The problem of how society deals with individuals suffering from severe personality disorders shows no sign of going away. Such disorders are classically grouped within the ancient Greek category of the choleric temperament, in which individuals are touchy, restless, aggressive, excitable, changeable, impulsive, optimistic and active. These individuals incline towards crime and violence, and once embarked on an antisocial career seem to be unable to adopt a different attitude to others.
Proposals have recently been brought forward for locking up, permanently, people suffering from a severe personality disorder who have committed no criminal offence but who might do so in future. It is a prevalent view of psychiatrists that most individuals with severe personality disorder are not amenable to medical treatment. As United Kingdom legislation stands at present, mentally ill people may be detained under the Mental Health Act only if psychiatric opinion is that they can be treated with some prospect of success. Studies have shown that it is doubtful whether predictions that a once convicted psychopathic criminal will reoffend can be made. In the United States and Canada nearly half those offenders who were not considered dangerous went on to commit violent crimes. Risk assessment in such cases is itself risky and the margin of error is wide. Proposed legislation poses serious challenges to fundamental human rights, and it is almost impossible for a detained person, from behind bars, to prove that he or she is not dangerous to society in future.
An editorial in the British Medical Journal for October 30, by a forensic psychiatrist in Victoria, Australia, points out that government proposals to detain individuals who have not committed a criminal offence but might possibly do so contravene the European Convention on Human Rights, which prohibits preventive detention except of persons proven to be of unsound mind. The idea that this might be disregarded is indeed profoundly unethical and reflects official interest in political facades as against the claims of justice and equity.