Violent crime and mental health - lessons are not being learned

The problem is bigger than you think, and ideology is getting in the way

Reports have emerged that the man responsible for the horrific antisemitic terror attack in Golders Green had left a psychiatric hospital just days prior.

I don’t mean to downplay any ideological, or anti-Jewish motivation on his part. And he had a prior record of criminal violence, which he should have been deported for.

But as well as those things this also appears to be yet another case of a dangerously mentally ill individual not being dealt with properly. This is a big problem, and one where time and time again, we fail to learn the lessons.

Let me start by taking you back three decades. Here’s a quote from the Psychiatric Bulletin, of August 1994:

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On Thursday, 17 December 1992, Jonathan Zito was travelling home by London Underground with his brother Christopher. Jonathan had met his family at Gatwick Airport and there had been insufficient room in his friend’s car, so the rest of the family had gone on ahead. The brothers stood waiting for a change of train on the Piccadilly Line at Finsbury Park Station, chatting to each other in a crowd of waiting passengers.

On the platform was a large, shabbily dressed, black man acting in a bizarre manner. In the era of community care, floridly psychotic per sons are not an unusual sight on the streets of the capital or on its transport services. The waiting passengers ignored Christopher Clunis until he came very close behind the Zito brothers on the edge of the platform. Without any warning, Clunis suddenly stabbed Jonathan Zito three times in the face, one of the wounds penetrating upwards over his eye and into his brain.

Clunis was a paranoid schizophrenic. He had occupied a filthy bedsit where a quantity of prescribed medication which he had not been taking was found by the police. There were various items of correspondence from both hospitals and the social services. At his trial he was subsequently found guilty of manslaughter due to diminished responsibility and admitted to Rampton maximum security hospital under Section 37/41 of the Mental Health Act, 1983.

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At Clunis’ trial the following summer, Zito’s widow Jayne, who had herself worked as a deputy manager of a rehabilitation unit for the mentally ill, declared that her husband’s death had been both predictable and avoidable.

An inquiry published in February 1994 agreed. The report catalogued 'a whole series of violent attacks' by Clunis over four years, often involving knives.

It lamented the “catalogue of failure and missed opportunity” in the care of Clunis, including the absence of any proper assessment of his history and propensity for violence, the treatment of successive hospital admissions as unrelated incidents, and a pattern of premature discharge. He had already been in hospital in Jamaica before moving to the UK. It turned out that he had been assessed by, or directly under the care of, no less than 30 named psychiatrists, had 10 episodes of in-patient care, and was remanded into prison or police custody on three separate occasions.

But he had bounced around the system for years without anyone ever getting a grip. The inquiry blamed “one failure or missed opportunity after another.”

And yet, and yet….

All the old problems, and some new ones too

Fast forward 34 years, and a new inquiry is currently running through almost exactly the same litany of failures in another case, which led to yet more innocent people being killed.

On 13 June 2023, Valdo Calocane killed three people in Nottingham: university students Barnaby Webber and Grace O’Malley-Kumar, both 19, and caretaker Ian Coates, 65.

Calocane was well known to mental health services, having been sectioned four times. He was also well known to the police. He had been discharged in late 2022 despite refusing his medication and failing to engage with staff. At the time of the killings, he was, in the words of the inquiry, “unlawfully at large.”

It has emerged that in May 2020, Calocane had kicked at a neighbour’s door while in a state of psychosis, so frightening her that she jumped from a first-floor window and suffered a serious spinal injury.

It has also been revealed in the CQC review of Calocane’s care that risk assessments minimised or omitted key details, including the fact that he was refusing to take his medication and was having ongoing and persistent symptoms of psychosis. It identified points where poor decision-making, omissions and errors of judgement contributed to a situation where a patient with very serious mental health issues did not receive the support and follow-up he needed.

The families of Barnaby Webber, Grace O’Malley-Kumar and Ian Coates have said that the services involved in Calocane’s care “have blood on their hands.”

They are right - almost every problem in the Zito case is replicated - but with some new problems on top.

For example, officials blamed “data protection” for failing to connect multiple incidents.

The therapeutic culture now also plays a role. For example, Nottingham University had thought about expelling Caolocane in early 2022 after he attacked his flatmate. But they decided not to expel the violent student because it might cause him “stress” and would have “impacted on his mental health”. Eleanor Turner, the university’s head of counselling, was worried that he would experience “stigma around what happened”.

