The first psychiatric patient to appear in public as part of an appeal against detention has admitted he does not want to engage with professionals treating him.
Albert Haines, aged 52, has been held under compulsion in Broadmoor high-security hospital and one other secure mental health unit for 25 years.
Psychiatrists say Haines has both personality disorder and mental illness and is a danger to the public. He is detained under the Mental Health Act, 2007.
In February he was granted, under European law, the right to a landmark mental health tribunal which was open for the public to attend.
Normally, such tribunals are held in private for patient confidentiality reasons.
But Mr Haines, convicted of attempted wounding in 1986, insists he is not mentally ill, is not dangerous and is in despair about a failure to be released.
Giving his oral statement yesterday to the three-member tribunal in London, and flanked by five nurses, he answered questions from lawyers for around 20 minutes.
He said it would be “a dream” to be given an absolute discharge from detention, and to instead live with his brother.
But when asked whether he would engage in psychological therapy as part of a condition of discharge he said bluntly: “I do not want to. I know staff are keen to help, but I do not want to work with them. The therapy that they want me to do is part of the problem.”
Earlier, Broadmoor staff had said Mr Haines, presently detained in a personality disorder unit, was not progressing clinically and was refusing to engage in treatment, including medication and psychological therapy.
In 2010, Mr Haines threatened to kill a psychotherapist helping him with his disorder, Broadmoor social worker Anne White told the tribunal.
She also said he consistently assaults or threatens Broadmoor staff, and was racist toward black nurses.
She said: “Mr Haines complains about the mental health system. And that just escalates himself to frenzied aggression.
“Mr Haines is the most difficult patient I have had in 10 years,” she said
Ms White said it was not viable, at present, for Mr Haines to move to a less secure setting.
When asked by Mr Haines’ counsel, Aswini Weereratne, as to whether Mr Haines might remain in Broadmoor for a further 25 years, Ms White replied: “I hope not but the current prognosis is not good.”
Speaking for Mr Haines’ counsel, Jonathan Watkins, an independent social worker, told the tribunal that, although not a clinician, he did not think Mr Haines had a mental illness.
On Tuesday, Mr Haines’ psychiatrist, Dr Jose Romero-Urcelay, said his patient had a delusional disorder. Part of this disorder was believing with “depth and intensity” that mental health professionals were conspiring against him.
Dr Romero-Urcelay said Mr Haines had responded to anti-psychotic drugs in the past, but now refused them, and that “this mental health tribunal has taken over his entire existence”.
He said Mr Haines believed it would see “him vindicated” and others exposed as “malevolent and conspiratorial”.
But Mr Watkins suggested Broadmoor staff could find “levers of change” that would enable them to conduct “sustained psychological therapy” with Mr Haines who complains that unaddressed childhood abuse is at the root of his anti-social behaviour.
Mr Watkins said this might “lower the anti” for Mr Haines, and enable him to progress clinically. He also suggested an assessment by a registered care home could end up with someone in Mr Haines’ position being discharged, with conditions, within 6-12 months.
Mr Watkins stressed that he has worked in the secure mental health field since 1982.
In February three tribunal judges ruled that under Section 6 of the European Convention of Human Rights psychiatric patients deprived of their liberty have the same right as a non-disabled person to have their case heard in public.
Mr Haines was first detained in Broadmoor, in Berkshire, in 1986, following two convictions of attempted wounding. Brandishing a machete, he had threatened mental health staff at Maudsley Hospital in London.
Mr Haines told the tribunal: “It was a criminal offence and I take responsibility for it. I have done wrong and I am trying to put my life straight.”
The hearing ended and the tribunal will make its decision within one week.
* Edited versions of this article appeared in the Guardian