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Undue emphasis on risk may increase stigma

Published online by Cambridge University Press:  02 January 2018

Santoch Rai*
Affiliation:
The Hutton Centre, St Luke's Hospital, Marton Road, Middlesbrough TS4 3AF
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Abstract

Type
The Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2001. The Royal College of Psychiatrists

Sir: I agree with Petch (Psychiatric Bulletin, June 2001, 25, 203-205) that an undue emphasis on dangerousness may not serve to protect the public. Indeed, it may actually do more harm than good by increasing the stigma of mental illness.

For example, the recent Government White Paper (Department of Health, 2000) expresses a desire to reduce the stigma of mental illness but, in the next paragraph, it talks of the “toll of homicides” by those with mental disorder. There is no recognition of the excellent work that mental health services routinely provide. Instead, the focus is on rare, mostly unpredictable tragedies, not on the disasters that services have averted. Policies appear to be influenced by media rather than scientific evidence: the proportion of homicides by those with mental illness, for example, has fallen since the introduction of community care (Reference Taylor and GunnTaylor & Gunn, 1999).

According to Government proposals, there will be a statutory duty to divulge patient information to non-clinical third parties, for example the police and housing associations. This will undermine patients' confidence and trust. The concern is that those who pose the greatest danger to others, may be the ones who become most motivated to avoid contact with services.

References

Department of Health (2000) Reforming the Mental Health Act. London: Stationery Office.Google Scholar
Taylor, P. J. & Gunn, J. (1999) Homicides by people with mental illness: myth and reality. British Journal of Psychiatry, 174, 914.Google Scholar
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