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Let’s Stop Pretending People with Serious Psychosis Can be Independent
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On 30 March last year, a man suffering from severe mental illness walked out of his flat in north London and stabbed a woman in the back with a knife, inflicting injuries that left her paralysed for life. She was a complete stranger to him, as were the four other people whom he met by chance in the street over the next three days and stabbed in the back.

Jason Kakaire, 30, had a long history of psychotic illness. He had once been in sheltered accommodation, but that had closed because of a lack of money. At the time of the attacks, he was living in a seventh-floor flat in a run-down tower block in Edmonton, where he was visited once a month by a mental health team that gave him his medication.

He later told psychiatrists that he suffered from hallucinations and heard voices in his head that told him to kill himself. In the days before he began stabbing strangers, these voices became more threatening, telling him that they were going to kill him. He said that he felt that “he needed to go out and kill people to prevent himself from being killed”.

Kakaire was going to stand trial for attempted murder, but admitted this week to 10 charges of wounding with intent and possessing a knife. He will be sentenced in May.

The case has become something of a cause celebre, because it shows up the failure of the NHS – and of health services around the world – to stop disasters like this. “No question it could have been prevented,” says Marjorie Wallace, the chief executive of mental health charity Sane, who has come to know the Kakaire family well.

She asks why somebody as sick as Kakaire, pursued by demons in his head, should have been assessed as low risk to himself and others. Described as a polite, lonely individual, he was too frightened by his voices to leave the building to go to an outpatient appointment. When his mother reported that he was thinking about suicide, she was told to seal up the windows in his flat so he could not jump out.

Fifty years ago, the severity of Kakaire’s psychosis would probably have meant that he would have been given a bed in a mental hospital, but these beds no longer exist. Despite repeated government claims that it is prioritising mental health, the number of beds available for people with acute mental illness fell by 30 per cent between 2009 and 2018, from 26,448 to 18,082. The number of mental health nurses dropped by 6,000, the number of specialist doctors by 600, over the same period.

Tragically, the provision of help to those with serious mental illness has been squeezed from both right and left over the last half century. Hospital care was supposed to have been replaced by “care in the community”, which makes an appealing but deceptive slogan, but has turned out to mean, as one former government minister put it: “Couldn’t-care-less in the community.”

A great attraction of this approach from the point of view of governments and health authorities is that it saves a great deal of money. If you compare the financial cost of treating a mentally ill person through an occasional visit by a care team with giving them a hospital bed, the care team is an estimated 44 times cheaper than the hospital, says Wallace. She stresses that the vast majority of mentally ill people are non-violent, but says that research by Sane showed that more than half of the 120 homicides committed annually by mentally ill people in the UK happened because of multiple failures by care services. The most common of these is simply not listening to repeated warnings from mentally ill people or their families about what they might do.

The running down of hospitals and other institutions caring for the mentally ill is one of the cruellest and most regressive developments of our era. Government has justified it, in the UK as elsewhere, by claiming from the 1950s onwards that “de-institutionalisation” was in the interests of patients. In reality, it was often exchanging one institution (a psychiatric hospital) for another (prison).

One reason why mentally ill people are so often being left to sink or swim on their own is that people of goodwill seldom have much understanding of the causes and treatment of mental illness. There is what some call the “One Flew Over the Cuckoo’s Nest” attitude, fostered by the film of the same name, which saw mental hospitals as essentially places of incarceration. It stood to reason, in this view, that patients would be better off free, and relied instead on some form of benign but unspecified communal care.

A more serious argument was that advances in medicine since the 1950s enabled doctors to control, though not cure, many aspects of mental illness. Moreover, these new medications did not require the patient to be in hospital because most of them (though not the most effective ones) could be administered by slow-acting injection.

The problem is that there are many gradations of mental illness, but this perception has been blurred by a well-intentioned but counterproductive effort to stop the mentally ill being marginalised. Rachel Jenkins, professor emeritus at the Institute of Psychiatry at King’s College, London, says that “in order to avoid stigma over the last 20 years, people have been calling mental illness ‘mental health issues’, thus creating endless confusions.”

