Julia C. Houston
The term "mentally disordered offenders" is a generic one, used in both clinical and legal settings to describe offenders with a mental illness, psychopathic or other severe personality disorder, or learning disability. This umbrella term clearly describes heterogeneous groups of individuals. The chapter therefore addresses mental illness and personality disorder separately, beginning by discussing the relationship with offending. The chapter reviews the research on the personal construct theory (PCT) perspective on mental illness and personality disorder, focusing on what is known about both the structure and content of construing of those individuals. For those who go on to offend, the PCT approach is particularly useful in understanding the meanings of their behaviour. Clinical applications of the PCT approach with these client groups are discussed, with one particular case example illustrated in detail.
Offenders diagnosed with a mental disorder have historically been treated differently by the legal system compared to those who are considered to be 'responsible' for their behaviour, and many such offenders receive a psychiatric or non-custodial disposal at court to reflect this. In most Western and many other countries, the provision of secure hospital facilities for mentally disordered offenders is well established. In the UK, about 2000 mentally disordered offenders are detained in the four maximum security ('Special') hospitals and there are also about 2000 beds in smaller, medium secure psychiatric units. Other mentally disordered offenders are managed in open psychiatric hospitals, therapeutic communities, specialist hospital wings in prison, or in the community.