Dr Sarah Hughes, chief executive of mental health charity Mind, has stated that organizations in the mental health sector have not sufficiently acknowledged the potential for violence from a small proportion of people with severe mental illnesses. Hughes, who has spent nearly four decades working in the field, made these remarks ahead of the conclusion of a public inquiry into a fatal attack that occurred in Nottingham on 13 June 2023.
The inquiry focuses on the deaths of students Barnaby Webber and Grace O’Malley-Kumar, both age 19, and caretaker Ian Coates, age 65, who were stabbed by Valdo Calocane. Calocane had received a diagnosis of paranoid schizophrenia three years prior to the incident. In 2024, Calocane was sentenced to an indefinite hospital order after admitting three counts of manslaughter with diminished responsibility and three counts of attempted murder. The inquiry has examined actions and omissions by local authorities, health professionals, and police officers, and heard evidence that Calocane had engaged in multiple violent incidents beforehand, refused medication repeatedly, and was sectioned four times within two years.
Hughes stated that mental health charities had avoided discussing violence risks due to concerns about increasing stigma toward people with mental health conditions. She acknowledged that while the majority of people with mental health issues do not commit violent crimes, some do, with serious consequences. Mind recently held a roundtable with experts to address how mental health services can ensure both patient and public safety. Emma Webber, mother of victim Barnaby Webber, supported Hughes’s statement, noting that danger to others had been insufficiently addressed in prior discussions.
Seena Fazel, professor of forensic psychiatry at the University of Oxford, clarified that while people with schizophrenia do have elevated violence risk compared to the general population, the absolute risk remains small and occurs primarily among a minority. He noted that available treatments can reduce this risk, particularly when combined with addressing factors such as substance abuse or violence history. Hughes emphasized that the sector’s reluctance to engage in difficult conversations about violence stemmed from fear of worsening stigma and discrimination, which could lead to more restrictive approaches.
Hughes called for the UK government’s upcoming mental health strategy to improve support and treatment for those with severe mental illnesses while addressing public safety through adequate hospital beds, assertive outreach, accountability, and improved communication between services. She stressed that patient safety and public safety are not mutually exclusive and can both be achieved through systemic improvements to mental health care.
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