Jenkins says that we are really talking about three distinct categories of mental illness: acute psychosis, which may require hospitalisation; non-psychotic mental disorders such as depression and anxiety; and people with lesser mental problems, which includes a large proportion of the population. People who are psychotic need to be treated very differently from the others.


People with serious psychosis frequently cannot look after themselves, and may be a risk to themselves and others. Looking after them and trying to improve their condition requires great resources, but these have been steadily stripped away since the mid-20th century. As a result, “care in the community” usually ends up meaning care by one’s family, so its degree depends on that family’s resources and income.

By trying to avoid frightening words like “madness” and “insanity”, people who had the laudable intention of destigmatising mental illness have ended up diluting the traditional – and quite correct – belief that acute psychosis is a shattering experience. The pretense that a psychotic person can take rational decisions in their own interests may appear to be a humane approach – but it sends out the message that a person who would once have been considered in desperate need of help can be left to their own devices – or, as happened to Kakaire, to their own voices.

(Republished from The Independent by permission of author or representative)
• Category: Science • Tags: Mental Health, Mental Illness 
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  1. It was a perfect storm created by a match made in heaven between the lovely liberals and the lovely conservatives. The liberals closed down the mental hospitals for civil rights reasons. And the conservatives closed down the half-way houses for “fiscal responsibility” reasons.

    What a bunch of assholes. Both of them. You too.

    • Replies: @Pheasant
    , @BDS Always
  2. Anonymous[416] • Disclaimer says:

    It must be a coincidence you choose the case of a man knifing a woman to base your argument on.
    A far more common, and exemplar, case of psychologically disturbed people assaulting others is women making false rape allegations on men.

    • Replies: @Herald
  3. Pheasant says:

    ‘You too’

    Why do you consider Patrick Cockburn a leftwing writer an asshole?

    In the UK it was mainly Thatcher who closed mental hospitals.

  4. Adûnâi says:

    This is such a clownworld.

    1. Psychiatry is based on a pseudoscientific belief that mental disorders are biological in nature. They are not. “Medication” is not medication.

    2. “says Marjorie Wallace, the chief executive of mental health charity Sane” > women have the power to prostitute themselves in the open, and yet it’s the dude who stabbed a few folks with a knife who is considered insane!

    3. “she was told to seal up the windows in his flat so he could not jump out” > a mad Christian society that prevents people from killing themselves somehow has the moral authority to lecture anyone! What hypocrisy. Their unquestionable belief in the absolute sanctity of life is the true crime against decency.

  5. So what you’re saying is extreme measures should be taken to ensure individuals such as Tarrant and Rathjen are not left to their own devices. Got it.

  6. Johan says:

    Yeah, lets now look at the bigger picture, at democracy, and the collective psychoses created by the media. And how society is left to its own devices, while collectively pretending to be sane, or at best the one psychotic collective blaming the other psychotic collective. Being a risk to themselves and others.

  7. jsinton says:

    I don’t care who you are. Everyone deep down inside knows the difference between right and wrong. Every knows to kill is bad. Even the insane. It doesn’t matter what the psycho gave as an excuse. Do you believe him? 10 cent 115 grain pill to head. Problem solved. Silly UK judicial system don’t know how to really punish and treats criminals like victims.

  8. Nah. We just need more knife control.

    Anti-Stab Knives for the UK

    • LOL: Amerimutt Golems
    • Replies: @RadicalCenter
  9. @obwandiyag

    “The liberals closed down the mental hospitals for civil rights reasons.”

    No they did not.
    Over a number of decades the councils in England have had cuts by the Government. Year upon year services have been stripped back with mental hospitals being closed and access to related mental out reach programmes etc cut back.

  10. Whats the deal with the article’s clip art?

    Some sort of pale skinned long headed Bhudda alien.

    Here’s my proposal for a revision:

    • Replies: @Angharad
  11. The sad fact is that the government is run by people who no longer feel any responsibility for the unfortunate nutjobs, psychotics, retards, and other terribly handicapped citizens. Our civil servants are consumed with ensuring that their pay, benefits, and pensions remain in high growth mode as a first and last priority. The judges and legislators (more civil servants) will not endanger their own salary, benefits, and retirement by calling for public funds to be properly expended to help the helpless among us as long as prison guards cannot afford Cadillacs, and county jails can be used to park violent nutjobs.

