A very poignant hearing for contempt by a mentally disturbed woman was held at Milton Keynes County Court last week presided over by Her Honour Judge Rebecca Brown.

Gillian Marriott was facing a committal hearing brought by Thames Valley Police for breaching a court order made two years ago which banned her from contacting the emergency services or attending Stoke Mandeville Hospital in Aylesbury except in a genuine medical emergency. She is now facing two six month prison sentences and the possibility of a much longer prison sentence if she breaches the order for the next two years. She had already been remanded in custody before the hearing.

The judge took the decision in her absence and without any statement by her in her defence but she was represented by a lawyer.

I am highlighting this story because it neatly encapsulates in one episode what is going wrong with mental health treatment, what is happening to a pressurised NHS in the current crisis and the desperation of public authorities to deal with disturbed people by deciding that incarceration in a prison is the only solution. I don’t know the woman concerned but her situation is very well summed up by the judge in her ruling.

114 calls to 999 and 217 calls to the 111 services

Thames Valley Police who brought the case say she “has made 114, 999 calls and 217, 111 calls reporting various medical episodes. These
have all been triaged and checked causing demand on the service unnecessarily” and had attended ” Stoke Mandeville Hospital on occasions which were not for genuine medical need. It is alleged that the defendant attended Stoke Mandeville Hospital on the 23rd of March 2022 claiming an overdose but all her vitals we checked and found to be normal.”

The court were told she turned up at Stoke Mandeville claiming to have taken an overdose on “7th of April 2022 , 11th of April 2022 , 13th of April 2022 , 15th of April 2022 , 21st of April 2022 , 26th of April 2022 , 22nd of May 2022 and 3rd of June 2022.”

She also turned up at the accident and emergency department claiming she had taken an overdose on the 15th , 19th , 21st 27th , 28th and 29th of June 2022 and the 18th of July 2022.

She admitted turning up but claimed she had genuinely thought she was ill and needed treatment

Her psychiatrist, Dr Srikanth Nimmagaddam said in a statement to the court that she had ” a history of being brought up in an overprotective environment in the context of the death of her brother. She also feels that she suffered from emotional abuse, as her parents regularly adversely compared her with her deceased brother. She gives a history of problems at school and being sent to a special school. She gives a history of being severely bullied and discriminated at school, as she went to a special school. She gives a history that at the age of 11, she was raped by a person, who later blackmailed to harm her father. She had to withdraw the case and that resulted in being accused by the police of wasting their time. All this seems to have been extremely traumatic for her given her young age. She did some farm jobs
until the age of 25, when she was married. One of her daughters was taken into care.”

He said “I believe there is clear evidence to suggest that she has a personality disorder – an emotionally unstable personality disorder of borderline type. The features of her personality disorder include impulsivity, including acting impulsively without considering the consequences; severe mood swings; chronic feelings of emptiness; uncertainty about her aims, objectives and goals in life; chronic low self-esteem; difficulties in sustaining relationships with a constant fear of rejection and abandonment; maladaptive coping mechanisms in the form of numerous acts of deliberate self-harm and of substance abuse.”

He ruled she was fit to plead and recommended a treatment programme that would not require a hospital admission but would require residential accommodation.

Some of the care plan unavailable because of resources

But Leanne Manning, Community Psychiatric Nurse, told the court: ” Some of the suggested aspects of the care plan are not available in terms of resources such as a residential placement. Ms. Manning thought supported accommodation would assist Ms. Marriott because it she may feel more supported and less isolated.“
Ms. Manning informed the court that Ms. Marriott could attend a number of courses at the Whiteleaf centre such as mindfulness classes, managing mood classes and managing and understanding your diagnosis classes. Ms. Manning also told the court that instead of telephoning 999 or 111, Ms. Marriott should first try to consider whether she really needs medical assistance by going through a checklist that she has. She can then telephone the Whiteleaf centre to speak to Ms. Manning or another worker or telephone a “social prescriber” who is based at the GP.”

The police’s lawyer took a hard line against her. Mr Garnett said: “the breaches were a deliberate flouting of the order and the breaches were serious and egregious.”

He argued that there was a high degree of culpability. No real mitigation has been put before the court because there is no evidence from Ms. Marriott. The evidence is that Ms. Marriott has refused to engage with any treatment plan which would
assist her in her impulse control which would stop this conduct.”

Ms Marriott’s Lawyer, Mr Killen, said she would agree to go on the course but not move into residential accommodation.

He said” she values her independence too much and has lived in her current accommodation for a long time.”

The Judge said she had considerable sympathy and compassion for Ms Marriott but ruled that her actions amounted to a criminal standard that Ms. Marriott knew that she was making unnecessary calls and as such continued to add unnecessary burdens to the NHS whether it be A and E, ambulance drivers and other medical staff. But she said she had not done it out of malice more because of her vulnerability.

People may die because ambulances are being diverted to Ms Marriott – judge

“There is immense pressure on the NHS and emergency services and people may die because an ambulance is not available because it
has been diverted to Ms. Marriott. I am satisfied that Ms. Marriott understands the terms of the injunction and knows that the number of callouts is unacceptable.”

Her judgement concluded: “The court therefore orders that Ms. Marriott serves a term of six months for the 999 and 111 calls and a further sentence of 6 months for the visits to Stoke Mandeville, each sentence to run concurrently and be suspended for two years until 22.8.2024. This court specifically warned Ms. Marriott that if she appears back before this court, has made no sustained attempt at engaging with work to address her behaviour and has carried on breaching the order, she is likely to receive a significant custodial sentence as well as serve the activated suspended sentence.”

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