BMJ 1999;318:549-551 ( 27 February )

Editorials

Public health psychiatry or crime prevention?

Government's proposals emphasise doctors' role as public protectors 

The first 150 words of the full text of this article appear below.

In the wake of the recommendations of the Fallon inquiry into the personality disorder unit at Ashworth Hospital ^{1 2} the government has now announced its own solution to the problems presented by people with antisocial³ or dissocial⁴ personality disorder.⁵ After a joint Home Office and Department of Health review which ran in parallel with the Fallon inquiry it has proposed for consultation new services and law. Although not prescriptive about the detail of its solution, both the government's philosophy and its resolve are clear. In pursuing, above all, public protection, it intends services which essentially hybridise punishment and health care, with law that allows preventive detention of even the unconvicted.

The uncertain treatability of antisocial personality disorder,⁶ consequent professional therapeutic ambivalence,⁷ and inherent uncertainty about the moral status of the condition (whether individuals "suffering" from it are mad or bad)⁸ combine sensibly to imply a hybrid service solution which is far . . . [Full text of this article]

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