Who Cares?

Jean McNicol

  • The Report of the Inquiry into the Care and Treatment of Christopher Clunis by Jean Ritchie, Donald Dick and Richard Lingham
    HMSO, 146 pp, £9.50, February 1994, ISBN 0 11 701798 1
  • Creating Community Care: Report of the Mental Health Foundation into Community Care for People with Severe Mental Illness by William Utting
    Mental Health Foundation, 76 pp, £9.50, September 1994, ISBN 0 901944 17 3
  • Finding a Place: A Review of Mental Health Services for Adults
    HMSO, 94 pp, £11.00, November 1994, ISBN 0 11 886143 3
  • The Falling Shadow: One Patient’s Mental Health Care. Report of the Committee of Inquiry into the Events Leading up to and Surrounding the Fatal Incident at the Edith Morgan Centre, Torbay, on 1 September 1993 by Louis Blom-Cooper, Helen Hally and Elaine Murphy
    Duckworth, 230 pp, £12.99, January 1995, ISBN 0 7156 2662 0

At around 9 p.m. on 9 December 1992 Nigel Bartlett was walking down a quiet suburban street near Wood Green in North London when a man began to follow him. The man – Bartlett said he looked ‘like the Michelin man’ – started walking backwards in front of him and asked him if he was the devil, and then if he was happy. He had something in his hand; Bartlett thought it was a knife as it glinted in the streetlights, but then realised it was a screwdriver. The man waved it around and then hit Bartlett on the bridge of the nose, probably with his fist. As Bartlett lay in the road shouting for help his assailant walked away. The policeman who eventually arrived said that he thought he knew who the culprit was, that he lived locally and that he was mentally-ill – and so was unlikely to be prosecuted. The policeman, a PC Sullivan, seems to have made the connection between Bartlett’s attacker and the elusive subject of an abortive Mental Health Assessment he had attended the week before. He later, rather unconvincingly, denied all this and claimed that he had had no idea who attacked Nigel Bartlett.

About half an hour later, Susan Parashar, who lived nearby in Whittington Road, bumped into her son and his friends while she was taking her dogs for a walk. A large man came up and began, incoherently, to talk to them. He tried to pat one of her dogs, but it growled at him and the man became abusive. Mrs Parashar walked off with her dogs. The man chased the children in between the cars parked in the street, again waving a screwdriver.

Mrs Parashar rang the police, as did one of the boys and a local shopkeeper. Parashar spoke to an officer at Edmonton Police Station, who asked for a description and then said: ‘I think we know who that is.’ The man, meanwhile, had gone into a house on Marlborough Road – a side street pretty much parallel to Whittington Road, which is split between two police divisions and two local authorities. When the police finally arrived no one was asked to give a statement. The next day one of the boys saw the man again, followed him home and went to the local police station and told them the address – 112 Marlborough Road. That evening Susan Parashar rang Edmonton Police Station again and was told by the woman she had spoken to the previous night that they already knew the address because the police had been present at an attempted Mental Health Assessment there the previous week, but that they couldn’t ‘just go and arrest him’.

The case was transferred to Winchmore Hill Police Station on 12 December; on the 15th an Inspector Gill told Mrs Parashar that everything was in hand. He also contacted Haringey Social Services and told a social worker there that one of their clients had been chasing children and asking people if they were the devil. The man, she said, had an appointment with them for 24 December; Gill seemed satisfied with this. (Like PC Sullivan, Gill denied that he had known who the man was when he gave evidence to the Inquiry, but a record of the conversation was entered in the relevant file.)

Another social worker phoned the man’s consultant psychiatrist (who had never seen him) on 17 December and after some wrangling about whose responsibility he was – which hospital and which social services department – the two decided that an emergency Mental Health Assessment should be organised for the following day. That afternoon Ursula Robson, the duty Approved Social Worker – ASWs have training in mental health, and become involved if there is a possibility that a client will be committed – was given his file. Alarmed by the history of violence it contained, she decided to call at his address that evening. He wasn’t there, so she left a note asking him to come and see her the next morning. She and her colleagues were waiting for him to turn up when they were told that he had been arrested for murder the previous day.

It was not until the following June that Susan Parashar realised that the man who had frightened her was Christopher Clunis, on trial at the Old Bailey for murdering Jonathan Zito on the northbound Piccadilly Line platform at Finsbury Park tube station on 17 December 1992.

