"[most]...criminals are neither mentally ill nor victims of addictions" Forensic psychologist Dr Stanton Samenow (Samenow, 1998; p.127).

"Crimes are what we commit. Diseases are biological processes which happen to our bodies. Mixing these two concepts by defining behaviours we disapprove of as diseases is a bottomless source of confusion and corruption" (Szasz, 2002).

Home Office Minister Beverly Hughes said: "Research shows that as many as nine out of ten prisoners have a diagnosable mental disorder"; however these figures included non-mentally ill people with immature or anti-social personalities...

Nicolas Burton...claimed...that he had heard voices in his head telling him to kill. But the judge told him: 'The first time that you told anyone of the 'voices' was nine months after your arrest. You failed to hoodwink the jury" (Wilkinson, 1998).

Nail bomber David Copeland pretended to hear voices but "confessed that he enjoyed tricking and confusing people as he was questioned by doctors attempting to discover if he was mad" (Twomey, 2000).

"Yvonne Coen QC said [Lee Brown] had concocted his tales of hearing a commanding and evil voice...in order to escape a life sentence for murder" (Barrow, 2004).

MAD OR BAD?

A damaging development for psychiatric patients has been the blurring of the boundaries between character defect and psychiatric illness: quasi-medical categorisations having been extended to include non-mentally-ill people with immature or anti-social personalities.

While the public is now largely aware of the distinction between mental illness and learning disability (realising that people with Downes Syndrome, for example, are not mentally ill) apparently few fully understand the concept of 'psychopath'; a term attributed to many dangerous or difficult individuals who are also not mentally ill.

Confusingly, these people are also often described as having 'personality disorders' - when not deemed 'psychopaths' or 'sociopaths'. Unlike authentic sufferers from mental illness, 'psychopaths' do not lose touch with reality and rarely suffer much anguish or distress. They are essentially selfish, shallow and immature - yet are sane and usually of normal intelligence.

They have been described as: "...social predators who...ruthlessly plow their way through life... Completely lacking in conscience and in feelings for others, they selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret" (Hare, 1994; p.xi). Giving these people a quasi-psychiatric status has fuelled false fears about the mentally ill.

Referring to the fallacious perception of the failure of care in the community, Professor Julian Leff pointed out: "Part of the misperception of the situation is a confusion in the mind of the public between schizophrenia and personality disorder" [i.e. between people who are seriously mentally ill and those who are just anti-social or immature] (Leff, 2001; p381).

SOCIOPATH OR PSYCHOPATH?

Many writers use the terms psychopath and sociopath interchangeably, although, increasingly, psychopath is falling into disuse -possibly to avoid confusion with terms like 'psychotic' or 'psychosis' i.e. a sufferer from insanity: one who has a mental illness.

(Commenting on the murderer-rapist Colin Pitchfork, Joseph Wambaugh wrote that it was unfortunate that a psychiatrist described Pitchfork as a 'psychopath' - rather than 'sociopath' - because "everyone connected with the case seemed to confuse the word [psychopath] with 'psychotic'" [i.e. they thought that Pitchfork had a psychiatric illness] -Wambaugh 1989).

Many people must also be puzzled by reports such as those relating to the Tasmanian mass-murderer Martin Bryant -i.e. that Bryant 'had a severe personality disorder' but 'was not mentally ill' (Independent, 1996). The confusion is increased when notorious - but non-mentally ill - criminals, exemplified by the Moors Murderer Ian Brady, are sent to the 'special' psychiatric hospitals. No wonder the public are terrified of psychiatric patients.

'Personality disorder' seems to be the current vogue term or euphemism for 'psychopath' - i.e. a sane, selfish and amoral person with no conscience - but, confusingly, it can also refer to other personality types as well. (Some diagnosed 'personality disordered' individuals have a well-developed conscience and they empathise readily: traits entirely absent from the text-book 'psychopath').

As Peter Beresford remarked: "...'Personality disorder'...seems to be used in two different, yet equally unhelpful ways: first, as if it explained away and removed responsibility from some people who behave in brutal and selfish ways; second, particularly when framed as 'borderline personality disorder', to oppress and stigmatise people (especially women) who commit no crime and pose no threat' (Beresford and Hopton, 2002).

