ABSTRACT
Caring for PD patients is not an easy task. They are generally considered to be difficult patients by all psychiatric professionals at every level of service. Even those treated as outpatients are considered hard to care for, let alone those whose condition is so severe and associated with such criminal behaviour that they are residing within the High Security Hospitals. In this chapter the problems faced by staff in managing and caring for PD patients will be described. The crimes committed by patients evoke emotional reactions from staff. In addition the nurses who were interviewed described five aspects of the behaviour of PD patients that contribute to making them ‘difficult’: manipulation, self-harm, violence, complaints, and their tendency to form among themselves an informal and exploitative hierarchy within the ward.