According to his solicitor, Christopher Clunis, who was found guilty of manslaughter and sent to Rampton Hospital, is ‘contemplating’ suing North East Thames and/or South East Thames Regional Health Authorities for negligence in releasing him into the community without support. Jayne Zito, his victim’s widow, is said by the Guardian to support him in this. Jayne Zito had worked with the mentally-ill and was on a postgraduate course in social work and social studies at Middlesex University when her husband was killed. Her vehement disagreements with the Health Minister Virginia Bottomley about the degree of responsibility the care in the community programme bears for her husband’s murder have been widely reported. The two women met at the end of Clunis’s trial and Zito tried unsuccessfully to persuade Bottomley to hold a public inquiry. The politicians, she said afterwards, ‘tried to turn this into my personal tragedy instead of tackling the questions that need to be answered about care in the community’. In their view a closed inquiry by the two health authorities responsible for Clunis’s care in the six months before the murder, and investigating his care only during this period, would be adequate. Zito doubted this. Jean Ritchie, the QC engaged to chair the Inquiry, seems to have shared Zito’s feelings, and the two health authorities were persuaded that the Inquiry should investigate Clunis’s case back as far as 1986. The resulting report approximates in scope to the public inquiry for which Jayne Zito originally pressed and also comes close to endorsing her explanation of the causes of the murder.

Clunis was born in 1963 in Muswell Hill, North London of Jamaican parents and went to school in Luton where his father worked at the Vauxhall car plant. He did quite well academically but left before sitting A-levels: he wanted to be a jazz guitarist. He joined the Aqua Vita Showband; in 1985, while he was touring with the band, his mother died – she had had a stroke in 1980 and his parents had gone back to Jamaica. Clunis and his family seem to date the onset of his illness to this period. His father was worried and suggested that Clunis join him in Jamaica. It was there in 1986 that schizophrenia was first diagnosed.

He came back to England in 1987 when his father became ill. On 27 June one of his sisters found him in a ‘terrible state ... uncommunicative, confused, disoriented, staring into space, laughing and giggling to himself’ and took him to the A & E department at Chase Farm Hospital in Enfield. This was his first admission to hospital in this country and he was seen at Chase Farm another five times in the following eight months; and each time, according to the Ritchie Report, was treated ‘almost as though he were a new patient’. There was no investigation of his circumstances or any attempt to check the inaccurate statements he made about them. For example, his claims to have abused drugs were often taken on trust – the Ritchie Report suggests that because Clunis was black there was an undue willingness to believe that his illness was a drug-induced psychosis. Admitted the day after a Community Psychiatric Nurse (or CPN) had visited him at the house of his sister, where he was living, he was described as ‘homeless’. His GP and family weren’t officially informed of the majority of his spells in hospital. This pattern continued: the family’s lack of formal involvement in Clunis’s care over the years was such that the Inquiry was ‘surprised’ to hear from his sister that she had remained in touch with her brother. She was only rarely informed of his discharge from hospital and no member of the family was ever contacted when he was compulsorily detained, despite their statutory right under the 1983 Mental Health Act. Clunis was treated as an itinerant, homeless man, a model which he came more and more to approach.

On 26 April 1988, less than a month after he was last seen at Chase Farm, Clunis was arrested in Tottenham for stealing two loaves of bread, which he had tried to hide by stuffing them down his trousers, and remanded to a bail hostel. Because there was no space in the local hostel he was taken to one in Tulse Hill in South London, troublingly unfamiliar territory. He was clearly disturbed, and a probation officer from the hostel took him to King’s College Hospital. But there were no beds available and he was seen as an out-patient every day until his trial on 3 May, at which point a bed was found for him in Dulwich North Hospital. He was remanded on bail on condition that he went to hospital – if a bed had not become available he would have gone to prison. There have been several cases recently in which High Court judges have threatened to call Virginia Bottomley before them to explain why secure beds could not be found for mentally-ill defendants.

A doctor from Dulwich North contacted Chase Farm and was told that Christopher Clunis was ‘a difficult young man who just wanted a bed’, that Chase Farm doubted the diagnosis of schizophrenia and refused to accept any responsibility for him. On 6 May a nurse at Dulwich North noted that he was carrying a cutlery knife around. On 12 May, having been described as violent and threatening on several occasions, he was discharged. The consultant psychiatrist at Dulwich North, Dr Davies, told the Inquiry that the ‘ward was old and Dickensian and that violence was commonplace’. Its unsuitability, he added, meant that patients were discharged earlier than they should have been.

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