ABSTRACT
The detention of an individual with Psychopathic Disorder in hospital under the 1983 Mental Health Act is unique in requiring that the condition be ‘treatable’. Although this criterion was introduced to protect the patient from unlawful detention, many believe that it had the paradoxical consequence of excluding individuals from care that might otherwise benefit them. As a result, psychopathic disorder has been excluded entirely in the revision of the Mental Health Act.
Nonetheless, the provision of treatment is of central concern when any mentally disordered individual is detained against his/her will. This chapter will consider the necessity of treatment and its various interpretations for those with psychopathic disorder (with or without a history of sexual offending) with reference to two landmark Court rulings (i.e. Kansas vs Hendricks, 1997; and ex parte A, 1995). History shows that this criterion of treatability is a mixed blessing for those with psychopathic disorder, having both unfortunate consequences as well as the intended benefits. The recent service development to incarcerate those with severe personality disorder who are deemed to be dangerous (i.e. DSPD), and where treatability is no longer a criterion of entry, alarms many professionals who see this as a means of preventative detention without the checks and balances of the previous system. Despite difficulties in both its definition and implementation, therefore, I will argue that it is the anchoring of decision making within accepted clinical norms that provides the best protection for the patient and clinician alike, when decisions on the detention of personality disordered individuals are required to be made.
