R v Miller [2021] EWCA Crim 1955

The case: This applicant (now aged 63) is of low intellect, with an IQ of 61. In her 30s, she was assessed as having a level of comprehension approximately equal to that of an 8-year-old child. She suffered sexual abuse, neglect and poverty during her childhood. She has been diagnosed as suffering from a personality disorder, learning disability and behavioural disorder linked to her abuse of alcohol and substances. Starting at the age of 15, she appeared before criminal courts on more than 20 occasions, for offences including arson. Then on 22 July 1987 (aged 29) she killed Vivienne Elliot, a family friend. She was charged with murder, but her plea to manslaughter on the ground of diminished responsibility was accepted. On 21 July 1988 she was sentenced to life imprisonment. The medical reports before the judge unanimously stated that the applicant's mental responsibility for the killing was substantially diminished by her psychopathic personality disorder and her "mental handicap". They also stated, however, that her disorder was not (or was not likely to be) susceptible to treatment, with the consequence that the criteria for making a hospital order pursuant to the Mental Health Act 1983 could not be met.

In February 2014 there was a breakthrough in the treatment of the applicant when she was prescribed clozapine.

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