Presumed dangerousBMJ 1999; 319 doi: http://dx.doi.org/10.1136/bmj.319.7205.326 (Published 31 July 1999) Cite this as: BMJ 1999;319:326
- Geoff Watts, freelance medical journalist
Visit the Royal College of Psychiatrists' website (www.rcpsych.ac.uk) and you find an anxious message: “Urgent call to members. Managing dangerous people with personality disorders.” It goes on to explain that, as members may know, the Home Office and the Department of Health have put forward proposals for the detention of people who have no criminal convictions but who are judged to have an antisocial personality disorder. Members of the royal college who read the Sun will certainly know what this is about. The edition of Tuesday 20 July carried a crisp, six word headline: “600 psychos to be locked up.” By way of explanation, it carried the subheading: “Swoop on maniacs before they strike.”
You don't have to be a fan of tabloid journalism to recognise its strengths The person who wrote those headlines had managed, in just two phrases, to capture both the content of the government's proposed action and its justification. Nor do you have to be especially cynical to imagine that this saloon bar message, or something like it, is what the government would be content—privately, of course—for us all to think It may not be the kind of policy statement that a political party would consider printing on a pre-election pledge card, but you have to admit that it fits the space.
So, how was the announcement covered elsewhere? For those who take their news at a more leisurely pace, the Daily Telegraph of the same day spelt out the government's plans: “Potentially dangerous psychopaths could be locked away for good without ever committing a crime under Government proposals published yesterday. Ministers said they intended to change the mental health laws to allow the indefinite detention of people who pose a risk to the public. They would either be held in prison or hospital, or in new purpose-built specialist units.”
Compared with television, radio, and newspapers, the internet barely rates as a source of serious news. But if only to contemplate what the future may be like, it is worth an occasional trawl to see what's being posted and by whom. The best known of the web's news services is BBC Online (news.bbc.co.uk/). Continuous updating is the selling point of services like this, and news items are fashioned accordingly. Online's big advantage is speed: its first story appeared on Monday, half a day before the newspapers had even begun printing. At 3 20 pm “Psychopaths face indefinite sentences” outlined the government's proposals but offered no dissenting comment. These came in a separate story at 3 45: “Psychopaths: the reaction.” This included brief and suspicious comments from the mental health association MIND, the National Association for the Care and Resettlement of Offenders (NACRO), the National Schizophrenia Fellowship (NSF), and Liberty. The Zito Trust and SANE (Schizophrenia: A National Emergency) offered cautious but more sympathetic views. A third piece, at 4 37 pm, gave much of its space to two quite long and critical quotes from the chief executives of SANE and the NSF.
In the nature of an online service, the stories supplement rather than supplant one another. A click of the mouse takes you between them—and to relevant items published days or months previously. Among those on immediate offer (that is, without you having to search for them) were pieces on other ways of dealing with psychopaths, on personality disorder itself, and on the reform of mental health legislation in general. Moderately useful, but still desperately thin in comparison with the extent and variety of newspaper coverage (OK, forget the Sun). However, a service of this kind isn't geared to publishing articles like the one in the Guardian by Anselm Eldergill, commissioner of the Mental Health Act. He bravely argued that if the defence of our freedoms was worth the sacrifice of millions of lives during two world wars “it must withstand the death of a few during peacetime.”
The real point of the web is that it gives access to views that remain unfiltered by the needs, biases, and perceptions of journalists. The Royal College of Psychiatrists is keeping its powder dry, but the NSF (www.nsf.org.uk/news/) has already posted some sharp comment (“That can only lead the general public to believe that all people with a severe mental illness are dangerous”), as has MIND (“Mind's offices have again been flooded with calls from people diagnosed with a personality disorder who fear that they may be locked up unfairly”) (www.mind.org.uk/press/pds.htm).
What is lacking on this topic is a range of individual views. Trawling the newsgroups and forums set up to discuss mental health in general and personality disorder in particular is a disappointment. One message in alt.society.mental-health features a Press Association story on detention for psychopaths. At the time I checked, there was only one response, from “Liam”, who wrote: “I personally don't reckon psychiatry to be much of a science, too subjective. As for public reaction, I think they'll be all for it because of media portrail [sic] of mental health issues.” Not very rewarding. Surfing the net is like listening to local radio phone-ins.
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