Dangerous and severe personality disorder: An investigation of the construct

Introduction of the construct “Dangerous and Severe Personality Disorder” (DSPD) by the UK Home Office and Department of Health has provoked strong debate and opposition. Its aims and that of proposed subsequent legislation was to enhance public protection by identifying and detaining a minority of persons with severe personality disorder who pose a high risk of serious sexual/violent offending. The most serious criticism was the ethical implication of allowing indefinite detention of people without criminal convictions. More recently, policy emphasis has shifted towards treatment. 1396 male prisoners serving sentences of 2+ years for sexual/violent offenses were prospectively interviewed (personality disorders, psychopathy, and risk) at a mean follow-up of 2 years. The prevalence of DSPD was 15%. Significantly more re-offended. Five DSPD offenders would need treatment to prevent one violent act. Based on an estimate of attributable risk, successful treatment of DSPD could reduce violent re-convictions among DSPD offenders by 71% and violent/sexual re-offenses in the prison population by 27%. DSPD criteria correctly identify high risk prisoners but primarily through risk-related demographic features. DSPD does not accurately identify serious sexual/violent re-offenders. The DSPD programme may reduce major violent re-offending if treatment interventions prove effective.     

Self-Awareness and Mental Perception

The purpose of this paper is to clarify Prajñākaragupta’s view of mental perception (mānasapratyak?a), with special emphasis on the relationship between mental perception and self-awareness. Dignāga, in his PS 1.6ab, says: “mental [perception] (mānasa) is [of two kinds:] a cognition of an [external] object and awareness of one’s own mental states such as passion.” According to his commentator Jinendrabuddhi, a cognition of an external object and awareness of an internal object such as passion are here equally called ‘mental perception’ in that neither depends on any of the five external sense organs. Dharmakīrti, on the other hand, considers mental perception to be a cognition which arises after sensory perception, and does not call self-awareness ‘mental perception’. According to Prajñākaragupta, mental perception is the cognition which determines an object as ‘this’ (idam iti jñānam). Unlike Dharmakīrti, he holds that the mental perception follows not only after the sensory perception of an external object, but also after the awareness of an internal object. The self-awareness which Dignāga calls ‘mental perception’ is for Prajñākaragupta the cognition which determines as ‘this’ an internal object, or an object which consists in a cognition; it is to be differentiated from the cognition which cognizes cognition itself, that is, self-awareness in its original sense.     

Enrollment in Mental Health Courts: Voluntariness,Knowingness, and Adjudicative Competence

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts. Although most clients claimed to have chosen to enroll, at the same time, most claimed not to have been told the court was voluntary or told of the requirements prior to entering. The majority knew the “basics” of the courts, but fewer knew more nuanced information. A minority also were found to have impairments in legal competence. Implications are discussed.     

The Notion of Consent to Sexual Activity for Persons with Mental Disabilities

This paper seeks to examine the notion of consent to sexual activity as it is applied to situations involving persons with mental disabilities both by both medical professionals and the law. This will be achieved by analysing sexuality and consent through the lens of disability theory and subsequently by including feminist theories on the notion of consent and of sexual activity generally where this serves to assist in coming to a genuine assessment of the nature and existence of consent to sexual activity for persons with mental disabilities. It is concluded that in order to ensure that genuine substantive consent to sexual activity on the part of the persons with mental illnesses is accurately assessed at both a civil and criminal level, a fusion of both feminist and disability theory into such assessments and adjudications is vital.