Mental Health Homicide and Society : Understanding Health Care Governance

A homicide committed by a mentally disordered person who is under the care of health service professionals is a shocking event. Otherwise known as a ‘patient homicide’, these incidents are followed by an investigation into the care and treatment received by the perpetrator. These investigations are often regarded as a way to ‘learn lessons’, establish accountability and provide catharsis to families and the public. The book argues however that patient homicide events and the circumstances in which they occur are communicated about within closed systems of life (eg law, medicine). These systems operate according to unique internal logics. The communications produced by these systems, nevertheless, resonate in society and enable a diverse and complex space of governance to emerge – a space of governance in which universal understandings about patient homicides, health care, public safety and risk are unachievable. The Scottish Government initiated reform of their patient homicide investigation procedures in 2017 and plans to reform patient homicide investigations in England are slowly germinating. This original and compelling book is therefore a timely and important contribution. It concludes that health policy makers should re-evaluate their normative commitments to patient homicide risk reduction in a world of disharmony, objection and resistance. "A homicide perpetrated by a mentally-disordered person under the care of health services is a shocking event. Otherwise known as a 'patient homicide', these events attract investigatory responses that are widely understood to be episodes of procedure that seek the truth about what happened and promote the learning of lessons. This monograph however incorporates systems theory into its novel theoretical design and argues that these events are communicated about within closed systems of life (eg, law, medicine). These systems operate through unique internal logics. Yet, they resonate in society and enable a contingent and chaotic space of governance to emerge in which universal understandings about patient homicides and the realisation of pre-defined goals to minimise their occurrence is unachievable.The book is timely because the Scottish Government initiated a process of reforming their patient homicide investigation procedures in 2017. In England more recently, plans to reform patient homicide investigations are slowly germinating. Original and compelling, the book concludes that policy makers should re-evaluate their normative commitments to improve public safety and health service quality in a world of disharmony, objection, and resistance"-- Provided by publisher Preface Acknowledgements Contents Table of Cases Table of Legislation Introduction 1. Homicide and Health Care: Context and Complexity I. Introduction II. Patient Homicide and Health Care III. Background and Context IV. Thinking About Complexity V. Central Questions and Themes VI. Conclusions 2. The Investigatory Domain I. Introduction II. The Inquiry III. The Inquiry Industry IV. Conclusions 3. Social Systems I. Introduction II. Theoretical Background III. Conclusions 4. The Patient Homicide Governance Space I. Introduction II. Legal Realities III. Political Realities IV. Scientific Realities V. Medical Realities VI. Economic Realities VII. Moral Realities VIII. Mass Media Realities IX. The Implications of Social Autopoiesis X. Conclusions 5. Accountability and Time I. Introduction II. Accountability as Communication III. The Concept of Time IV. Accountability and Time V. Conclusions 6. Risk and Protest I. Introduction II. The Concept of Risk III. Protest and Politics IV. Conclusions Conclusions Bibliography Index "A homicide committed by a mentally disordered person who is under the care of health service professionals is a shocking event. Otherwise known as a {u2018}patient homicide{u2019}, these incidents are followed by an investigation into the care and treatment received by the perpetrator. These investigations are often regarded as a way to {u2018}learn lessons{u2019}, establish accountability and provide catharsis to families and the public. The book argues however that patient homicide events and the circumstances in which they occur are communicated about within closed systems of life (eg law, medicine). These systems operate according to unique internal logics. The communications produced by these systems, nevertheless, resonate in society and enable a diverse and complex space of governance to emerge {u2013} a space of governance in which universal understandings about patient homicides, health care, public safety and risk are unachievable."