‘The Mentally Disordered Offender’ — Who S/he?
| Date | 01 June 1996 |
| Published date | 01 June 1996 |
| DOI | https://doi.org/10.1108/13619322199600016 |
| Pages | 18-20 |
| Author | Simon Keyes |
| Subject Matter | Health & social care |
18 The Mental Health Review 1:2 © Pavilion Publishing (Brighton) 1996
Simon Keyes
REVOL
VING DOORS AGENCY
‘Use respectful language’ say the Guidelines for
Contributors to the Mental Health Review. It
set me thinking. I often have to struggle with
psychiatric language. It’s not just having to decode
all that technical jargon that’s wearisome (I do some-
times find myself agreeing with Shaw’s description
of professionalism as ‘a conspiracy against the laity’).
It’s the corrosive effect of too much exposure to the
academic taxonomies of forensic psychiatry on my
ability to conceptualise this problem in wider terms.
It was the ‘The’ in most of the literature that first
signalled the problem. It seems to suggest that those
to whom the label of ‘mentally-disordered offender’
is applied share a clearly-defined set of common
characteristics. More dangerously, it might imply
that it is these characteristics that are the ‘problems’
that need to be addressed in working with the
individuals thus labelled.
What might be — and often is — missed is
the central importance of the social problems —
homelessness, unemployment, isolation, loneliness
— that are such striking features of the lives of
people with mental health problems in the criminal
justice system. At the same time, the term can
actually deny people the help they most need;
label someone a ‘mentally-disordered offender’ or
worse, an ‘MDO’ and suddenly hostels and other
forms of housing, day centres, and even health
professionals and social workers don’t want to know.
‘Mentally-disordered offenders’ are not simply a
problem of forensic psychiatry or criminal justice,
they are people in whose lives major social problems
cast enormous shadows.
Homelessness: there is a large and detailed
literature on the relationships between mental
health problems and homelessness.1The latest
Home Office Circular (12/95)2on mentally
disordered offenders acknowledges that it is a
key issue. A growing number of studies are starting
to show that housing problems are a major obstacle
to effective care for people whose route into health
services has been through the criminal justice
system. For instance, in Brixton Prison in 1995,
49% of remand prisoners with mental health
problems had nowhere to call home.3
Substance Abuse: drink and drugs complicate
things further. Some 53% of all mental-health cases
referred to a CPN based in central-London police
stations admitted to the use of illicit drugs and/or
excessive quantities of alcohol on the day of arrest;4
this can clearly create considerable additional
barriers to securing treatment and care, let alone
a fulfilling life.
Human Distress: there is not a professional
literature on loneliness, loss of self-esteem, the
near impossibility of earning money, the side effects
of medication (well not a psychiatric one, anyway —
pace Dostoevsky). But every person working on the
front-line with these clients knows that their lives
are prone to great hardship and unhappiness. I, for
one, refuse to believe that this is an incidental
factor.
‘The Mentally Disordered Offender’ –
Who S/he?
VOLUNTARY SECTOR PERSPECTIVE
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