‘Dangerous and severe personality disorder’: A psychiatric manifestation of the risk society

Abstract

This paper analyses the newly proposed United Kingdom (UK) psychiatric diagnosis of ‘dangerous and severe personality disorder’ (‘DSPD’). The aim is to show how the category of ‘DSPD’ manifests aspects of Beck's analysis of the ‘risk society’ and poststructural ‘governmentality’ approaches to understanding the notion of risk. Concepts such as ‘dangerousness’, ‘violence’ and ‘risk’ are critically reviewed in relation to ‘DSPD’ and are found to be less than objective. The paper interrogates the political underpinnings of this newly proposed diagnosis and analyses pre-existing frameworks of potential utility for developing further understanding of dangerousness and violent behaviour. Key issues are critically discussed in relation to the concept of ‘dangerousness’ including the reliability of assessment tools, the socioeconomic status of those potentially diagnosed with DSPD and detention without committing any prior offence. The paper also discusses the potential for conflict between the proposed legislation, the UK Human Rights Act 1998, healthcare practice and the likelihood of divided professional loyalties. The paper argues that this newly proposed public health policy has a sociopolitical rather than psychiatric rationale for justifying psychiatric detention and, as such, is a psychiatric manifestation of the late modern culture of risk.

Acknowledgements

The authors would like to thank their colleagues who kindly gave feedback on earlier drafts of this paper, including the anonymous reviewers of Critical Public Health.