Detention on the Grounds of Mental Illness
Should the government have the power to detain people identified as having dangerous personality disorders?
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The public is at risk from people with known dangerous mental health problems. Two people are kille...
The public is at risk from people with known dangerous mental health problems. Two people are killed every month by Care in the Community patients. Jonathan Zito was stabbed to death by Christopher Clunis in 1992; Jason Mitchell beheaded his father and strangled two pensioners in 1994; Stephen Laudat killed his grandfather in 1994, believing him to be the gang leader Ronnie Kray; John Rous stabbed care worker Jonathan Newby to death in 1995; Michael Stone killed Lin and Megan Russell in a field near their home in 1996. All of these killers had diagnosed mental illnesses but could not be detained under UK law.
People with mental illnesses are no more dangerous than other sectors of the population. Most people with mental health problems commit no crimes at all. There are other, far more accurate, predictors of criminal behaviour which nobody would consider to be sufficient to justify detention. The vast majority of crimes are committed by young men; 51% of violent crime and well over two-thirds of homicides are committed by people under the influence of alcohol. Yet, rightly, the law does not permit the pre-emptive detention of young men, or of alcoholics. Why should people who have mental illnesses be treated differently?
Currently, people with mental health problems who have not committed an offence may only be detained...
Currently, people with mental health problems who have not committed an offence may only be detained for the purposes of treatment, and may avoid treatment if they can argue that they will receive no benefit from it. There is no known effective treatment for Dangerous Severe Personality Disorder (DSPD). This means that people with DSPD fall through a gap between the criminal justice system and the healthcare system – they cannot be treated, so they never get less dangerous, but they cannot be detained, so the public cannot be protected from them.
DSPD is not a psychiatric diagnosis, but a legal category – it is not surprising, therefore, that it cannot be treated. It is a convenient label, however, for people whom the government fears and would like to have an excuse to detain, and who are unlikely to generate strong public sympathy. Rather than demonising and detaining people, the government should be providing mental health services which work in partnership with the people they are supposed to be helping.
It is not unreasonable to detain people who you have good grounds to suspect could be dangerous. We...
It is not unreasonable to detain people who you have good grounds to suspect could be dangerous. We already detain potentially dangerous people when we can treat them for their mental health problems; the public safety imperative is just as compelling for people we cannot treat.
It is absolutely unacceptable to detain people indefinitely against their will when they have committed no crime, simply on the suspicion that they may be dangerous in future, when we are not going to do anything to help them with their condition. Assessing the risk that someone may be dangerous is extremely difficult, and has to be balanced against the harms of indefinite detention – for example, loss of employment and family contact, loss of dignity and self-esteem, institutionalisation.
The number of people likely to be affected by these proposals is actually very small – the authoriti...
The number of people likely to be affected by these proposals is actually very small – the authorities are aware of up to 600 people whose detention might be justified on public safety grounds.
The number of people the government has in mind may be small, but more people, for example the large number of people with diagnosed personality disorders, could nevertheless be covered by the wording of the proposals – we should frame laws in such a way that they are as difficult as possible to abuse, rather than creating wide definitions and then trusting the authorities to follow the framers’ intentions
Public safety has to be the first concern. If these people are detained on the grounds that they ar...
Public safety has to be the first concern. If these people are detained on the grounds that they are a danger to the public, and their condition never changes, of course they should not be released. This does not mean that conditions in the secure institutions in which they are housed should not be as comfortable or supportive as possible, or that regular assessments should not be made to see if there is a possibility that they should be released.
The fact that DSPD is not a treatable condition means that people described as having it will, once detained, effectively be abandoned – they will not be able to be offered treatment which might improve their condition and make their release more likely. Unlike other detained psychiatric patients, their detention has no clear goal and it is difficult to see how anyone could argue for their release on the grounds of improvement.
The stigma attached to mental illness is unfortunate, and efforts should be made to combat it – but ...
The stigma attached to mental illness is unfortunate, and efforts should be made to combat it – but it is unlikely to be helped by continuing to permit a tiny minority of potentially dangerous individuals to continue to roam the streets unsupervised. When people with dangerous mental health problems commit murder, this tends to generate unfavourable headlines of the “violent loony” variety: stop the murders, stop the headlines.
There is a strong stigma attached to mental illness, with a widespread public perception that people with mental health problems are “dangerous nutters” – despite the fact that 1 in 7 people will experience mental health problems, almost always without exhibiting violent or dangerous behaviour. Detaining people with such problems will help to feed this false perception, and will be detrimental to efforts to improve the public understanding of mental illness.
These proposals will not affect the overwhelming majority of people with mental health problems, and...
These proposals will not affect the overwhelming majority of people with mental health problems, and there is no good reason for anyone to avoid seeking help.
The knowledge that certain diagnoses may result in indefinite detention is likely to deter people who know they have a mental health problem from seeking diagnosis and treatment – a survey by the mental health charity Mind in 2002 found that more than 1 in 3 members of the public would be deterred from seeking help from their GP for depression if this proposal was passed. This would mean that medical professionals would not be able to help them. It would also mean that if they really are dangerous, the public would receive absolutely no protection from them.
If doctors are satisfied that there is nothing wrong with a patient, or that there is no appropriate...
If doctors are satisfied that there is nothing wrong with a patient, or that there is no appropriate treatment or action to be taken, that’s fine. They have a duty to act in their patients’ best interests at all times, and so long as they do that then they, and the general public, have nothing to worry about.
Doctors should not be turned into jailers – and many of them will refuse to be. Many medical professionals will avoid identifying a patient as having DSPD if they know that this may result in their patient being detained. This could result in people with dangerous mental health problems going entirely unidentified – far worse than the current situation.
The financial and human cost of assaults and killings by people with DSPD is enormous, and measures ...
The financial and human cost of assaults and killings by people with DSPD is enormous, and measures to prevent such suffering, and to protect the public, are worth paying for. All sorts of important public policy initiatives cost money: this does not mean they should not go ahead.
The NHS and the prison system are already underfunded and overcrowded. We already have insufficient resources to deal with those psychiatric patients who want to be treated, let alone those who want to be left alone. We should not add people who are being detained indefinitely without their consent, and who are therefore likely to be difficult and resource-intensive to manage, to the list of people our health system has to deal with.
The Mental Health Bill is being drawn up to be in line with the Human Rights Act – it is being intro...
The Mental Health Bill is being drawn up to be in line with the Human Rights Act – it is being introduced partly in order to update the Mental Health Act 1983 so that it conforms to current human rights law. It is inevitable that individuals and mental health charities will attempt to bring test cases to the European Court of Human Rights, but the UK government is confident that its proposals will stand up to legal challenge.
Pre-emptive indefinite detention is potentially in breach of the ECHR and the Human Rights Act. Article 5 (Right to liberty and security), Article 6 (Right to a fair trial) and Article 8 (Right to respect for private and family life) are all threatened by the proposals. It is best to avoid making legislation which the European Court of Human Rights will rule to be illegal; it is best to avoid making legislation which breaches human rights in any case.
These proposals neither increase nor reduce alleged structural problems which may lead to racial inj...
These proposals neither increase nor reduce alleged structural problems which may lead to racial injustices in psychiatric diagnosis. Racial inequality in mental health treatment can be and should be investigated and combated whether or not this proposal, or any other change in mental health policy, takes place. The racism argument is a red herring.
These proposals will have racist consequences. Minority ethnic people, and Afro-Caribbean men in particular, are already disproportionately likely to be mistakenly diagnosed with mental illnesses compared with the population as a whole – this will put them at risk of being wrongly imprisoned as well.
What do you think?