Law and disorders
BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39097.614977.94 (Published 18 January 2007) Cite this as: BMJ 2007;334:158
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I was disappointed to read the contents of Des Spence’s article in
this week’s BMJ (Des Spence Law and disorders BMJ 2007; 334: 158). I
understand and agree with some of his concerns regarding the proposed
amendments to the Mental Health Act 1983 but I found his description of
antisocial personality disorder to be both offensive and stigmatising.
He may not be aware of the “Changing Minds” campaign run by the Royal
College of Psychiatrists since 1998 and designed to counter the unhelpful
perception of those with mental disorder oft portrayed in the media and
unfortunately continued in his article. It is well documented that people
with personality disorder are often blamed for their difficulties and
rejected as “untreatable” by the very professionals who are charged with
offering them help (G Lewis and L Appleby Personality disorder: the
patients psychiatrists dislike. Br. J. Psychiatry, Jul 1988; 153: 44 –
49).
Dr. Spence suggests that all patients with antisocial personality disorder
are inherently bad and untreatable. These are increasingly outdated
viewpoints and I was surprised to see them aired in you journal. Evidence
for the treatability of personality disorder continues to grow and it has
previously been suggested that those who continue to hold views similar to
those of Dr. Spence should be offered further training so they may avoid
being ostracised and stigmatised by their more up to date peers (Every
Family in the Land – Understanding prejudice and stigma against people
with mental illness (2003) Royal Society of Medicine Press). I wonder if
Dr. Spence might avail himself of such an opportunity.
Competing interests:
None declared
Competing interests: No competing interests
Re: Outdated and Stigmatising
My apologies. This was not my intention and perhaps I have been too
tabloid in my effect to get my point across.
I have a good relationship with patients who have a forensic history
and these patients do benefit from various psychological support. They are
not bad nor beyond redemption. I have had some fairly unnerving
experiences over the years though. My concern is that the proposals in the
new mental health act would simply demonise them further.
Frankly, I find the idea of all personality disorders far too
simplistic and unhelpful with all of us exhibiting different traits at
different times - clearly as columnist I am by nature narcissistic.
Thank you for the resources which I will follow up
Competing interests:
None declared
Competing interests: No competing interests