A judge yesterday repeated long-standing calls for Bermuda to have a Mental Health Court in the wake of the Shiloh Payne case.As reported in today’s edition, Payne, a 27-year-old schizophrenic, launched a brutal and unprovoked attack on his neighbour while in the grip of a mental health crisis.Puisne Judge Carlisle Greaves issued an indefinite hospital order rather than a prison sentence in the case yesterday. That means Payne will be treated at the Mid-Atlantic Wellness Institute [MAWI] for an unspecified time rather than being sent to prison.However, the judge cited concerns that a Mental Health Court is needed so judges can work with health experts to review such cases and make recommendations.He labelled Payne a “very dangerous man” and said he needed to hear from experts how long he should be kept at MAWI for. No expert from MAWI was available to give evidence during yesterday’s hearing.Prosecutor Nicole Smith said the mental hospital agreed to accept Payne as a patient. However, according to information she gleaned from Grant Farquhar, a consultant psychiatrist at MAWI, the hospital only has a small secure unit for patients who need short term intensive care.After that, Payne would have to be treated on an open ward.According to Ms Smith, psychiatrists have reported previous problems with Payne absconding from MAWI and expressing reluctance to be there.“If the defendant is ordered to be at MAWI for a longer period of time, do they have the facilities to keep him there?” queried Ms Smith.Mr Justice Greaves also raised concerns that Payne could end up being released from MAWI quickly.“One of the concerns the court has always had with these types of persons is a perception that the institutions seem to let them out as they like and sometimes the will of the court is not honoured,” he observed.“I don’t want a situation where he goes in and gets a few injections or whatever they do and the next month one sees him on the street again.”He reserved the option of a further court hearing where he could assess the best way forward in the Payne case. However, he said: “In this jurisdiction we need a Mental Health Court. Leaving it up to lay persons to carry out the rulings of the court is not the best option. The court would then have them under its supervision and they must appear on those days the court is sitting.”The judge pointed out: “We have been talking about it for a long time. I believe in a review system. Courts should review the orders all the time rather than leaving it to John Citizen.”A Government task force was set up as far back as 2003 to plan a Mental Health Court, as part of a PLP election pledge. The following year, the then-Attorney General Larry Mussenden said the court was being considered by a think-tank of top lawyers.In 2006, Senior Magistrate Archibald Warner also suggested the Island needed a specialist Mental Health Court. The following year, the new Attorney General, Philip Perinchief, said Government was planning such a court as part of a pledge made during the 2007 Throne Speech.As yet, no such court has been implemented. There was no mention of a Mental Health Court in the Mental Health Plan published by Government and the Bermuda Hospitals Board last June.A “statement of intent” to allow prisoners with severe mental health problems such as schizophrenia to be treated at a secure unit in England was signed between the UK Government and the Bermuda Hospitals Board on October 8 2010.Minister of Health Zane DeSilva was asked to comment yesterday on the Payne case, and to give an updates on the memorandum of understanding with England and the launch of a Mental Health Court. The same questions were sent to the Bermuda Hospitals Board. Neither had replied by press time.Shadow Minister of Health Katherine Michelmore called for an update on the memorandum of understanding.“I raised this issue in the Senate in June when I expressed concern regarding the ability to implement the objectives of the Mental Health Care Plan in the face of budget cuts,” she said.“I indicated that these cuts were being implemented at a level which affects front line service provision, and this current situation with Mr Payne appears to demonstrate that this is indeed the case.”