    God help us, though we don’t deserve it.

  12. Great article — hits all the major nails on the head.
    Neoliberalism, associated with various PC ideas & forces have & are slowly choking off all kinds of community “care”.
    Individual freedom (of the “woke” kind) & cost cutting are a marriage made in buggery.
    As usual we find the common types of Elite/Right wing hypocracy: it’s wasteful to provide beds & care for the mentally ill (when medication & “care visits” are adequate, but its ok to spend millions per year on giving the mentally ill “bed & care” in a prison.
    On top of all this, as some comments here make clear, there are usual fringe attitudes — ie, the psychotic are able to make complex moral judgements & that psychosis has no basis in biology & that psych medication is essentially a fraud.
    Dont expect things to improve anytime soon….

  13. @Suggma J. Balzach


    Left to his own devices? That guy was mind controlled by intelligence agencies since infancy! I heard him confess so himself in his video messages.

    Now listen here you! How often have we read on these UR and other pages, like veteranstoday and many more sites, that so many of these terrorists are false flagging mass murdering for intelligence agencies as part of some mind controlled MK Ultra or Manchurian candidate programme. If I remember correctly, many claimed that the very Tarrant you mentioned was also working for the CIA, Mossad, or whatever other agency so as to provoke confiscation of weapons and greater government snooping and control. And at last when we do get a terrorist who actually confesses to being mind controlled and directed by the secret agencies, like this Rathjen fellow, everyone turns around and says he’s crazy. Honestly … people …

  14. Profuse but frivolous virtue signaling aside importing people like Jason K from lawless Uganda in Africa isn’t helping matters.

    Regardless of more or less youth clubs and mental facilities, they are prone to drug abuse and resultant “voices” plus joining gangs and wanton violence.

    Cannabis addict who stabbed five people did it to stop voices in his head

    Idi Amin’s son jailed for London gang attack

  15. As a result, “care in the community” usually ends up meaning care by one’s family, so its degree depends on that family’s resources and income.

    The problem is smaller families wider spread thanks to angloism that haunts this world.

    In a weird way, the knivings are a solution for Earths largest problem.
    Eternal Anglos.

  16. @Hippopotamusdrome

    They call the big one the Somali Special.

    The little one is the Pakistani pocketknife.

  17. Tom Rogers says: • Website

    Patrick Cockburn, a left-wing Irishman, omits to mention two key facts:

    – the offender is black; and,
    – the offender frequently took cannabis.

    • Replies: @Daniel H
  18. The Scalpel says: • Website

    Its a “sticky wickett” as they would say in the UK. But you have to be CRAZY to think that countries will ever bring back long term institutionalization – not with the costs and negative virtue signalling involved

  19. Daniel H says:
    @Tom Rogers

    Cockburn has written about the dangers of Marijuana and it’s connection to schizophrenia and psychosis. His own son became ill due to Marijuana use.

    Marijuana is not a harmless drug, still, I think that it should be decriminalized. I cannot understand Marijuana’s appeal, though.

    • Replies: @Tom Rogers
  20. melpol says:

    Euthanizing those in long term mental facilities is a tax saving plan. But the Jewish owned media disagrees because they fear being next down the road. Without media objections long term homeless could also be euthanized. Lots of violent criminals instead of expensive prisons could be put to permanent sleep. Jews should not feel threatened by these tax saving programs. Jews pay their taxes and are honest hard workers.

    • Troll: Commentator Mike
    • Replies: @Polemos
    , @Angharad
  21. Svevlad says:

    then have ’em executed

  22. onebornfree says: • Website

    And the answer , as always round these parts, is, tah-dah! : mo’ gubmint, mo’ gubmint, mo’ gubmint! 🤪

    “Regards” onebornfree

  23. Thomasina says:
    @Suggma J. Balzach

    I had to look up who Rathjen was and found an article that said:

    “He said that he, for one, has been under surveillance since birth and called on American citizens to wake up and ‘fight now.’

