April 1999
SEVERE PERSONALITY DISORDER
(This policy was approved by UK Federation members at the 1999 AGM)
The Home Secretary, Jack Straw, announced earlier this year that the government were considering new measures to protect the public from dangerous people. The UKFSMHA represents a diverse range of viewpoints and the statement below follows consultation with our membership.
- The UKFSMHA acknowledges the distinction between those suffering from a personality disorder and those suffering from mental illness. However, forensic psychiatry recognises ten forms of personality disorder and all but Severe Personality Disorder (SPD) (also referred to as Anti-Social Personality Disorder or Psychopathy) are not linked to violent behaviour. Any proposals should clearly make this distinction in order to avoid confusion, great offence and/or distress to those living with this label and to the media and the public at large.
- Furthermore, some people diagnosed with schizophrenia have previously been diagnosed as suffering from SPD and vice versa. The boundaries are not clear and the term is often given to those who are difficult to treat. Moreover, although personality disorders per se are generally untreatable from a psychiatric perspective, psychological therapies, such as talking treatments and therapeutic communities can be beneficial. Whatever the arguments about treatability, those with personality disorders have needs often requiring support and assistance, usually from mental health care professionals.
- ¨There are many people who pose a threat to society who do not have SPD and therefore it is not a realistic or effective approach to use the label to implement public protection. Moreover, the provisions may encourage people to go underground to avoid detection/detention and encourage the use of covert surveillance. These potentially draconian provisions are likely to have a severe impact on many people's civil liberties for the sake of a few.
- There is a risk that those suffering from distress, whether previously diagnosed or not, will be deterred from seeking help for fear of these provisions. Many people with SPD want help and alert the authorities of their dangerousness but are turned away as voluntary patients, due to lack of beds; and are not detained under the provision of the Mental Health Act, as they are deemed untreatable. A suggestion for reform would be to amend mental health legislation to detain these people and offer treatment on the psychological model, and for there to be beds made available for those suffering distress. However, there is concern that this would only increase the number of secure beds.
- There should be adequate safeguards introduced including the right to a tribunal, the right to a second opinion, the right of advocates and/or carers to attend assessments and hearings. These should be in addition to any quasi-judicial review proceedings announced by the government.
|
Policy Statement