‘It doesn't have to be treatable’: Mental Health Review Tribunal (MHRT) members’ views about Dangerous and Severe Personality Disorder (DSPD)

Abstract

The development of four high security Dangerous Severe Personality Disorder (DSPD) units in the prison service and mental health system has been controversial. Drawing from a case-note review of DSPD patients’ Mental Health Review Tribunal (MHRT) records and qualitative interviews with MHRT members and DSPD clinical staff, this article explores the outcomes of DSPD patients’ MHRTs and MHRT members’ views about DSPD. Mental Health Review Tribunal members most often identified the high security location of the DSPD units to be more relevant to their decision-making than the label of DSPD. Many made clear distinctions between patients with mental illness and those with personality disorder. However, while MHRT members held a range of views about DSPD and some notable doubt about the clinical treatability of DSPD patients, nearly all identified that this was a population who were legally treatable under the Mental Health Act (MHA) 1983 (prior to the MHA 2007 amendments).