    Rathjen also wrote about the coming ‘war’ on his website, claiming that it would be a double blow, both against the secret organizations that he says are reading his mind…”

    Obviously paranoid as he thought he had been under surveillance since birth and secret organizations were reading his mind.

    Sounds like a paranoid schizophrenic to me. There are a lot of sick people out there.

    Some, like Rathjen, kill foreign strangers, others kill native strangers. This poor kid was 22, asleep on a bus, when he was stabbed and then beheaded by a schizophrenic man sitting beside him. This guy served no time and was released back out into society within a few years. Apparently they trust him to take his medication now.

    I agree with the author of this article, many of these people should really be in institutions, for the good of the public, for their own good, and for the good of their families.

    But we must be careful, though, that we don’t start locking up people just because they happen to say things we don’t agree with.

    • Replies: @Commentator Mike
  24. By trying to avoid frightening words like “madness” and “insanity”, people who had the laudable intention of destigmatising mental illness have ended up diluting the traditional – and quite correct – belief that acute psychosis is a shattering experience.

    And sometimes dangerous. I’d have added that word too, dangerous. Even though it means stating the obvious. It is often times necessary and helpful to state the obvious. In public discourse, we have traded in caution for being looked upon as – – – interesting, ever so surprising, diverse, multicultural (and thus – bright!…). We should go back to normal, so to speak. Call dangerous people, even if ill and with a multi-ethnic background etc. – dangerous.

  25. @Thomasina

    And are all those who claim that these mass and serial killers are mind controlled by agencies to pursue a government agenda also insane?

    • Replies: @Thomasina
  26. @Daniel H

    I stand by my comment, which I will now repeat:

    Patrick Cockburn, a left-wing Irishman, omits to mention two key facts:

    – the offender is black; and,
    – the offender frequently took cannabis.

    Instead, Cockburn calls for expanded state involvement in people’s lives, including more frequent long-term incarceration of people (almost-all of whom will be harmless) in institutions.

    Cockburn will no doubt reassure me that this will be done humanely and that these massive secure hospitals will be managed properly and boast tennis courts and swimming pools and days out in the countryside.

    But if I called for the humane deportation of subversive Jews, violent drugged-up blacks and fanatical ethnic Moslems back to the countries and territories where they will fit in better – and where they will probably be happier in the long run – this same Mr Cockburn will start screaming and shouting that I am a “Naarrrrtzee” and it’s Hitler all over again.

    Patrick Cockburn is a f_ idiot. Sadly, however, he is indicative of our intellectual classes.

  27. Polemos says:

    I taught ethics intro classes, and I often had students argue that a good way to save money was to kill prisoners who committed violent crimes or molested kids. But there were also some among that group who then argued themselves into advocating killing any long-term prisoners, because that will motivate more people to commit less of all crimes anyway. Eventually, they argued, there won’t need to be prisons except for very serious cases and people would be kind to each other and not kill or harm strangers.

    The same logic kernel rests inside the idea that open carry societies will be gentler, more respectful places, because if any other citizen can kill you with the guns they’re carrying, you’re less likely to choose violent crime as a way to engage others. Meanwhile young boys, those called ‘invisible children’, walk around African communities with AKs protecting the peace as perfect demonstrations of the logical appeal of using violence to end the threat of violence.

    Killing off folks to save on tax waste is a great idea. We need to pay taxes responsibly, and we shouldn’t forget our responsibility to those burdened with collecting them from us.

    • Replies: @melpol
  28. melpol says:

    Tax payers and collectors were highly respected under the Polish kings and Russian Czars. Today we have 50% who pay no taxes. Targeting those who never pay taxes and using a tax paying military to eliminate them is a good idea. Exemptions should be decided by the courts.
    Preventing the start of this program are numerous elites who profit from millions of freeloading parasites.

    • Replies: @Jeff Stryker
  29. ko says:

    Yes, absolutley correct. Take Hillary Clinton for example.

  30. Angharad says:

    Thank you. Some one with the surname of Kakaire does not belong in England. He is not English. He belongs in Africa. With his own kind.