Professor of Psychiatric Social Work Herschel Prins has commented: "...there has been a tendency amongst penal and other workers to use the term psychopathic as a kind of 'dustbin' label, through which it is possible to disclaim responsibility for trying to manage offenders or patients who are merely unresponsive, irresponsible, unlikeable, or difficult". (Prins, 1982; p.75)

'MENTALLY ILL' STALKER GETS LIFE

Even the serious newspapers sometimes use the terms 'psychopath' (sane but amoral) and 'psychotic' (insane - but often harmless) interchangeably, as though they are synonymous.

This confusion was illustrated by a Guardian article headlined 'Mentally Ill Stalker Gets Life for Killing Boy' which reported the killing of a 12 year-old boy by a non-mentally ill individual "who had a severe personality disorder". The killer was a 52 year-old pederast and occultist called Henry Allen Bibby who had changed his name to Alex Crowley (Vasagar and Hopkins, 2001).

Confusion was compounded because Crowley was given a psychiatric assessment during which he simulated psychotic symptoms. (Individuals with immature personalities are extremely mendacious and manipulative, and enjoy deceiving people -especially psychiatrists -see Hare, 1994; Moyes, 2001; Twomey, 2000). Unfortunately, most newpapers subsequently reported that Crowley was mentally ill.

DAMILOLA TAYLOR

Confusion about the distinction between anti-social personality and mental illness was displayed in another Guardian article - Angela Neustatter's 'Pity the Killers' - regarding the case of murdered schoolboy Damilola Taylor (Neustatter, 2000).

This article referred to a report that 20% of children and adolescents have psychological problems and claimed: "It is very likely that Damiola's killers are among them, as was the psychotic cellmate who killed Zahid Mubarak in Feltham". In fact, this cellmate - skinhead Robert Stewart - was not 'psychotic' but had a grossly unpleasant and anti-social personality - in archaic terms, he is a 'psychopath': i.e. a bad character; but not mentally ill.

Given the confusing terminology, it is understandable that journalists should confuse character defect (i.e. 'psychopathy') with mental illness, but many criminologists and forensic psychiatrists would be surprised if Damilola's killers turned-out to be suffering from a mental illness.

Too many news reporters make assumptions about assailants' mental states; seemingly unaware that mentally distressed people do not roam around in gangs; that they tend to practise social withdrawal and, overwhelmingly, share mainstream social values, loathing cruelty, abuse and violence - just like almost everyone else.

In fact, many mentally ill people themselves have been seriously victimised in childhood. Worse, they are likely to be victimised again when in the power of institutional 'carers'.

CHILD MOLESTERS

Perhaps nothing is so damaging for psychiatric patients than the mis-conception of child molesters (paedophiles) as being mentally ill. While most of us feel that paedophiles must be 'sick' in the colloquial sense, they are almost never sick clinically.

Paedophiles are no more likely than others to experience being mentally ill: "Paedophilia is not a mental illness, but is regarded as a 'disorder of sexual preference', to quote the World Health Organisation formulation" (Innocence in Danger, 2001). Essentially, paedophilia is just a sexual orientation. People with this orientation have the same moral choices as anyone else i.e. to behave with decency and restraint or to force onto others their preferred type of sex (Szasz, 2002).

Paedophiles frequently claim that they themselves were abused, but as a leading forensic psychologist pointed out: "People do not become abusers and criminals because they were abused" (Samenow, 1998; p.39). According to NSPCC research huge numbers of people have experienced abuse or other victimisation in childhood (Clarke, 2000); however only a tiny percentage later choose to abuse other people.

While we applaud efforts to stop paedophiles re-offending (it seems that a cognitive-behavioural approach - psycho-babble for getting offenders to change their thinking and acting - does meet with some success; although the statstically-aware will note that 're-conviction' is not the same as 're-offending' -see Player, 1992) we deplore the portrayal of sexual deviancy as mental illness.

Significantly, the Wolvercote clinic -Britain's major 'treatment' centre for paedophiles - did not accept as patients people who were mentally ill: "Wolvercote does not accept men for intervention with current active mental illness..." (National Probation Service, p.2).

As sexual orientation - however 'deviant' - does not constitute an illness, it is unsurprising that many experts are pessimistic about finding a 'cure' (Kenny, 2000). As Dr. Stanton Samenow remarked: "If you've worked with sexual offenders - people who have committed these offences again and again - you know that we do not in psychiatry and psychology have a way to change sexual orientation" (Douglas and Olshaker, 1998; p109).

