The Dangerous and Severe Personality Disorder (DSPD) initiative was introduced a decade ago against overwhelming opposition from psychiatrists and others concerned with the implications of extending the public protection agenda through the use of a questionable medical ‘diagnosis’. As this initiative is now being scaled down, it offers an opportunity to consider the positive and negative aspects of the initiative together with its longer-term legacy.
The DSPD initiative then went on to identify explicitly the characteristics of individuals that would make it appropriate to detain them for ‘ treatment’. To be detained, the individual needed to satisfy the following triad:
being dangerous, defined as posing a ‘significant risk’ (>50%) on two risk assessment tools (the duration of this risk being unspecified);
having a severe personality disorder (SPD) as evidenced by a Psychopathy Checklist – Revised (PCL–R)11 score of >30 or PCL–R score of 25–30 plus a personality disorder (other than antisocial personality disorder) or two ICD–1012/DSM–IV13 personality disorders;
for there to be a functional link between dangerousness and personality disorder (in two or more offences/prison behaviour).