A survey of forensic psychiatrists' views on psychopathic disorder

Abstract

All forensic psychiatrists working in regional secure units (RSUs), Special Hospitals (SHs) and other forensic settings in England, Scotland and Wales were sent a questionnaire, with the aim of canvassing their views on psychopathic disorder (PD). The questionnaire, which used case vignettes, included questions about current legislation, treatment and treatability, dangerousness, facilities and decision-making. Of the 94 questionnaires sent out, 86 (91%) were returned. There was little difference in the responses of SH and RSU consultants and therefore the results were given as one group. Forensic psychiatrists were divided on the issue of whether PD should remain within the Mental Health Act, 53% being in favour and 47% against. Although there was no consensus view about changing the legislation for PD patients, a substantial proportion of forensic psychiatrists were against indeterminate hospital orders, but supported the transfer of PD patients after sentence instead. The majority were in favour of offering treatment to psychopaths, using a multidisciplinary approach, and only about 10% believed that psychopaths were untreatable. There was considerable support for setting up specialized units for treating PD patients, especially in prisons and Special Hospitals.