MPs call for safeguards for people with personality disorderBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7237.731 (Published 18 March 2000) Cite this as: BMJ 2000;320:731
UK government proposals to detain dangerous people who have a severe personality disorder but no criminal conviction should be applied to individuals only when an assessment predicts that it is almost certain that they will commit a very serious criminal offence, a report from a cross party committee of MPs said this week.
New powers to detain such people should be accompanied by the most stringent safeguards—to satisfy the requirements of the European Convention on Human Rights and the liberties traditionally protected by parliament, the report adds.
Substantial extra funds will be needed to manage dangerous people with severe personality disorder, according to the MPs. “This is a cost which, in the interests of public safety, we believe to be justified.”
Continued detention should be subject to regular review by a judicial body at stated intervals “on the basis of multidisciplinary assessment and subject to independent medical opinion,” their report adds.
The House of Commons home affairs committee was responding to the consultation paper from the Department of Health and the Home Office on managing dangerous people with severe personality disorder (BMJ 1999;319:1146).
One of the triggers for the paper was the murders of Lin and Megan Russell by Michael Stone, who was reported to have a severe personality disorder but was not classified as mentally ill and was not a detained patient.
The government proposed, as one of the options, legal powers for detaining indefinitely people with dangerous, severe personality disorder. The proposal was criticised by psychiatrists at the time (BMJ 1999;319:1322).
The committee accepted that there are differing views and approaches among doctors about treating dangerous people with severe personality disorder, but it says that it is not convinced by the argument that personality disorders are untreatable.
The MPs suggest that, having looked at the experience of clinics in the Netherlands, the government should consider a new specialist service that is separate from but linked to prisons and hospitals. The committee thinks that this would protect the public, meet the needs of the individuals concerned, and satisfy the requirements of the European Convention on Human Rights.
The Home Office, the Department of Health, and the Department for Education and Employment should examine how they could identify in early adolescence individuals who may develop a severe personality disorder and become dangerous.
The Royal College of Psychiatrists welcomed some of the proposals but said that it remained concerned at any implication that psychiatrists should be involved in imposing a sentence on anyone who had not committed a crime.
The home affairs committee's report, Managing Dangerous People with Severe Personality Disorder, is available from the Stationery Office, price £14.70.