Victims of Crime Trust spokesman Norman Brennan has reportedly said: "There is no medical cure of paedophiles. It beggars belief why they are released in the first place" (Hull, 2004).

Paedophiles themselves have sometimes expressed scepticism about the feasibility of 'treatment'. As one convicted paedophile commented: "There has been a considerable amount of discussion recently about rehabilitating, even curing paedophiles. I do not believe this is possible. I am a paedophile" (Atherton, 2001).

This suggests that sometimes sex offenders are more realistic than 'experts' about changing their behaviour: jailing for life sex-sadist Paul Beart (who horribly tortured a woman to death) Mrs Justice Hallet said she was "...astonished Beart managed to fool experts into believing he was not a risk". Beart had previously been jailed for five years but released after three, having "passed a sex offenders' rehabilitation course and posed as a model prisoner" (Lakeman, 2001).

PRISONS FILLED WITH THE MENTALLY ILL?

Public perception of the false linkage between mental illness and criminality must have been re-inforced by the sensational - if mis-leading - statement by Home Office Minister Beverly Hughes (19th November 2001) that: "Research shows that as many as nine out of ten prisoners have a diagnosable mental disorder". These figures - taken from the 1997 ONS Survey on psychiatric morbidity among prisoners - included abusers of alcohol and street-drugs as well as the (inevitably) huge numbers of convicts with immature or anti-social personalities.

Former Chief Inspector of Prisons, Sir David Ramsbotham (Batty, 2002b) also fuelled false fears about the mentally ill with his statement that "more than 70% of prisoners" have "a personality disorder" (i.e. many convicts are extremely selfish and immature - what's new? Only that these character defects are now seen as constituting some kind of mental illness).

If immature and anti-social individuals are now to be regarded as having a mental illness, then the most damaging negative stereotypes are seemingly validated: i.e. the mentally ill are dangerous and dishonest - they molest children and carry out random, unprovoked assaults and murders.

While there have been cases where the genuinely mentally ill have been inappropriately imprisoned - sometimes with tragic consequences (Honigsbaum, 1999; Inquest, 2002, Rayner, 2001) - it cannot be stated too often that most mentally ill people never commit any offence.

The whole issue of offending and mental illness has been confused by the fact that mental illness has been simulated - successfully and otherwise - by several high profile offenders e.g. the Son of Sam (Douglas and Olshaker, 1998, p.43); the Yorkshire Ripper (Yallop, 1985, pp. 350-351); 'Soho Bomber' David Copeland (Twomey, 2000); Mark Chapman, (Jones, 1994); and others (Corless, 1998; Wilkinson, 1998).

Presumably these hoped to receive more lenient sentences as 'mental patients' and sometimes succeeded in conning psychiatrists.

I'VE GOT THESE VOICES IN MY HEAD, DOC...

Apparently the idea is current in convict culture that prisoners can get 'nutted-out' to a psychiatric facility by simulating auditory hallucinations. Prisoners on remand pick up these tips and sometimes miraculously manifest a pre-trial 'psychosis'. For instance, in 1998, kidnapper and murderer Nicholas Burton tried to be sent to a mental hospital by claiming to hear voices (Corless, 1998).

"Nicolas Burton...had claimed after his arrest that he had heard voices in his head telling him to kill. But the judge told him: 'The first time that you told anyone of the 'voices' was nine months after your arrest. You failed to hoodwink the jury" (Wilkinson, 1998).

Rapist and murderer Lee Brown "concocted his tales of hearing a...voice he named 'Thingy' in order to escape a life sentence for murder" said barrister Yvonne Coen QC "the reality is that 'Thingy' never really existed...his behaviour was rational, purposeful and deliberate..." (Barrow, 2004). "He knew full well what he had done" (Ananova, 2004).

