“…Where MDOs are prosecuted to conviction, the law increasingly allows courts to take account of the opinions of psychiatrists (and perhaps psychologists) when deciding both the type and length of sentence to be passed. Hence, they may now be required to give diagnostic and risk assessment evidence towards the possible passing of a 'hybrid sentance' (Eastman, 1996;Eastman and Peay, 1998) a 'longer than normal' sentence designed to protect the public (Criminal Justice Act 1991, s 4 2 ) b and s.4) (Solomka, 1996) and, if enacted, the proposal by the Home Secretary (The Times, 1998;Straw, 1999) for 'reviewable orders' for the 'dangerous severely personality disordered' (including for the unconvicted and untreatable) will require psychiatrists both to diagnose the (legal) 'condition' and to advise on risk. This latter measure profoundly confuses the valid notion of public health psychiatry, in which there is some benefit to the 'patient', with that of crime prevention (Eastman, 1999).…”
Section: Prosecuting the Mentally D I S O R D E R E D 499mentioning
“…Where MDOs are prosecuted to conviction, the law increasingly allows courts to take account of the opinions of psychiatrists (and perhaps psychologists) when deciding both the type and length of sentence to be passed. Hence, they may now be required to give diagnostic and risk assessment evidence towards the possible passing of a 'hybrid sentance' (Eastman, 1996;Eastman and Peay, 1998) a 'longer than normal' sentence designed to protect the public (Criminal Justice Act 1991, s 4 2 ) b and s.4) (Solomka, 1996) and, if enacted, the proposal by the Home Secretary (The Times, 1998;Straw, 1999) for 'reviewable orders' for the 'dangerous severely personality disordered' (including for the unconvicted and untreatable) will require psychiatrists both to diagnose the (legal) 'condition' and to advise on risk. This latter measure profoundly confuses the valid notion of public health psychiatry, in which there is some benefit to the 'patient', with that of crime prevention (Eastman, 1999).…”
Section: Prosecuting the Mentally D I S O R D E R E D 499mentioning
“…We should also note that a number of clinical and legal authorities consider that the current espousal of the term 'psychopathic' and all that this entails in practice, is unhelpful. See Blackburn (1988), Lewis and Appleby (1988), Solomka (1990), Cavadino (1998), and Maden (1999).…”
The development of the concept, causes and management of severe (psychopathic) personality disorder is reviewed against the current background of government concern about the activities of a small group of individuals alleged to be showing the disorder to a dangerous degree. The authors acknowledge the problems involved in 'labelling' the disorder. The term psychopathic has a somewhat chequered history. It did not enter U.K. legislation until the Mental Health Act 1959. To this extent, it is a legal term and does not equate to any exact degree with the clinical descriptions currently in use. However, the term 'psychopathic disorder' will be used as a kind of shorthand for variants in everyday use. It is important to note that in this contribution we are only considering those 'psychopaths' who have come to the attention of the criminal justice and mental health systems. There are also 'psychopaths' who, for a variety of reasons, have not come to official attention and a recent contribution by Board and Fritzon (2005) highlights some interesting common characteristics in business managers and a sample of forensic patients detained in high security establishments.
“…When setting the sentence tariff for the period of imprisonment as part of the HD, the sentencers indicated that they would use psychiatric evidence in either mitigation or aggravation. This might raise concerns about the role of psychiatrists in the sentencing process in terms of the prediction of future offending and in terms of sentencers using psychiatric diagnoses such as personality disorder as a justification for harsh sanctions (Solomka, 1996;Smith, 1998).…”
The Crime and Punishment (Scotland) Act 1997 introduced the hospital direction (HD), often termed the 'hybrid order' because it allows courts to simultaneously send a mentally disordered offender to hospital and impose a prison sentence, to be completed after hospital discharge. It is the first measure that explicitly allows the imposition of a prison sentence for an offender meeting criteria for detention under the Mental Health (Scotland) Act 1984. A previous survey showed that psychiatrists in Scotland favoured the principle of a hybrid order (Darjee et al., 2000). In this study all Scottish Sheriffs (n = 110) and High Court Judges (n = 26) were surveyed for their views on the HD. Of the 56 respondents 19 felt unable to participate largely due to lack of experience in sentencing mentally disordered offenders. Respondents felt the HD was a useful measure, but, in contrast to Scottish Office guidance, indicated that psychiatrists should recommend it directly if they considered that it was an appropriate disposal. Respondents viewed the HD as primarily an incapacitating measure and most respondents hoped that it would encourage psychiatrists to admit 'psychopaths'; although Scottish psychiatrists do not favour the hospitalisation of offenders with primary personality disorders. It is concluded that in its current form and with current guidance the HD is difficult to use, as there are no criteria to differentiate it from a hospital order (HO) and psychiatrists cannot recommend it. Further, recent legislation that makes public safety the primary concern when deciding on the discharge of restricted patients in Scotland, erodes the utility of the HD as an incapacitating measure. However following the Reports of the Millan and MacLean Committees in Scotland, the role of the HD may be strengthened and clarified.
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