  31. Angharad says:

    Jews have 4x the genetic defects that Humans have, usually resulting in lunacy and cretinism. So let’s consider your plan….

  32. I was living in Uptown on the North side of Chicago in the Seventies when the trend to “mainstream” individuals with mental health or developmental deficits (then called mental retardation) started taking off big time.

    It was a financial boon for some property owners in the neighborhood. They could rent rooms and small apartments to the recently freed guests of the state and receive payment from said state.

    Not everyone in Uptown was thrilled. It became common to see individuals who clearly had no idea what planet they were on roaming the streets aimlessly, talking to themselves and/or panhandling. Another frequent scene was individuals foraging through garbage cans looking for food and drink.

    I remember telling the young lady with whom I cohabited that we didn’t need a television. Looking out our apartment windows at the corner of Sheridan Rd. and Sunnyside was way more fascinating than anything on television.

    • Replies: @The Grim Joker
  33. @melpol

    Well the King of Poland did invite you as tax collectors and that went south for Polish Jews eventually. I mean, Melpol, you have to remember history.

  34. Paddy seems to be totally ignorant of the fact that “care in the community” was mandated, as with so much, by the unelected unaccountable, unspeakable Nazgul of the Supreme Court,
    Nothing can be done.

  35. I hear voices in my head ! What are they saying ? I have constant hallucinations. I hear the voices of strangers. They repeat the same thing over and over. What are they saying ? Yes, I can hear them clearly now.

    Capital Punishment for ANY murder committed regardless of the degree, circumstances, mental state, substances used, age or condition of the murderer !

  36. @Enemy of Earth

    You are a very jokey guy. I accuse you of stealing the comedic traits of the Grim Joker. However I would like to point out to you that I do have a television but I do not watch the soaps and situation comedies. I watch the goings on in political circles especially in Washington

    I can assure you that on the screen I observe the same traits you did in the 70″s
    -People who don’t seem to know what planet they are on
    -Recently freed guests of the state
    -People about to become guests of the state
    -People who want to be guests of the state
    -People talking to themselves
    -People talking to others who are not listening
    -People talking to others but talking shit
    -People who forage through the lives of others looking for food and drink

    Has anything changed in 50 years ? Has anything changed in 100,00 years ?

  37. Mental hospitals in the UK were often in the countryside and did have tennis courts.

    People were also strapped down onto their beds 24/7 or so drugged that they might have been better lobotomized (was lobotomy so bad in such cases?) in order to ensure staff safety. There is no good answer. Choice one is incarceraton. Choice two is public danger. I don’t think there is a Christian answer.

    It is not just the psychotic. There are also the incapable. Once they tramped the countryside. Then and now, many were old soldiers. Now they are the people who sleep in doorways and under the bridge despite shelter being available. Are they incapable because insane or do they make avoidable bad choices? They are nuisances but not public dangers. Shouldn’t they be Sectioned (UK legal procedure – Section 9 of the Mental Health Act) and placed in mental hospitals for their own good or is should they be supported in their lives of bad choices? The Christian answer is clearer to me in this case.

  38. Herald says:

    For crying out loud, some people drag sex into everything. Give it a rest!

  39. BAP says:

    Few people talk about the absurd concentration of psychopaths and sociopaths in jobs that can grant them power, status, easy money, attention, ability to get away with a terrible performance, …
    The harm caused by them exceeds this kind of isolated incident by orders of magnitude, yet they are able to do whatever they want without any oversight or somebody to stop them.

  40. Let’s Stop Pretending People with Serious Psychosis Can be Independent Foreign Correspondents.

    There, I fixed the truncated title.

  41. Jake says:

    Common sense will not be allowed to operate in this area of concern, any more than common sense would be allowed to operate in, say, education or juvenile delinquency. The primary reason is Race.

    Both the Left and the neoconservative parts of the contemporary West use non-whites as pampered pets in order to hold death grips on the ‘white trash’ majorities of their own people which they despise. The mentally ill non-whites do not have access to robbing or raping or murdering the rich whites, any more than do the criminal non-whites. They prey on other non-whites and the ‘white trash.’

    The Elites of the West find that conducive to their expansion of wealth and power.

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