And above all, racial ideology now provides another factor preventing effective action.

As part of a preliminary investigation in the Calocane case an NHS Trust executive said:

“I think, also, people would be thinking about the over-representation of young Black men under the Mental Health Act … So I’m sure that they were considering it.

Mental health professionals had been “leaning towards” sectioning him, but they eventually decided to release him into the community after considering “research that shows over-representation of young black males in detention.” He went on to kill three innocent people. Some of those involved deny this was a factor in how they handled him. I don’t believe them.

I cannot stress how strongly the culture in public services is shaped by this ideology. Since 2020 very few people in public services will not have had to go on training to do with racial justice, or been drilled about “intersectionality”. This ideology is everywhere.

And it has consequences. It is, for example, why the head teacher of Axel Rudakubana’s school was made to remove her description of him as “sinister” in an official document:

“I was told my attitude towards risk around him was because I perceived him to be a black boy with a knife, they thought I was racially profiling him.”

It is also why references to Rudakubana being “cold, calculating” and “angry” were removed from his care plan. The ideology will not let public servants describe accurately what they are seeing.

The scale of the problem

The Zito inquiry made a series of recommendations which were accepted in full. This included mandating an independent inquiry into every homicide committed by someone under mental health care.

The Confidential Inquiry into Homicides and Suicides by Mentally Ill People - which had been established two years before - was tasked with collecting these reports, and recording patterns across the country of violence of this kind, in hope that lessons were learned across the health service rather than buried in the specific trust where each tragedy occurred.

That organisation still exists today, now rebranded as the “National Confidential Inquiry into Suicide and Safety in Mental Health”, and run by the University of Manchester.

The rebranding - to drop the word “homicide” - is itself significant: it reflects the prevailing culture, where the most important thing is not to “stigmatise” anyone.

The NCISS’ most recent report analysed the 5,733 homicide convictions in England, Wales and Scotland reported between 2013 and 2023. Of these, an estimated 622 perpetrators were patients in recent (<12 months) contact with mental health services.

This accounts for more than one in ten general population homicides, an average of 57 killings every year, by someone with mental health challenges.

That’s a lot, but high as these figures are, they are in fact an underestimation of the complete picture:

• First, the data collected only includes perpetrators who were convicted of their crime, so excludes those who may have died by suicide immediately after the act, or were found unfit to plead. For example, the case of Jala Debella, who stabbed a grandmother, Anita Mukhey, eighteen times with a hunting knife in Edgware in May 2024. Since Debella was deemed too unwell to stand trial for murder, he was sentenced to a hospital order under the Mental Health Act which places the killing outside the standard homicide conviction statistics.

• Second, these statistics count offenders rather than victims. If a mentally ill person kills multiple people, as in the case of Valdo Calocane and the Nottingham killings, it is recorded as only a single case in the NICSS statistics.

• Finally, the data has no way of accounting for mentally ill offenders whose only medical contact was with a GP or A&E, or those who received no service at all. This means it doesn’t include cases like Alexander Lewis-Ranwell, who killed three elderly men in their Exeter homes in February 2019 after multiple contacts with a GP and police medical staff, only to be released from custody without a specialist psychiatric assessment.

In part because of the lack of recorded data on killings of this kind, in 2010 Julian Hendy founded the group Hundred Families. Hendy’s father was killed by a mentally ill stranger three years prior, and the organisation was set up to campaign to reduce the number of mental health-related killings, and to help other families affected.

As part of this work, Hendy has worked tirelessly to compile a database of mental health related killings in the UK, stretching back to 1993 when the government first ordered NHS Trusts to commission inquiry reports following mental health-related homicides, on the recommendation of Ritchie’s report.

This makes for sobering reading. Thousands of examples, all across the country, of devastatingly violent attacks on innocent loved ones or strangers. What connects them all is that they were committed by dangerously ill individuals, who simply should not have been allowed to roam the streets.

So far, Hendy has documented 2,462 mental health related homicides, from press reports, inquiry reports and sentencing remarks. This translates to over 100 deaths of this kind, per year.

These are big numbers, but reducing this problem to mere statistics glosses over the horror. Here are some recent examples of what those numbers mean in practice:

July 2024, Brompton - A British Army officer stabbed many times outside a barracks in Kent. The court hears that attacker Anthony Esan was discharged from the care of Medway Early Intervention Services to the Medway Low-Intensity Support Community Mental Health Team (CMHT) only a month before.

