Dr Sarah Hughes, chief executive of the mental health charity Mind, has stated that mental health organizations have neglected to address the potential for violence among a small subset of individuals with severe mental illnesses. Hughes attributed this omission to concerns that discussing violence could deepen stigma and discrimination affecting people with mental health conditions.
Hughes’s remarks come in advance of the closure of an inquiry examining the 13 June 2023 Nottingham attacks, in which three people were fatally stabbed. The inquiry has focused on events preceding the incident, including the perpetrator’s contact with mental health services, prior violent conduct, and repeated refusal of medication. Evidence presented to the inquiry included testimony from various authorities and the perpetrator’s family regarding systemic failings.
Mind held a roundtable discussion with experts to address the role mental health services should play in protecting both the public and patients. During this session, Hughes acknowledged that while the majority of individuals with mental illness do not engage in violent behavior, some do commit serious offenses with severe consequences. She emphasized that the sector has avoided candid discussion of violence and mental health, softening messaging in attempts to combat discrimination. Emma Webber, whose son was killed in the attacks, expressed support for Hughes’s position, noting that danger to others had been downplayed in public discourse.
Seena Fazel, a forensic psychiatry professor at the University of Oxford, provided research perspective, noting that while people with schizophrenia experience elevated violence risk compared to the general population, the absolute risk remains small. Fazel stressed that available treatments can reduce this risk, particularly when combined with addressing concurrent factors such as substance use or prior violence.
Hughes called for the UK government’s mental health strategy to enhance support for severe mental illness while addressing public safety through expanded hospital capacity, assertive outreach, and improved service communication. She advocated for demonstrating that patient safety and public safety are compatible objectives within an improved mental health system.
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