The death of David Bennett at a psychiatric clinic has prompted MPs to suggest that the mental health sector should be included in investigations into racism in the wake of the Stephen Lawrence inquiry. Barbara Millar reports
David Bennett spent 18 years of his life in psychiatric institutions. At the age of 38, he died in one, following an incident which his family believes was sparked by racist abuse. Now local MPs want to know why.
Mr Bennett's death happened last October at the Norvic Clinic in Norwich, where he was one of a handful of black patients, and followed an incident in which staff used control and restraint techniques on him.
The trust that runs the clinic says the techniques were 'well-tested' and followed national guidelines.
But the incident has raised questions about why and when such techniques are used, and a call from one MP to 'find out whether there is institutionalised racism in mental health'.
Mr Bennett's sister, Dr Joanna Bennett, is a lecturer in mental health at Middlesex University.
She claims that her brother was held face down for 20 minutes while being restrained by staff, and that he had been racially abused and physically attacked by another patient.
'From the family's perspective David was not a violent person,' says Dr Bennett. 'But he had become angry and frustrated during his 18 years in and out of psychiatric care.'
Graham Shelton, chief executive of Norfolk Mental Health Care trust, which runs the clinic, says restraint was used by staff who were trained in the 'well-tested' techniques, which conformed to those approved by the English National Board for Nursing, Midwifery and Health Visiting. He says: 'Staff were applying these techniques to Mr Bennett because he had assaulted another patient and a member of staff.'
Dr Bennett says: 'My brother's death has to be put in the context of other deaths from restraint. Very often they have been young black men and very often they have had mental health problems.
'You cannot separate these issues. You have to consider the parallels between what is going on with black men in police custody and in psychiatric institutions.'
The case has now been taken up by Mr Bennett's Peterborough MP, Helen Brinton, and Dr Ian Gibson, MP for Norfolk North. They have raised the matter at prime minister's Question Time and have applied for adjournment debates.
Last week Ms Brinton asked Tony Blair whether, following the Macpherson report on the Stephen Lawrence affair, he agreed that the mental health sector had to be included in those investigations and considerations.
Mr Blair replied that the government was committed to stamping out racism in all public services.
'There will be zero tolerance of racial harassment or racial discrimination of any kind in the National Health Service,' he promised.
Ms Brinton had been anxious to get the case of David Bennett into the public domain.
She says that not only had Mr Bennett been racially abused by other patients, he had also written to managers asking about the lack of black staff.
Mr Shelton says he is not aware of any such complaint. 'The MPs and family members are making these allegations to the media but not to the trust,' he says.
'When and if these allegations of racist attitudes and behaviours are made they will be looked at thoroughly. The trust takes the issue of racism very seriously.'
Dr Gibson asked health secretary Frank Dobson last week for a breakdown of the ethnicity of the patients at the Norvic Clinic. He also wanted to know when control and restraint techniques had been used there.
The trust replied that of the 52 patients detained at the clinic, 45 are white, five are black Afro-Caribbean, one is 'black other' and one is Pakistani.
Between 2 November 1997 and 4 December 1998 there were 45 occasions when control and restraint techniques were applied by nursing staff.
Thirty-six of these occasions involved a patient categorised as white, eight involved black Afro-Caribbean patients and one involved a patient categorised as 'black other'.
'We have got to find out if there is institutionalised racism in mental health,' says Dr Gibson.
'Almost 25 per cent of the Norvic Clinic's patients are black males, but how much black support is there in these places and what procedures are there to try to prevent racism?'
The inquest into the death of David Bennett has been adjourned and will not be opened again for two to three months.
But Inquest, the organisation that provides support and advice to families bereaved in controversial circumstances and which can offer free legal representation to families at inquests, says this is not unusual.
'The death of David Bennett has had to be investigated by the police, and the family also requested a second post-mortem by an independent pathologist. We are still waiting for this report,' says co-director Helen Shaw.
'Because Mr Bennett's inquest also raises questions of public concern, Inquest will ask the coroner to hold it before a jury and I am sure he will accede to this request.'
The police may also decide to refer the case to the Crown Prosecution Service, which will add to the delay, she points out.
Unison regional officer Brian Lynch says staff have been saddened by the death of David Bennett, which has had a 'traumatic impact' on everyone working at the clinic.
'Our members have been fully co-operative with the coroner's officials,' says Mr Lynch.
'They are as keen as anyone to get this case to an inquest as soon as possible. Everyone's life is on hold until this is held.'
Dr Bennett would like to see national and professional guidelines produced on the use of control and restraint techniques to ensure they are used as a measure of last resort and that mental health practitioners have proper training in the management of patients' anger and frustration.
'The anger and frustration of black men ought to be seen in the wider context of their experience of racism within the health service itself,' she says.
Melba Wilson, policy director of Mind, cannot comment on David Bennett's case, but says research shows that black and ethnic minority people, particularly young Afro-Caribbean men, receive 'the harsher end' of mental healthcare, with more detention, more drugs, more locked wards and less access to psychotherapy and counselling.
Ben Thomas, chief nurse and director of clinical services at the Bethlem and Maudsley Hospital, believes that control and restraint techniques are used as a last resort. 'It is also generally a safe practice,' he adds.
But he suggests that the techniques need to be strictly monitored. 'Perhaps nurses do not reflect as much as they should as to why and when control and restraint is used with particular patients,' says Mr Thomas.
'And perhaps mental health services in general are not always as sensitive as they could be to the needs of black and ethnic minority people in their care.'