Psychiatric Bulletin (2001) 25: 78. doi: 10.1192/pb.25.2.78
© 2001 The Royal College of Psychiatrists
Psychiatric Bulletin (2001) 25: 78
© 2001 The Royal College of Psychiatrists
Mentally Disordered Offenders. Managing People Nobody Owns
Crispin Truman, Director
Revolving Doors Agency
Edited by David Webb & Robert Harris. London: Routledge. 1999. 173 pp.
£15.99 pb. ISBN: 0-415-18010-4
This collection examines the difficulties of categorising mentally
disordered offenders and asks whether they are doomed to marginalisation
(Harris) as neither offenders nor mentally
disordered.
The contributors are agreed that this is not a homogeneous group and that
most people with mental health problems who offend pose no risk to the public.
They recognise that many of the most marginalised do not need the definition
of seriously mentally ill, but are made vulnerable by the multiplicity of
their mental health and social care needs. Preston-Shoot rightly argues that
when deliberating on policy and practice in this area, we must consider the
social and economic context and the impact of professional and organisational
structures on events leading to the crisis. He urges upon us a message
practitioners will recognise; that eligibility criteria and operational
procedures have become more important than the relationship and as a result
social work is losing its human purpose.
The status confusion of mentally disordered offenders is a consistent theme
throughout, as is the consequent importance of a multi-disciplinary approach,
flexibility and of balancing risk, needs and liberty on a case-by-case basis.
Many contributors are nevertheless drawn to risk and mental illness at the
most serious end of the spectrum, with little discussion on how we manage the
remainder who spend most of their lives in the community in poor housing with
little support.
There were times when one wondered what the benefit of bringing these
pieces together in one volume was, other than the (not unimportant) honouring
of Hershel Prins. The chapters vary widely in tone and quality: some being
rather dense analyses of what others rightly treat as a practical issue. Some
are simply a summary of current legislation and practice in the area. The one
on review tribunals, while interesting, was not really concerned with mentally
disordered offenders at all.
Of course, variety is the spice of an anthology and most people working in
the field will find something useful and stimulating in the arguments made in
this book. It highlights the damage done by excessive legalism and by a
reliance upon inquiries-with-hindsight to determine policy and procedures. It
leaves one with the heartwarming conviction that it is alright to bring
humanity into practice. As Prins says"... [the world is] a messy and
unpredictable place, but everyone... has to do his or her best to get by
decently, and to try to do more good than harm along the way".