30 July 2024, Telford - Paranoid schizophrenic off his medication fatally batters his mother with a claw hammer and seriously injures his father. The killer had previously been sectioned following an incident in 2021 in which he had attempted to attack his mother with a baseball bat.

30 Apr 2024, Hainault - Psychotic man with schizo-affective disorder fatally stabs schoolboy with a sword and seriously assaults others after taking ayahuasca and cannabis.

July 2023, Harrow - Psychotic man repeatedly and fatally stabs neighbour 39 times with a sword. The murder happened months after the killer had been sectioned and released.

11 Jul 2023, Hayes - Psychotic man with paranoid schizophrenia repeatedly and fatally stabs his stepfather after a drugs binge.

20 Nov 2020, Tamworth - Floridly psychotic man repeatedly and fatally stabs girlfriend then runs her over.

Feb 2019, Borth - Paranoid schizophrenic fatally stabs stranger 10 days after being released from a secure psychiatric unit. It was reported in April 2025 that the family of the victim had recently learnt that the killer was now allowed out on visits.

The Mental Health Act 2025

One might expect evidence of this sort to weigh heavily on those seeking to amend our mental health legislation, as Labour sought to do at the end of last year.

However, from the beginning, conversations surrounding this legislation were more weighted towards reducing “mental health inequality”, and increasing the “autonomy” of mentally ill people, rather than protecting the public.

Indeed, this was its guiding principle. Labour’s Manifesto declared that “the operation of the Mental Health Act discriminates against Black people who are much more likely to be detained than others” promising to “give patients greater choice, autonomy, enhanced rights and support”.

This hands-off view had been building up in the expert community for some time.

Milestones include the 2018 Wessley Report “Modernising the Mental Health Act: Increasing choice, reducing compulsion”. The 2020 “Summer of Floyd” accelerated the debate. The last government produced a white paper and draft legislation, criticised by a select committee for not going far enough.

For too long there has been an acceptance (without any debate) that any disparities in the rates of people sectioned must automatically reflect discrimination and be a problem.

This is odd, because we do not make this assumption in any other field of public health. We accept, and deal with, the fact that some communities are more likely to suffer from certain things, from sickle cell to diabetes. And in the case of potentially dangerous mental health cases, we have to think about not just the patient’s own wellbeing, but also the risk of harm to others.

Professor Swaran Singh, one of the leading researchers in this field, has also pointed out the obvious flaw in trying to crowbar into health legislation the language of racial disproportionality. Put simply, disease is not egalitarian, and the higher rates of detention among Black patients, Singh’s research suggests, reflect higher rates of serious mental illness rather than discriminatory clinical practice.

Despite these criticisms, Labour’s Mental Health Act passed in 2025 included provisions to raise the threshold for detention and Community Treatment Orders under the 1983 Act, while reducing the duration for which patients can be held.

As a result of this legislation, it is no longer sufficient to justify detention or a CTO based on the “interests of the patient’s health or safety”; instead, there must now be a risk of “serious harm” to the patient or others, with explicit consideration given to the “nature, degree, and likelihood of that harm arising.”

These changes to the law will reinforce and accelerate the hands off approach to mental health. They will directly lead to more dangerously unstable individuals left to their own devices in our communities, posing a grave risk to themselves, their families and the general public.

Conclusion: Time to think again

There are all kinds of things we need to do to change the treatment of dangerous mentally ill people.

We need to deal with the problems of fragmentation and chaos which have gone unsolved from Zito to Calocane.

We need to think about big questions about who should be out in the community at all - and the downsides of the well-meaning closure of secure institutions since the 1960s.

But as a first step we must think again and bin the disastrous hands-off, racial ideology which has grown up around mental health in recent years.

In March, Kemi Badenoch said:

We will stop putting ideology ahead of public safety.

We will overhaul Labour’s Mental Health Act. And we are going to detain people who pose a risk to the public. Keeping them safe, keeping the public safe.

We cannot have dangerous men running around our towns and cities stabbing people.

Ladies and gentlemen, this was not a one-off. There was one in Edinburgh this week. Another one in Birmingham.

In November, a man got on a train in Cambridgeshire and started stabbing passengers even though earlier that day, he had already stabbed someone on a train in London.

It’s the state’s job to stop these things - but the British public is being left in harm’s way.

Sadly, just a month later, we see yet another example of violence and people in harm’s way from someone who should not be on our streets.

It is time to put the interests of the public, and the victims, first.