Government set to ride out storm over definition of mental disorder

Some of the controversial proposals in the draft Mental Health
Bill look set to remain, according to guidance on personality
disorders released by the Department of Health last week.

Although the DoH has said it is reviewing about 2,000 consultation
responses to the draft bill, the guidance states: “The proposed
mental health legislation introduces a generic and inclusive
definition of mental disorder.” The definition is one of the
proposals in the draft bill that has provoked the most opposition
from mental health campaigners.

The definition “will mean that in future people with all forms of
personality disorder including psychopathic disorder can be subject
to compulsion in the same way as those with other forms of mental
illness”.

It says how the broad definition, the introduction of compulsory
treatment in the community and the abolition of the treatability
test will “highlight the need for new community and in-patient
services for people with personality disorders”.

“This will place a new emphasis on the assessment and treatment of
personality disorder as part of the legitimate business of mental
health services,” it states.

But Simon Lawton Smith, head of public affairs at the Mental After
Care Association, said:”The way the mental health legislation
chapter of the guidance is drafted suggests it’s all cut and dried.
You’d need to be a pretty optimistic person to believe that there
is going to be any significant change to the proposed inclusive
definition of mental disorder, or to the powers to detain and treat
some people with a personality disorder diagnosis.”

The guidance also highlights how clinicians will need to develop
skills in identifying and assessing personality disorders, with
appropriate training provided.

It says the government is planning personality disorder centres to
assess, treat and manage personality disorders in male offenders,
most of whom will have a primary diagnosis of antisocial
personality disorder. They will take referrals from a range of
places including courts, prisons and general mental health
services.

‘Personality Disorder: No Longer a Diagnosis of Exclusion’ from www.doh.gov.uk/mentalhealth/whatsnew.htm