The killer of Swedish foreign minister, Anna Lindh, originally denied her murder until "confronted with overwhelming evidence". He then claimed to have been told to kill by "voices" (Metro, 2004)

'YORKSHIRE RIPPER' PETER SUTLCLIFFE

Despite supposedly suffering from a serious psychosis, Sutcliffe displayed considerable cunning and competence (Bilton, 2003; Mount, 1981). As David Yallop points out: "This man evaded the biggest manhunt in the history of this country for over five and a half years" (Yallop, 1981; p.330). "Sutcliffe was interviewed twice but aroused no suspicions" (Robbins and Arnold, 1996, p88). Subsequent revelations in Michael Bilton's Wicked Beyond Belief show "Sutcliffe hoodwinked psychiatrists before his trial" according to Leeds MP Fabian Hamilton (BBC, 2003).

Unlike the authentically mentally ill (who usually withdraw socially) Sutcliffe led a gregarious existence: he had a variety of girl-friends and often drank with friends in pubs. After his arrest he co-operated fully with the police but made no mention of 'voices'.

Six days after his arrest (long before his talk of a "mission from God") prison officer John Leach overheard him tell his wife, Sonia,"...I am going to do a long time in prison, thirty years or more, unless I can convince people in here I am mad and maybe then ten years in the loony bin" (Yallop, 1981; pp.350-351). Only later did he mention 'voices'.

Suttcliffe claimed to have a divine mission to kill prostitutes; yet "out of at least twenty women attacked, ten are not and never have been prostitutes..." (Yallop, 1981; p.337). Sutcliffe told a Broadmoor nurse that he'd fooled psychiatrists and later admitted that "There was no voice in my head. There was no voice from God" (Moyes, 2001).

BOMBER ADMITTED HE'D INVENTED VOICES

Nail-bomber David Copeland also conned psychiatrists into believing he was insane, but the jury rejected this ruse after hearing he'd admitted that he'd invented 'voices'. "Defence expert Dr. Paul Gilluley...agreed Copeland admitted he had pretended that 'voices' had spoken to him" (Twomey, 2000). "[Copeland]...confessed that he enjoyed tricking and confusing people as he was questioned by doctors attempting to discover if he was mad" (Twomey, 2000).

"Copeland told the doctors that he had been chosen by God to spark a race war...But he never mentioned his divine mission during police interviews despite being asked 16 times why he planted the...devices" (Twomey, 2000). His defence was that he was mentally ill but the jury rightly found him guilty. Yet regrettably - like Sutcliffe - he was sent to Broadmoor anyway, thereby seemingly confirming his concocted psychosis.

"WHAT ARE MY CHANCES OF GETTING OUT OF BROADMOOR?"

Killers have often feigned insanity. This ploy was attempted by 'acid bath murderer' John George Haigh: a smooth-talking charmer and life-long liar, cheat and fraudster, who may have murdered 8 or more people in order to obtain their assets and savings.

Haigh cleverly planned his methodically-executed murders. Following his arrest he asked the interviewing detective: "What are my chances of getting out of Broadmoor?" Only later did he mention the much-cited 'psychotic symptoms' of drinking blood and urine.

The jury rejected this crude defence but Haigh continues to be cited in true-crime books and magazines as a psychotic killer and 'real life' vampire, thereby contributing to the mythology surrounding murder and mental illness.

"JOHN LENNON KILLED BY 'SCREWBALL'"

Following the 1980 shooting of John Lennon, the media carried various bizarre stories about his killer, Mark David Chapman, none of which were subsequently substantiatiated. Chapman was probably just a narcissistic drug-abuser who wanted to be famous and decided to gain fame by killing a celebrity (Jones, 1994).

Despite the usual label of 'loner', Chapman led an active social life: a superficially charming individual, he was an out-going, smooth-talker who had worked successfully as a counsellor and assistant director in a kids' summer camp.

Although Chapman claimed (months after his arrest) that he'd killed Lennon to promote the reading of The Catcher in the Rye, he'd never shown any earlier interest in that book until just before the killing - planned months previously. Some twenty years later, when he became eligible for parole, he reportedly stated: "The mental illness is over". Fortunately the authorities were not fooled; but he has further fuelled the mythology linking homicide and mental illness.

THE SON OF SAM

'Son of Sam' killer David Berkowitz, who terrorised New York, was another conman who duped psychiatrists. His implausible tale of being 'controlled' by his neighbour's Labrador - supposedly host to a three-thousand-year-old demon - convinced doctors he had paranoid schizophrenia.Yet later, in a prison interview with FBI researchers, Berkowitz admitted that he'd lied. "He laughed and owned up to the hoax. It was just one more example of manipulation, domination and control" (Douglas and Olshaker, 1998; p43).

