant issues to be picked up at this stage for the very first time. Two that spring immediately to mind are a history of sexual abuse or an unrecognised learning disability. In the case of the former understandably victims will have buried painful experiences very deep and disclosure may not surface until years later and when dysfunctional behaviours are played out in the form of some form of criminal activity. In the case of the latter, incredibly a significant number of people in my experience get to early adulthood without a learning disability being properly diagnosed. In both circumstances I feel it is important to bring the information to the attention of the court before sentence is passed, and sometimes with a request for a specialist report from a clinical psychologist. 

To be honest, even as I write this I realise that many colleagues are simply not prepared to stick their neck out at PSR stage and risk going back to the court either with a Nil Report or full report recommending further adjournment for a specialist report. I can understand why because the whole system is now geared up for speed and supposed efficiency, but I need to point out that it is only at this pre-sentence stage that a specialist report and diagnosis can be obtained. It is the only point at which funding is available and it will be appreciated that it is only when there has been a definitive diagnosis that appropriate treatment can be identified or even arranged as part of any plan for rehabilitation. 

I have often been told that cost is a factor. Clinical Psychology reports are not cheap and significantly more expensive than Psychiatric Reports. But is it not worth society spending the money at this stage in getting to really understand what lies behind a persons offending and identify a route for treatment, than paying much more further down the line in terms of more offending and costly incarceration? Research continually shows how many people are in prison with either mental health issues, learning disability or psychological damage. It's at the PSR stage that these can be identified by skilled probation officers and who sometimes request specialist reports as a result. Can I make a plea to sentencers for such rare suggestions to be heeded, as potentially they could be hugely beneficial to us all in the long term. Thanks. 

Saturday, 22 January 2011

Probation and the Car

When I joined the Probation Service in 1985 it was basically a requirement of the job to be able to drive and have a car. I think I am right in saying that without a car you would not have been appointed. I was certainly not aware of anyone who could not drive and it was generally accepted that prison visits, home visits and meeting attendances could not be undertaken without a car. This was recognised by employers in the form of the so-called Essential Car User allowance that was paid monthly and depended on engine capacity. Of course this was in addition to the amount paid per mile travelled on business. 

Probation officers who have been around awhile will remember how the car was often extremely useful in ferrying clients about in all sorts of circumstances and not infrequently with their belongings as well. This ability was invariably regarded positively by clients and in my experience often afforded the opportunity for some really in-depth conversations that would either have been more difficult or not as fruitful if attempted in the office. Over the years some of the most valuable and revelatory conversations have occurred in this way and during journeys in the car. Access to a car also meant you were able to respond to a crisis, take advantage of new information and you had a safe haven or bit of neutral space available in difficult situations.

I well remember calling on one client some years ago to conduct a PSR interview specifically for the purpose of getting a feel for his home circumstances. He had a learning disability and I knew he lived at home with his parents and brother and sister. On arriving at the house I was met by the larger-than-life mother who duly bellowed for her son, whilst serving up tea for her husband in the living room. Whilst waiting for him to appear, she proceeded to bellow at her husband who  merely responded by turning up the volume on the TV. An interview was clearly going to be impossible and I suggested we went out to the car. I remember being stunned by the sheer chaos in the young mans home and my enquiry as to if it was always like that was met with a bemused grin. It seems he coped by simply 'switching off' and absented himself for long periods. I fully understood why.

Of course management eventually got around to taking our car allowance away on economy grounds and I remember our union only managed a compensation payment of a few hundred pounds. In more recent years I've noticed that other branches have managed to increase this to several thousand pounds. In essence management increasingly seem to be of the view that a car is not now necessary, or indeed the ability to drive. I still find it astonishing to accept that, disability issues aside, a colleague using public transport can be as efficient or effective as an officer using a car, but there it is. Of course I have already outlined why I feel video links to jails are inadequate and unlikely to engender a useful working relationship and discussion of highly sensitive issues. Just ask yourself if you would discuss personal stuff in this way? 

But actually in reality it's much worse than that because current standing instructions in my Service now basically forbids the carrying of clients in a private vehicle, unless in exceptional circumstances, I assume for health and safety reasons. Another astonishing example of changes within this job over my working lifetime. From it being a routine and expected part of the role, to being forbidden. I find it so worrying that yet another tool is removed from our armoury in being able to help clients change and basically cope. 

For those possibly unimpressed I will give the following recent example from my time in court as a Court Duty Officer. It was a case of a youngish man with a significant learning disability and granted bail for a serious offence. I'd managed to get him a place at a probation hostel in the big city some 15 miles away by bus or train. But he did not have the capacity to make that journey independently and my manager confirmed that payment for a taxi was not an option. In my professional judgement the right and obvious thing to do was drive him there myself and this is what I did. As a bonus the journey time of some forty minutes gave me the opportunity to really get to know the guy and the many problems life threw at him by virtue of his disability. Isn't this exactly what the job is supposed to be all about?  

