The Christopher Clunis enquiry

Abstract

On Thursday, 17 December 1992, Jonathan Zito was travelling home by London Underground with his brother Christopher. Jonathan had met his family at Gatwick Airport and there had been insufficient room in his friend's car, so the rest of the family had gone on ahead. The brothers stood waiting for a change of train on the Piccadilly Line at Finsbury Park Station, chatting to each other in a crowd of waiting passengers. On the platform was a large, shabbily dressed, black man acting in a bizarre manner. In the era of community care, floridly psychotic per sons are not an unusual sight on the streets of the capital or on its transport services. The waiting passengers ignored Christopher Clunis until he came very close behind the Zito brothers on the edge of the platform. Without any warning, Clunis suddenly stabbed Jonathan Zito three times in the face, one of the wounds penetrating upwards over his eye and into his brain. Clunis was a paranoid schizophrenic. He had occupied a filthy bedsit where a quantity of prescribed medication which he had not been taking was found by the police. There were various items of correspon dence from both hospitals and the social ser vices. At his trial he was subsequently found guilty of manslaughter due to diminished responsibility and admitted to Rampton maxi mum security hospital under Section 37/41 of the Mental Health Act, 1983. Clunis was receiv ing ongoing community care and supervision from both psychiatric and social services at the time he committed the offence. The enquiry (Ritchie et al, 1994) revealed a "catalogue of failure" in its assessment of the care that Clunis had received. Its publication was largely due to the tireless efforts of his widow Jayne, aided by a media campaign spearheaded by The Independent newspaper. The Independent had carried out its own investigation into the circumstances and had published them in a full page article on 19 July 1993 (Waterhouse & Williams, 1993). The same month, the North East and South East Thames Regional Health Authorities set up an investigation into the care and treatment Clunis had received in the months before the killing. They sought to examine the quality of inter-agency collaboration, examine individual responsibilities, and to make recom mendations for future delivery of care to people in similar circumstances. This paper examines the implications of the Clunis Report for psychiatrists in the future. The report is an indictment of community psychiatric-care in London. It should be read by all psy chiatrists as it questions many of our current policies for community psychiatric care of the severely mentally ill.