As Prof. Elliot Leyton observed: "...he appeared insane" yet "a close examination of his person forces us to revoke his proffered madman credentials" (Leyton, 1986; pp.185-186).

However, many serious text-books on psychiatry and criminology continue to cite Berkowitz as exemplifying the danger supposedly represented by some schizophenics - despite his "...admitting that his story of Sam Carr, demons, and spirit possessions had been an invention ...[and that he] confessed that the entire demonic story had been a well-planned, carefully co-ordinated hoax" (Leyton, 1986; pp.204-205).

DR. HAROLD SHIPMAN

Possibly the biggest serial killer in British criminal history (the minimal estimate is that he killed 215 people -and probably at least another 45; maybe more c.f. Tameside Advertiser, 2002) Shipman was clinically evaluated by forensic psychiatrist Dr Richard Badcock, who found no evidence of any formal mental illness.

Although Shipman was supposedly addicted to pethidine, he may have invented this addiction to cover his over-prescribing in order to kill his Todmorden patients: investigators found many more deaths amongst Shipman's patients than amongst those of other Todmorden doctors - Department of Health, 2001.

STALIN AND HITLER

The tendency to attach dubious psychiatric diagnoses to anyone whose behaviour is amoral or outrageous is typified by the cases of Stalin and Hitler. These cunning and calculating individuals were responsible for the murder and torture of millions. Understandably, given the enormity of their crimes, people prefer to believe they were acting under the influence of a psychosis.

Stalin is now routinely cited as a paranoid schizophrenic; yet the distinguished historian R. A. Medvedev carefully scrutinised Stalin's personality and conduct in conjunction with a specialist psychologist. They concluded that although Stalin was often 'paranoid' in the colloquial sense, he was not paranoid clinically (Medvedev, 1989) i.e. he did not act like someone in the grip of a pathological paranoid illness (Graham, 1994; p.180). Dr James Graham concluded that alcohol - not psychiatric illness - was probably the major factor in Stalin's various miscalculations and blunders (Graham, 1994; p.169).

Regarding Hitler, the best psychiatric survey is probably 'Hitler: Diagnosis of a Destructive Prophet' by Prof. Fritz Redlich -Professor Emeritus of Psychiatry at the University of California at Los Angeles and Chair of the Department of Psychiatry at Yale. (Redlich, 1998).

Prof. Redlich made a 10-year study of Hitler after realising that, like Van Gogh, Hitler had been posthumously accredited with just about every psychiatric condition imaginable. After an exhaustive examination of the evidence, he concluded that although Hitler's personality was 'abnormal' and his character defective, he did not suffer from any mental illness.

Prof. Redlich convincingly argues that Hitler knew what he was doing and was entirely responsible for his behaviour.

ORWELLIAN IMPLICATIONS...

The trend to 'medicalise' grossly selfish or anti-social behaviour has been exacerbated by the well-meaning but mis-guided efforts of some penal reformers and others who think that all offenders - but especially career criminals, child molesters, and other persistent predators - must somehow be 'sufferering' from mental illness.

This fallacy seems to have fuelled the formulation of the concept of Dangerous and Severe Personality Disorder -a development which carries sinister Orwellian implications; as Guardian correspondent David Batty points out: "DSPD...has no legal or medical basis [and]..many psychiatrists see [proposals to incarcerate people deemed to be personality disordered] as a flawed political gesture and fear it will turn them from doctors into jailers" (Batty, 2002).

If, having encountered the writings of Max Stirner or Freidrich Nietzsche, someone subsequently rejects conventional morality and become grossly selfish, is this philosophical position to be regarded as an illness?

MIND has called DSPD a "dustbin diagnosis" which could become "a dumping ground for patients who are considered to be difficult or different" (Donnelly, 2000 p.15).

As the former Director of the Sainsbury Centre for Mental Health Dr Matt Muijen pointed out, people deemed to have 'personality disorders' "...are not necessarily people with psychiatric problems" (Donnelly, 2000).

PSYCHIATRISTS OPPOSED...

