Modernising mental health services

BMJ 1999;318:806 ( 20 March )

Letters

Modernising mental health services

Personality disorders are arbitrary medicalisation of human variation

Strategy does not seem to be based on systematic evidence

Strategy is driven by public opinion

Psychiatrists should oppose community treatment orders

Government has failed, not community care

Personality disorders are arbitrary medicalisation of human variation

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

EDITOR $---$ Over the past few months the issue of personality disorder has come up several times, most recently in Marshall's editorialon Modernising Mental Health Services.¹ It seems that the reportingof the Michael Stone case fuelled the madness or badness argumentto the point that the home secretary chose, in the usual populistrhetoric, "to take a pop" atpsychiatrists.

The difficulty with personality disorders is that, by their nature, they are an arbitrary and subjective medicalisation ofhuman variation. It is hardly surprising that they are often notamenable to treatment. A supervising consultant psychiatrist onceasked me to name any psychiatrist I knew who did not have a personalitydisorder. When I considered this poisoned chalice and declinedto reply, he said a person without a personality disorder is aperson without apersonality.

If personality disorder is sufficient legal grounds to detain someone, some . . . [Full text of this article]