   

     

Saturday, 11 December 2010

In the Clients Best Interest?

During the course of their career, most probation officers will pick up a rudimentary knowledge of the Mental Health Act and in particular the provisions for assessment, compulsory treatment and detention. Many of our clients have mental health problems and generally speaking we are aware of the processes involved under the terms of the Act.

I have written previously about the distinctions to be drawn between mental health and learning disability. In relation to the latter, fairly recently I became involved in a case being supervised by a colleague and in particular the enormous amount of effort that had to be expended in trying to get the Local Authority to make an assessment and agree to assume responsibility for the clients suitable care and accommodation. In the process, what puzzled both of us was the eventual realisation of the clients restriction of liberty and by exactly what mechanism?

All the questions directed at the social worker seemed only to confuse the situation further. My colleague and I were both vaguely aware of the Mental Capacity Act but it wasn't until I became aware of this case on the Law and Lawyers Blog that I fully realised what an Orwellian nightmare seems to have been created:- 

"Stephen Neary is aged 20.  He is autistic.  He lived with his father (Michael) until his father had a serious bout of influenza and was temporarily unable to care for him.  Michael arranged for Stephen to be cared for at a local authority run respite centre for just 3 days.  Stephen had been there before.  The respite centre decided to transfer Stephen to a "Positive Behaviour Unit" alleging that he had committed assaults whilst at the respite centre.  The Unit decided to deprive Stephen of his liberty so that he could be "assessed."  He has been held for almost a year and it is argued that he is not suitable to return home.  It now appears that the local authority has applied to the Court of Protection for "Welfare Deputyship."

There is a disturbing full account of this case on the Anna Racoon blog that would reward reading in order to fully appreciate the frighteningly Kafkaesque world that this Act has created, pretty much unnoticed by the public and many professionals alike. What is becoming apparent is just how complex and non-transparent the whole thing has become and I for one remain very uneasy about the process for appeal, or even review of decisions. It's very uncomfortable indeed to realise that what we felt was in our clients best interest in ensuring that he avoided a custodial sentence, has clearly resulted in the deprivation of his liberty, but via a completely different route. A most unintended and worrying outcome.

Tuesday, 16 November 2010

False Choices


We supposedly live in a world where choice is deemed to be 'a good thing'. In fact successive governments have made choice in public services such as housing, health and education absolute top priorities in their political pitch to the electorate. All this in addition to the consumer choices that have increased exponentially during my lifetime and since the end of the Second World War. Personally I've never been that impressed with significant amounts of choice and suspect many other people may feel the same, but that might merely be a reflection of our age and nostalgic memories.

In addition to politicians feeling that choice is what the public want, there has been an increasingly politically correct view about 'choice' and this impinges directly upon our client group. The ethos seems to be that all citizens should be treated as being essentially responsible and should be trusted and encouraged to make decisions for themselves and that those choices will be in their own best interests. In essence the view is that we should move away from an essentially paternalistic approach by the state to one of enabling instead. Now, like many social policies, it sounds great in theory, but the effect in practice is often quite different, leads to unintended consequences, but worst of all some might be deemed as just plain cynical because they involve hidden agendas. 

Following on from the whole 'Community Care' agenda in the 1990's which many would say was simply about saving money, another cynical example I would cite is the current trend to give people with Learning Disabilities control and choice about their care as part of Personalised Care Budgets. Under this system, staying with the status quo is not one of the choices on offer and yet many individuals would choose that option if it were available. They don't want change and cannot comprehend all the factors involved in making alternative care decisions. Many lack true capacity to understand fully, and even with careful and professional mentoring, the whole process is really just about saving money, but dressed up as delivering 'more choice'. 

It will be patently obvious to any probation officer that many of our clients are often in trouble and have great difficulty resolving their chaotic lives precisely because they are not very good at making decisions and quite often make the wrong decisions. I have lost track of the number of times in a PSR I have used the phrase 'Mr X has clearly not acted in his own best interests' in a PSR. It is often astonishing and depressing when we learn of a clients spending decisions when they have so little money by virtue of living on State Benefits. Now I appreciate that this is dangerous territory for someone who is middle class and has always been reasonably well off and it is not my intention to conjure up the stereotypical tabloid image of flat screen TV's, fags and booze. All these might well be deemed important for individuals with little other cheer in their life. I think it's much more fundamental and one reason why programmes like Enhanced Thinking Skills are so important for many of our clients.