To their credit, many psychiatrists (e.g. Crawford, 2001; Eastman, 1999; Lawson, 1999; McKie, 1999; et al.) have registered objections to medicalising non-psychiatric criminal behaviour. Referring to reports that paedophiles could be transferred from prison to psychiatric hospitals, Prof. Malcolm Weller wrote: "This suggestion illustrates a worrying trend to use psychiatric services as an instrument of social policy. Psychiatrists have no wish to be placed in the position of "treating" people who do not wish to be treated (and are likely in consequence to be untreatable)" (Weller, 1998).

Referring to proposals to detain people deemed 'personality disordered' Consultant forensic psychiatrist Harry Kennedy said: "The position of most psychiatrists is that we would be opposed to a form of preventative detention in which the notion of psychiatric treatment is used as an excuse to deprive people of their liberty" (Lawson, 1999)

An individual's personality grows organically over many years and is formed by a complex variety of factors -genes, environment, socialisation and other life-experiences (Morea, 1990). Consequently people with anti-social personalities cannot be 'cured' -even if, exceptionally, a modicum of behaviour modification may take place (Black, et al, 1995).

Numerous studies show that: "Anti-social personality traits tend to persist and no interventions have been shown to change their course" (Crawford, 2001). As Linda Steele wrote: "You can't 'treat' someone's personality, however aberrant or unpleasant. So, people with personality disorders, as opposed to mental illnesses, are not deemed treatable by psychiatrists" (Steele, 2001).

'TREATMENT' MAKES THEM WORSE

Apart from the ethical implications of forcing psychiatric 'treatment' on non-mentally-ill offenders, there is evidence that it may actually make them worse (Hare, 1994, p.242; Harris, et al. 1991; Hemphill, 1991). This is because these clear-thinking and manipulative individuals often extract and adapt psychological insights from 'therapy' which later help them to exploit and prey upon others with more facility. One such 'patient' remarked: "These programs are like a finishing school. They teach you how to put the squeeze on people" (Hare, 1994, p.243).

As Dr Robert Hare cautioned: "...our efforts to 'treat' psychopaths may be misplaced. The term treatment implies that there is something to treat: illness, subjective distress, maladaptive behaviours, and so forth. But, as far as we can determine, psychopaths are perfectly happy with themselves, and they see no need for treatment..." (Hare, 1994 p247).

This is not to say that nothing can be done more generally about anti-social behaviour like male violence. As Neil Boyd wrote in 'The Beast Within: Why Men are Violent' it is certainly worthwhile to eliminate environmental factors which, we know, lead to anti-social behaviour - such as the over-use of alcohol; tackling childood abuse or neglect and the glorification of male violence (Boyd, 2000). But labelling serious and persistant offenders as mentally ill doesn't help anyone -and is immensely damaging to genuine sufferers of mental illness.

NEUROLOGICAL ABNORMALITIES

Sometimes the brains of 'psychopathic' personality-types display physiological abnormalities (Black, 1999; Boyd, 2000; Hare, 1993 et al.); however, the brains of many good-natured, ethical, law-abiding, individuals are 'abnormal' also. For example, Albert Einstein's brain was abnormal. It is likely that Mozart's or Michaelangelo's would be abnormal as well.

As consultant neurosurgeon Henry Marsh pointed out, even if some serious offenders have abnormal brains, we don't yet know whether their criminality is a cause or a consequence of that abnormality. He cited the example of London Taxi drivers whose brain scans usually reveal an enlarged hippocammpus - the section of the brain most involved in navigation. He said: "It's the hen and egg situation. We don't know what comes first". (Anjana, 2002).

As Anjana Ahuja wrote: "It could be the deviant behaviour practised by an evil individual throughout his life that may result in an abnormal brain architecture, rather than the other way round" (Ahuja, 2002).

Consultant forensic psychiatrist and barrister, Professor Nigel Eastman, also commented: "Even if [some psychopaths' brains have abnormalities] does it mean anything? Does it mean a loss of control sufficient to impact on legal responsibility? Do you abolish free will on the basis of an odd brain scan?" (Ahuja, 2002). Referring to 'personality disorders' consultant psychiatrist Harry Kennedy said: "There is no clear evidence they impair mental capacity or responsibility" (Lawson, 1999)

As Henry Marsh asked: "If we say that antisocial behaviour is determined by our biology, where does that leave morality?" (Ahuja, 2002).

