Premium
Holding the patient to account at the gatekeeping stage
Author(s) -
CARSON DAVID
Publication year - 1992
Publication title -
criminal behaviour and mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 54
eISSN - 1471-2857
pISSN - 0957-9664
DOI - 10.1002/cbm.1992.2.2.224
Subject(s) - gatekeeping , psychology , criminal responsibility , morality , authoritarianism , mental illness , criminal justice , personality , psychiatry , social psychology , mental health , psychotherapist , criminology , criminal law , politics , law , political science , democracy
Underlying the arguments against hospitalisation of some mentally disordered offenders, and violent offenders in particular, is the fear that such people are ‘getting away with it’ or that the psychiatrists have been ‘duped’ . There may be some justification for these concerns in that health service staff often have a very muddled approach to concepts of responsibility among their patients. This in turn can confuse the patients and be counter‐therapeutic. Among staff it can foster unduly authoritarian approaches of dubious morality. A proposal is presented for a much more objectively enquiring approach to patient behaviour, with rational, reasoned responses, which may include prosecution under the criminal justice system. Such approaches are not incompatible with hospital treatment, whether as an inpatient or outpatient. While these approaches may be applied to a patient with any mental disorder, including a psychotic illness, they are perhaps of particular importance in relation to those patients with an antisocial personality disorder, for whom limits must be clear and the appropriate establishment of personal responsibility is so important.