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Managing dangerous people with severe personality disorder

a survey of forensic psychiatrists' opinions

The Edenfield Centre, Prestwich Hospital, Bury New Road, Prestwich Hospital, Manchester M25 38L

J. Parker, (MB, ChB, MRCPsych), Specialist Registrar in Forensic Psychiatry and H. Rees, (MB, ChB, MRCPsych), Specialist Registrar in Psychiatry

Fromeside Clinic (MSU), Bristol

See editorial, pp. 282-283, this issue.

AIMS AND METHOD

To canvass the opinions of psychiatrists working in forensic settings on the recent proposals relating to dangerous people with severe personality disorder (DSPD). Psychiatrists from secure settings were invited to a series of meetings. A questionnaire was circulated and the discussions recorded.

RESULTS

Opinion remains divided over diagnosis, treatability and assessment of risk in personality disorders. The medicalisation of DSPD to allow indeterminate detention in unconvicted cases is unacceptable to the majority (75%). There is no consensus on the Government proposals relating to DSPD. Only a minority (20%) of psychiatrists would work in a new specialist service, which has significant implications for service development.

CLINICAL IMPLICATIONS

The involvement of psychiatrists in preventative detention solely for public protection requires greater discussion.

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