"MOST CRIMINALS ARE NEITHER MENTALLY ILL NOR VICTIMS OF ADDICTIONS"

Clinical psychologist Dr Lucy Johnstone speculated that perhaps "the erosion of the distinctions between the 'bad' and the 'mad' is partially attributable to the widespread availability of street drugs..." (Johnstone, 2001). This may be because street-drugs are now so commonly consumed in the criminal sub-culture: when people with anti-social personalities use drugs, this will inevitably tend to exacerbate their offending behaviour.

Although some substance abusers are undoubtedly self-medicating to relieve symptoms of underlying mental illness, many will have other motivations e.g. hedonism, sensation-seeking or peer-pressure. Participation in substance abuse should not automatically be equated with mental illness or serve as an excuse for offending. As expert forensic clinical psychologist Dr Stanton E. Samenow remarked: "[most]...criminals are neither mentally ill nor victims of addictions" (Samenow, 1998; p.127).

As John Douglas so rightly wrote: "A lot of people don't seem able to grasp the concept that you can have mental or emotional problems - even severe ones - and still be able to distinguish right from wrong and conform your behaviour accordingly" (Douglas and Olshaker, 1998; p40).

DANGERS OF MIS-DIAGNOSIS

Even if personality 'disorders' actually exist (i.e. they constitute a genuine medical condition - not simply part of the human condition) many psychiatrists admit that they could not diagnose them with any reasonable degree of success (Crawford, et al. 2001; Donnelly 2000; McKie, 1999).

As Dr Bernard Dixon remarked: "With only a few exceptions, like phenylketonuria and general paralysis of the insane...mental illness is not a subject of exact science" (Dixon, 1978; p.115).

Dr. Matt Muijen, former Director of the Sainsbury Centre for Mental Health, warned: "Personality disorder in general is defined as an enduring pattern of inner experience and behaviour that deviates markedly form the expectations of the individual's culture. This is a definition riddled with ambiguity" (Muijen, 1999). It has also been remarked that: "Psychiatrists and others fear a return to the days when social misfits could be removed behind high walls with the flourish of an asylum doctor's pen." (Johnston, 1999)

The World Health Organisation definition of personality disorders is "deeply ingrained and enduring behaviour patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations" (Batty, 2002). But like many other diagnostic definitions in psychiatry, this is potentially so all-encompassing that there is a huge potential for false-diagnosis. Dr. Paul Moran of the Institute of Psychiatry "...warned that the clinical diagnosis of personality disorder is 'unreliable'..." and said: "Agreement between clinician's diagnosis of personality disorder is often no better than chance" (McKie, 1999).

Lois Rogers, writing in the Sunday Times, reported on a study which showed that even someone's name can influence the decision to label them as being personality-disordered. "Researchers at a Hampshire psychiatric hospital found that males with the name Wayne are more likely to be considered malingering, feigning, and personality-disordered than those called Mathew, for example" (Rogers, 2000).

Referring to people with Dangerous Severe Personality Disorders, Dr Matt Muijen, remarked: "We don't know who this group is, we don't know how to predict what they do..." (Donnelly 2000 p15). This accords with the views of other eminent psychiatrists who've stated: "What we do know is that discrete personality disorders do not exist and that levels of agreement between clinicians about who should be classified in this way are often no better than chance" (Crawford, et al. 2001).

ARE THEY JUST EVIL?

Many who've encountered grossly selfish, amoral, people have favoured the obvious explanation: they are just evil. However there's no need to invoke supernatural explanations: these are equally as unsatisfactory and unconvincing as the pathological motivations sometimes offered up by psychologists. As Conrad pointed out: "The belief in a supernatural source of evil is not necessary: men alone are quite capable of every wickedness" (Conrad, 1996).

AN INSULT TO THE MENTALLY ILL

Mis-representing vicious criminality as mental illness puts society at risk: both by undermining the concept of personal responsibility and by holding out un-realistic prospects of 'treatment' (as well as unfairly stigmatising the genuinely mentally ill). As former FBI profiling-expert John Douglas commented: "We have to stop excusing the inexcusable and insist that people be held accountable for their actions. Why is there such a tendency, I continue to wonder, to allow raw cruelty to masquerade as mental illness? It is an insult to the mentally ill..." (Douglas and Olshaker, 1998; p348).

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