The Rabones' story

Article 2 - Protecting the right to life of voluntary mental patients

In February 2012, the Supreme Court ruled that under Article 2 voluntary patients are entitled to the same duty of care as a patient detained under the Mental Health Act.

In April 2005, Melanie hanged herself the day after a psychiatric unit in Stockport, Cheshire, allowed her to go home. For Melanie's parents, Richard and Gillian, their grief at her death was compounded by a six-year legal battle to prove that the local NHS Trust had failed in its duty under Article 2 to protect their daughter's life. 'Melanie's death was a great shock to us. It completely blew us apart and we did not know where we were or what we could do,' says Richard.

Parents' grief was compounded by a six-year legal battle to prove the NHS Trust had failed in its duty under Article 2 to protect their daughter's life.

Melanie, who had a history of depression, was 24 when she took her life. She had been diagnosed with depression in 2000 but made a full recovery, Richard recalls. Then in 2005 she became ill again, shortly after the Boxing Day tsunami in Asia when she was working for a relief agency in Manchester. 'Following the disaster she was completely overwhelmed with work and just seemed to lose confidence in herself,' he says. 'She had also split up with a boyfriend a couple of months earlier.'

On 4 March 2005, Melanie tried to commit suicide and was admitted to Stepping Hill Hospital in Stockport. She was diagnosed as suffering from severe depression and prescribed a course of drugs. The hospital discharged Melanie on 18 March, but two weeks later she attempted suicide again. Although the hospital wanted to admit her to its psychiatric unit, no beds were available, and she remained at home. On 11 April she tried again to kill herself, and agreed to return to hospital voluntarily, where she was monitored every 15 minutes because she was deemed at high risk of suicide.

Two days later, Melanie's father expressed grave concern to hospital staff about his daughter's condition and told them that she should not be allowed home in case she tried to self-harm. Despite this information, a consultant psychiatrist agreed on 19 April to give Melanie home leave for two days at her request. She hanged herself the next day.

Richard and Gillian maintained that staff at Stepping Hill Hospital should not have allowed Melanie to go home and that Pennine Care NHS Trust was responsible for their daughter's death. They started proceedings against the trust in August 2006, claiming negligence and breach of the right to life under Article 2. The high court ruled in 2010 that the NHS had no duty under the Human Rights Act to protect Melanie's life because she had not been detained at Stepping Hill, but was a voluntary patient. The Court of Appeal upheld this decision.

The Supreme Court's decision is a landmark in human rights law.

The Rabones then took their case to the Supreme Court. In February 2012, the court found in their favour. The five judges unanimously decided that under Article 2 Melanie was entitled to the same duty of care as a patient detained under the Mental Health Act. They ruled that the trust should therefore have taken reasonable steps to protect her, even though Melanie was a voluntary patient.

Gill Edwards, a partner at Manchester law firm, Pannone, who represented Gillian and Richard says: 'The Supreme Court's decision is a landmark in human rights law in that it recognises that non-detained psychiatric patients are entitled to the same level of protection as detained patients. Now the parents of adult children who die in such circumstances have a remedy in law which acknowledges their own loss and bereavement.'

Richard says that while the decision won't bring back their daughter, it was an important victory. 'Hopefully the judgment will mean hospitals will take far more care, as it is now irrelevant whether a psychiatric patient has been sectioned or not.'

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