Ratio Decidendi
The operational duty under Article 2 ECHR (right to life) to take reasonable steps to protect a person from a real and immediate risk of suicide applies to voluntary psychiatric patients, not only to detained patients. The NHS Trust owed an Article 2 operational duty to a voluntary patient who was known to be at real and immediate risk of suicide.
Facts
Melanie Rabone, a 24-year-old woman with a history of depression and a recent suicide attempt, was admitted to a psychiatric hospital as a voluntary patient. Despite being assessed as at high risk of suicide, she was granted home leave. She hanged herself from a tree on the second day of leave. Her parents brought a claim against the NHS Trust for breach of the operational duty under Article 2 ECHR.
Judgment Summary
The Supreme Court unanimously held that the Article 2 operational duty applied to Melanie as a voluntary psychiatric patient. Lord Dyson, giving the leading judgment, held that the key factors were: the Trust assumed responsibility for her care; she was in a vulnerable state; she was known to be at a real and immediate risk of suicide; and the Trust had the power to prevent the risk from materialising (by refusing leave or detaining her under the Mental Health Act 1983). The distinction between detained and voluntary patients was not relevant to the scope of the Article 2 duty.
Key Quotes
"The trust's duty to protect Melanie from the real and immediate risk of suicide was not diminished by the fact that she was a voluntary patient. She was in a very vulnerable state. The trust assumed responsibility for her treatment and care."
— Lord Dyson
Subsequent Treatment
Leading authority on Article 2 duties owed to voluntary psychiatric patients. Applied in subsequent mental health cases involving suicide risk.