But as a society, why do we compound the problems facing so many clients and feel it's sensible or fair to set many of them up to fail by giving choices such as that relating to Housing Benefit? At present it is not possible to elect to have Housing Benefit paid direct to a private landlord, until at least 8 weeks arrears of rent have accrued. I feel this is such a cruel situation to put many clients in when many have difficulty with managing a budget on a restricted income. Having the money paid direct into a personal bank account when they are quite likely to be facing other competing financial demands such as utilities and food is going to add considerably more stress and temptation to an already difficult situation. They may well have money owing to dodgy local money lenders who often threaten violence for repayment and who could blame someone for giving that priority over rent payments? For our clients, it almost seems to be a system designed specifically to encourage debt to build up. Quite understandably it annoys landlords and does nothing to increase the pool of properties available to clients. Indeed it simply serves to encourage many to turn claimants away.

I find it particularly galling from a politically correct point of view to see that Social Landlords have very recently won reversal of the decision to pay their tenants direct under the proposed new Universal Benefit coming into effect in 2013. I notice they didn't complain that tenants might not be trusted to hand the money over, rather they were concerned that it "would jeopardise the stable income they receive from housing benefit". Now just how disingenuous is that?    



Tuesday, 28 September 2010

A Shocking Statistic

It has been estimated that up to 90% of the prison population have a mental health problem. This is an official figure from the Office of National Statistics, but unfortunately no distinction is made between those individuals with a learning disability, as opposed to those with a mental health problem. Or indeed how many that might be personality-disordered or emotionally disturbed. Of course they are all very different conditions, possibly over-lapping, but each requiring specialist diagnosis and appropriate intervention. With something so complex, it's perhaps not surprising that there is often confusion in all parts of the Criminal Justice System. I've known professionals in court admit that they have no idea as to the difference between a psychiatrist and a psychologist and as a consequence request the wrong specialist report. A psychiatric nurse is trained to deal with mental illness, but a clinical psychologist will be more appropriate for someone with a learning disability and a specialist counsellor might well be required for a client suffering emotional distress.

Unfortunately this confusion was compounded by the well-intentioned Bradley Review set up by the last government to look into the whole issue. Even this august body had trouble in agreeing on terminology and failed to decide between 'learning difficulty' or 'learning disability' as a definition. I think it's most unfortunate that the experts seem unable to clarify the matter, as it would be an assistance to the Criminal Justice System in deciding how to deal with such people appropriately. We know that many learning-disabled end up incarcerated, due as much as anything to a basic lack of understanding of the condition and how it differs fundamentally from a mental health issue. I firmly believe that 'learning disability' is the appropriate term as this accurately describes a state from which an individual cannot significantly improve. It is not a 'difficulty' which implies a minor condition that could be overcome. 

As part of the last governments' response to the Bradley Review, Jack Straw set up two experimental Mental Health Courts in Stratford, East London and Brighton and their work is being evaluated. They are modelled on the Drug Review Courts that have been running successfully in many areas, the idea for which having been borrowed from North America. The aim is to ensure that an offenders state of mental health and level of intellectual functioning are accurately assessed, prior possibly to the imposition of a Community Order with appropriate conditions. Progress is reviewed at regular intervals by either a District Judge or Lay Justices. In the case of a mental health issue, a Mental Health Treatment condition might be appropriate. 

Of course this type of condition has been around for a very long time, previously as part of a Probation Order and more recently a Community Order, but in my experience they are about as rare as hens teeth. This is borne out by the statistics. Between July 2008 and June 2009 there were 754 compared to 13,000 Drug Rehabilitation Orders and 5,800 Alcohol Treatment Orders. The discrepancy being basically because probation officers know only too well that it is pointless going down this route as the appropriate medical and social service provision will not be available. It would be especially naive to believe that NHS managers, GP's, consultants, psychiatrists or psychologists are the slightest bit impressed by Court Orders and that they might feel obliged to do their bit in ensuring their success. I think some believe treatment associated with any form of requirement goes against their professional ethics. 

Apart from mental health issues, I'm not at all sure how those with learning disabilities are intended to be dealt with by these experimental courts. Such people don't require 'treatment' but they almost certainly do require sheltered housing; ongoing community support; probably a social worker and ideally special help with employment. As someone who has tried to supervise such cases, I'm very interested to know how a court disposal will ensure these services are provided by Local Authorities and the NHS, because in my experience they are not available. As an example, I've been told in one particular area, there simply is no Adult Clinical Psychology provision at all. How can that be in what is supposed to be a national service? In my view, this particular field of professional expertise is so necessary for some probation clients that I have long-argued we should employ our own. 

 It has always amazed me how a learning-disabled person can pass through State Education, come into contact with various parts of the NHS and reach the age of 18 with no definitive diagnosis or assessment of IQ or mental capacity. It often takes a court appearance and possibly a remand in custody and a PSR request before a probation officer suggests it might be a good idea to get some answers to some very basic questions such as 'does this person have the capacity to understand what is going on?' or 'why don't we know the level of intellectual functioning of this person?' These experimental Mental Health Courts might well be a way forward, but the questions are firstly, will there be any money to fund them with court closures looming and secondly, will the specialist service provision they will undoubtedly identify as being necessary actually be available? I doubt it.