Westwood: Affirming the Primacy of Psychiatric Evidence in Sentencing for Diminished Responsibility

Introduction

In the landmark case of Westwood, R v ([2020] EWCA Crim 598), the England and Wales Court of Appeal (Criminal Division) addressed critical issues surrounding sentencing in cases involving defendants with severe mental health disorders. The appellant, Westwood, pleaded guilty to manslaughter by reason of diminished responsibility for the murder of his mother, Susan Westwood. The initial sentencing imposed an extended term of imprisonment combined with a hospital direction under section 45A of the Mental Health Act 1983. Dissatisfied with the sentence, Westwood appealed on the grounds that his mental health condition was not adequately considered, advocating for a hospital order under section 37 with a restriction under section 41 instead.

Summary of the Judgment

The Court of Appeal meticulously reviewed the appellant’s case, focusing on whether the sentencing judge appropriately assessed Westwood’s level of retained responsibility and the suitability of the imposed sentence. The appeal was granted, with the appellate court determining that the sentencing judge had erred in evaluating Westwood's retained responsibility as "medium to high." The court emphasized that psychiatric evidence overwhelmingly supported a "low" level of retained responsibility due to Westwood's paranoid schizophrenia and other mental health issues, which were the principal factors leading to the offence. Consequently, the appellate court quashed the original sentence and reinstated a hospital order under sections 37 and 41 of the Mental Health Act, aligning the sentence more closely with psychiatric recommendations.

Analysis

Precedents Cited

The judgment extensively referenced previous cases to establish the correct framework for sentencing offenders with mental disorders. Notably:

• R. v Vowles and others [2015] EWCA Crim 45 – Provided guidance on considering all factors before being bound by psychiatric opinions.
• R. v Edwards [2018] EWCA Crim 595 – Clarified that section 45A does not serve as a default sentencing mode and emphasized the importance of evaluating all sentencing options.
• R. v Rendell [2019] EWCA Crim 621 and R. v Fisher [2019] EWCA Crim 1066 – Further delineated the considerations for protecting the public and managing risk when dealing with mentally disordered offenders.

These precedents collectively underscored the necessity for judges to thoroughly assess psychiatric evidence while also considering broader aspects of culpability and public protection.

Legal Reasoning

The court analyzed whether the sentencing judge appropriately evaluated Westwood's retained responsibility. It was established that the psychiatric reports unanimously indicated Westwood's mental illness as the primary cause of the offence, suggesting a low level of retained responsibility. The appellate court found that the sentencing judge erroneously attributed a medium to high level of responsibility to Westwood, thereby justifying an extended custodial sentence with a hospital direction. The appellate court reasoned that this assessment was inconsistent with the psychiatric evidence, which emphasized that Westwood's ability to exercise self-control was significantly impaired by his mental health condition.

Furthermore, the court deliberated on the adequacy of public protection under different sentencing regimes. It concluded that a hospital order under sections 37 and 41 provides sufficient mechanisms for managing and mitigating risks associated with mentally disordered offenders, without the need for an extended custodial sentence.

Impact

This judgment has profound implications for sentencing practices involving defendants with mental disorders. It reinforces the importance of:

• Relying heavily on comprehensive psychiatric evaluations when determining the level of retained responsibility.
• Ensuring that sentencing aligns with both medical recommendations and legal standards for public protection.
• Encouraging judges to adopt a holistic approach that balances culpability, rehabilitation, and public safety.

By emphasizing the primacy of psychiatric evidence, the decision in Westwood sets a precedent that may lead to more nuanced and medically-informed sentencing outcomes, potentially reducing unnecessary custodial sentences for offenders whose actions are predominantly driven by severe mental health issues.

Complex Concepts Simplified

Diminished Responsibility

Diminished responsibility is a partial defense in criminal law that reduces a charge of murder to manslaughter if the defendant was suffering from an abnormality of mental functioning at the time of the offence, which substantially impaired their ability to understand the nature of their conduct, form a rational judgment, or exercise self-control.

Sections of the Mental Health Act 1983

• Section 37: Hospital Order – Mandates the defendant's admission to a hospital for treatment of a mental disorder.
• Section 41: Restriction Order – Imposes conditions to prevent the offender from acting violently or causing harm.
• Section 45A: Extended Sentence with Hospital Direction – Combines a custodial sentence with a hospital order, allowing for continued treatment and supervision.

Retained Responsibility

Retained responsibility refers to the degree to which an offender is considered accountable for their actions despite any mental disorders. It is a crucial factor in sentencing, influencing whether the court imposes custodial sentences or opts for hospital orders.

Conclusion

The Court of Appeal’s decision in Westwood, R v ([2020] EWCA Crim 598) underscores the judiciary's obligation to meticulously evaluate psychiatric evidence when sentencing offenders with mental health disorders. By rectifying the initial misassessment of retained responsibility, the court not only aligns the sentencing with medical expertise but also reinforces the legal framework that prioritizes appropriate treatment and public safety over unnecessary incarceration. This judgment serves as a pivotal reference for future cases, ensuring that the legal system remains sensitive to the complexities of mental health in the context of criminal responsibility.