A paranoid schizophrenic who killed three elderly men in the university town of Exeter in the west of England earlier this year has been detained under the Mental Health Act.
On Monday, 2 December, Alexander Lewis-Ranwell, 28, was acquitted of the murders of Anthony Payne, 80, and 84-year-old twins Dick and Roger Carter, by reason of insanity.
Lewis-Ranwell was hearing voices and told police he thought the three men were part of a paedophile ring preying on children.
Exeter Crown Court heard Lewis-Ranwell, from Croyde near Barnstaple, had earlier assaulted a farmer and had twice been freed by police after an on-call doctor said he did not present a danger.
Jurors Flagged Up Their Concerns
As the jury deliberated they passed a note raising their concerns about the "state of psychiatric services in Devon and the failings in care in Alexander Lewis-Ranwell's case".
Julian Hendy, who runs a charity called Hundred Families which helps the victims of mental health homicides, said the Lewis-Ranwell case was sadly all too familiar and was typical of Britain’s “culture of optimism” when it came to people with serious mental illness.
Mr Hendy said there were around 100-120 cases a year in the UK where a convicted killer had a serious mental illness but he said that did not include cases where the perpetrator took their own life or was judged mentally unfit to stand trial.
In April 2007 his 75-year-old father, Philip, was stabbed in the neck by a complete stranger when he went to his local newsagents in Bristol to pay his paper bill.
His killer, Stephen Newton, had a history of mental illness, violence and drug abuse and he, like Lewis-Ranwell, suffered delusions about tackling a paedophile conspiracy.
The 'Care In The Community' Era
Mr Hendy said prior to the 1960s most mentally ill people in Britain were locked up in large Victorian asylums but the advent of new anti-psychotic drugs encouraged politicians to believe they could be treated “in the community” and that it would not only be more civilised but cheaper.
He said: “That’s all very well if the patient takes his medication. But if they don’t they end up in a crisis and in most of these cases people are unwilling or unable to access treatment when they need it.”
The court heard Lewis-Ranwell was arrested in Combe Martin in rural north Devon on Friday 8 February and charged with criminal damage and burglary.
His mother phoned police, expressing her “grave concerns should he be released” but he was given bail.
Lewis-Ranwell was arrested the following day on suspicion of causing grievous bodily harm with intent. A police inspector said he believed he "potentially presents as a serious risk to the public if released" but a forensic medical examiner employed by G4S Health Services said Lewis-Ranwell was not "acutely unwell" and did not believe he needed a full mental health assessment.
Killed Three Men Hours After Police Released Him
A few hours later he was released with bail conditions and took a taxi to Exeter where he killed the three men with a hammer and a spade and was finally arrested the following day and eventually sectioned under the Mental Health Act and taken to Wonford House Hospital.
Devon and Cornwall Police issued a statement saying that while he was in custody officers had “continually engaged with mental health services and partner agencies” and Lewis-Ranwell had interactions with five different health care professionals.
They concluded that he did not present a danger and did not need a full mental health act assessment.
Mr Hendy said he found that staggering in view of the evidence.
“It was said in court that after assaulting the farmer Lewis-Ranwell had been talking gibberish and talked about seeing unicorns. The police inspector had concerns but the doctor thought he was okay,” Mr Hendy said.
He said: “They called the Devon Partnership and they said he’s clearly psychotic. But the forensic medical examiner who was called out said he was not ill enough to be detained.”
The Dangers of the 'Culture of Optimism'
Mr Hendy said: “There are questions about this case. Sometimes psychotic people come in, they are talking to the wall and to invisible people and the police will be told ‘he’s fine’. The mental health system works on the basis of least restriction. There is a culture of optimism where people say ‘oh, he’ll be alright’.”
Mr Hendy said people like Lewis-Ranwell often have “chaotic lifestyles” and take street drugs and stop taking their medication - sometimes because they do not like the side effects - and then they are caught and sent to hospital and in that environment they can get better quite soon but he said the danger comes when they are released and, if there is insufficient support, they can suffer another mental health crisis.
Mr Hendy said there had been 29 homicides committed by mental health patients in the Avon and Wiltshire area alone since his father’s death and there had been seven patient homicides in Devon between 2013 and 2018.
“There is a tension between individual liberty and public protection,” he said.
Mr Hendy said most mental health nurses and doctors see their primary duty being towards the patient, not the public.
He said he had no comment on Labour’s plans to invest in the system but he said that in most cases the lack of staff and resources was usually to blame.
“A lot of the money does not end up going to the seriously mentally unwell. It goes into wellness and mental health awareness, which people like Prince Harry get involved in,” said Mr Hendy.
Devon and Cornwall Police’s Head of Major Crime, Detective Superintendent Mike West, said: “We fully accept our responsibilities to look after those detained in our custody units, however it is unreasonable to suggest that police officers or staff, in these circumstances, should have over-ridden decisions made by those who are trained, qualified and skilled in health care.”
The head of custody for G4S Health Services, Jon Allen, told the BBC they "stood by their decision" that "Lewis-Ranwell was not suicidal and did not meet the requirements of a full Mental Health Act assessment in the out-of-hours period".