Views & Reviews Personal views

Time to act on behalf of mentally disordered offenders

BMJ 2007; 334 doi: (Published 07 June 2007) Cite this as: BMJ 2007;334:1222
  1. Becky Sales, lead GP,
  2. Nigel McKenzie, consultant psychiatrist
  1. HM Prison Pentonville, London
  1. Correspondence to: B Salesbecky.sales{at}

    Over the past six months the British media—general and medical—have increasingly focused on two apparently unlinked issues relating to offenders and the criminal justice system. The first issue is the current overcrowding crisis in prisons, as the number of prisoners exceeds capacity (80 000 in England and Wales). The second is the new Mental Health Bill and the debate surrounding it as it passes through parliament. In terms of criminal justice this debate has largely centred on the balance to be struck between the human rights of mentally disordered offenders and protection of the public. What is striking is the focus on patients with potentially untreatable disorders (such as personality disorders) rather than any debate concerning—or even with reference to—the human rights of those with treatable disorders, such as people with acute psychosis.

    Each year in England between 5% and 8% of all patients (or 1300 to 2000 patients) detained under section in psychiatric hospitals come through the court or prison systems. Unlike their …

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