Compulsory treatment of patients with psychopathic disorder: an abnormally aggressive or seriously irresponsible exercise?

Chiswick, Derek

doi:10.1002/cbm.1992.2.2.106

Cited by 19 publications

(3 citation statements)

References 5 publications

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“…Tens of thousands of men are convicted of violent crimes every year; a handful fi nd their way into Special Hospitals -how do they get selected? ' (Chiswick, 1992 ).…”

Section: Developments In H Ealth -B Ased Pd S Ervicesmentioning

confidence: 99%

“…Despite these problems, and concerns about the ' elastic ' nature of the psychopathic disorder concept which it was argued could allow almost any violent offender to be classifi ed for admission (Chiswick, 1992 ), a majority of forensic psychiatrists at that time continued to support the inclusion of personality disorder within mental health legislation and that there should be specifi c treatment facilities within prisons and high security to support this (Cope, 1993 ). However, there was confusion about assessment, including how treatability (required for legal psychopathic disorder) might be determined.…”

Section: Developments In H Ealth -B Ased Pd S Ervicesmentioning

confidence: 99%

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Risk Assessment for Aggressive Behaviour in Personality Disorder

Daffern

2010

Using Time, Not Doing Time

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Changes to mental health legislation are relatively rare. The new Mental Health Act 2007 (in force from 3 November 2008) in England and Wales updated the 1983 Mental Health Act ' to ensure it keeps pace with the changes in the way mental health services are-and need to be-delivered ' (Department of Health, 2008 , p. 4). Arguably the most dramatic changes affect the detention and inpatient care of individuals with personality disorder which partly drove the government ' s initial desire to update the legislation. From 1983 until the new Act was enforced, individuals with personality disorder who were assessed for formal detention in hospital were required to meet the legal criterion of ' psychopathic disorder ' and also be deemed ' treatable '. However, from November 2008 no separate legal category for personality disorder exists, merely the presence of ' mental disorder ' , and treatability has been sublimated into the ' appropriate medical treatment ' being available in the hospital. The legislative change from an individual needing to be ' treatable ' to a service having treatment for them is a subtle but important distinction and arose from growing government frustration with the way professional practice had developed under the old Act. Although the original so-called ' treatability clause ' was introduced into the 1983 Act partly to ensure that individuals who were admitted were able to benefi t from the treatment available, critics (for example Hoggett, 1990) argued that it became a tool for use by psychiatrists to avoid admitting the ' unmanageable ' on the grounds of ' untreatability '. Instead the new Act now allows for the detention of individuals with personality disorder even though they may refuse to engage in treatment or the treatment may not initially be effective for them.

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“…Tens of thousands of men are convicted of violent crimes every year; a handful fi nd their way into Special Hospitals -how do they get selected? ' (Chiswick, 1992 ).…”

Section: Developments In H Ealth -B Ased Pd S Ervicesmentioning

confidence: 99%

Section: Developments In H Ealth -B Ased Pd S Ervicesmentioning

confidence: 99%

Risk Assessment for Aggressive Behaviour in Personality Disorder

Daffern

2010

Using Time, Not Doing Time

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“…Continued inclusion of psychopathic disorder in the Mental Health Act is controversial15 because it defines disorder largely by behaviour and because it represents the border between “madness” and “badness” and between the appropriateness of treatment and of punishment. The fact that its use is almost entirely restricted to hospital orders made by courts emphasises the civil rights issue.…”

Section: Psychopathic Disordermentioning

confidence: 99%

Mental health law: civil liberties and the principle of reciprocity

Eastman

1994

BMJ

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At a conference organised by the Law Society, Mental Health Act Commission, and Institute of Psychiatry possible reform of mental health legislation in England and Wales was discussed. It was concluded that radical legal reform was required, and that the law should be designed specifically for provision of care in both hospital and the community. Reform should be based on principle rather than pragmatism, particularly the principle of reciprocity--patients' civil liberties may not be removed for the purposes of treatment if resources for that treatment are inadequate. Protection of society from nuisance or even violence is insufficient reason for detention. Legal provision for compulsion of patients, whether in hospital or the community, must be matched by specific rights to treatment.

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Using Time, Not Doing Time

Tennant¹,

Howells²

2010

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Compulsory treatment of patients with psychopathic disorder: an abnormally aggressive or seriously irresponsible exercise?

Cited by 19 publications

References 5 publications

Risk Assessment for Aggressive Behaviour in Personality Disorder

Risk Assessment for Aggressive Behaviour in Personality Disorder

Mental health law: civil liberties and the principle of reciprocity

Using Time, Not Doing Time

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