M ental I llness C oncerns A ll	The Chair makes a sort of apologia for not asking more about whether to include 'the new friend and fellow perpetrator' into this Inquiry. The Report does not find out whether he was a patient where he came from. Some were waiting anxiously about that ( in Worcestershire ? ) and to take on an Inquiry there seems to have been too much. But why did the Worcestershire Health Authority not set up its own. Why did the Department of Health which insisted upon this one against the advice of the local Health Authority, not ask for one about the care - if there was any - given by the Worcestershire Health Authority locality, to the other perpetrator. We have to assume that the companion in crime had no specialist psychiatric contact The tragic act seems to have occurred only after this recent 'friend' arrived at the Hostel, and they were jointly condemned. It was MH who felt uncomforable and revealed his direct involvement. The Inquiry Report declares that reviewing the quality of risk assessment estimation by the mental health service is a good enough reason for setting up the Inquiry ( and that would be a sound reason for an Inquiry into the care given to the companion ) and also finds enough in its examination of the Health contribution to the homeless support team for those 'not quite right' and living in the Hostel, to warrant recommendations towards a better incorporation of that into mainstream psychiatric supervision and accountability. ( and that might apply elsewhere as well ) The ability of the services over all, provided by East London and City Health Authority to take that on, is hardly touched upon - they have a high rate of Section 4 emergency admissions to explain - and the vulnerability of the homosexual companionship relationship in general is hardly peered into. The Inquiry sticks to its remit. We can find within it a distinction between severe mental illness as a management categorisation - so as to encompass the priority of the NHS mental health funding - and the reluctance of 'official' team psychiatry to take on board personality disorder as being within that category, and within their resources. As was the case here. They have neither secure institutional competence nor recognisable confidence in this area of work so as to feel responsible or accountable. They are secure enough with recognisable well circumscribed and experienced disease entities - schizophrenia, affective illness, 'hard' neurotic conditions - anorexia, addictions, severe obsessionalstates, but not the non-professional category - risky personality disorders. There they have experience to offer, but no certainties. They will try with their interview skills, but can offer no guarantees,and do not want to be faced with - 'you took them on, thereby excluding other alternatives - so, if it goes wrong, it's you who is to be blamed'. Nobody wanted MH as a case, and an acceptable longterm engagement for him was not there, could not be found, and he did not want to engage either. back to Inquiry Price; Hotson back to Inquiry Linking	E-mail reaction is welcome mica@didgy.freeserve.co.uk