The 18th-century wit, the Reverend Sydney Smith, when walking through an Edinburgh alleyway, saw two women shouting abuse at one another across the alley from their tenement windows. He famously concluded that they were never likely to agree, as they were arguing from different premises. Neither Bad Nor Mad has as its subtitle The Competing Discourses of Psychiatry, Law and Politics, and examines, through the specific case of Garry David, how these different groupings with different ‘premises’ resolve their conflicts. No prizes for guessing the winner.

Garry David was a serving prisoner in Australia in the 1980s, who (although something of a nonentity within the custodial system) became celebrated nationally because of his dramatic threats of violence against individuals and the community were he to be released – and released he would be, because he was serving a fixed-term sentence. These threats caused panic among politicians, resulting in a determination to prevent David's release at any cost. The cost to the State of Victoria was high, as it was forced to introduce a special Act of Parliament, the Community Protection Act 1990, that not only effectively subjected David to preventive detention, but also was a unique piece of legislation in that it was enacted to detain him as an individual. The process had an enormous financial cost; Garry David eventually died of peritonitis during the course of his continued incarceration, as a result of repeated self-injury, thereby relieving everyone of the burden of deciding how to manage him.

The theme of the different priorities of politics, psychiatry and the law dominates the book. If the first (and perhaps the only) objective of the state is to safeguard its citizens, then one ought not to expect that this would overlap with the law, whose purpose is justice through a proper legal process, or with psychiatry, whose objective (at least on a good day) is the delivery of care and treatment for those with a mental disorder. As Greig, a criminologist with an interest in the interaction of law and psychiatry, makes clear in this thoughtful book, individuals with extreme behavioural disturbance are only too capable of exposing the fault lines between these competing interests.

In addition to prison disruption and threats of violence against the public, David had another major weapon – self-mutilation. Cue for psychiatry to enter the debate. Psychiatry's dithering in trying to decide between incommensurable alternatives (mad v. bad; mentally ill v. personality disordered, etc.) is paralleled by David's oscillation between prison and mental health facilities, depending on whether his needs or those of the state were paramount. Greig, in the main, is generous to psychiatry, while recognising that it was out of its depth in this instance, where psychiatrists’ assessment of the issues and advice to the authorities were hopelessly contradictory.

From a clinical perspective, the issue insufficiently addressed in this book is the reason why David behaved in this way. Although he claimed that his purpose was to wreak havoc in Victoria, he could more easily have accomplished this by not drawing attention to himself and thereby automatically gaining his release. By signalling his destructive intent, he effectively sabotaged his release and involved himself and the authorities in a danse macabre from which no one emerged as a winner. As the signalling of destructive intent is a common presentation in forensic psychiatry, it is odd that it was the judiciary – rather than psychiatrists – who appeared to be more interested in the causes of David's abnormal behaviour. The reader will not find this book easy going, but it is worth the effort, and should inform our thinking in a difficult and topical area.