Straw's soundbites on psychiatry don't distinguish the 'mad' from the 'bad'

'Psychopathic personality disorder' is a descriptive term referring to individuals whose behaviour and morals are regarded as excessively bad, but this is where it begins and ends. It does not confer detailed knowledge or understanding; it merely describes the way an individual is, implying neither illness nor suffering. To misunderstand this misses the essence of the issue - the distinction between 'mad' and 'bad'.

A wide range of disorders do conform to any reasonable notion of 'illness', and psychiatry exists to treat them. But to broaden the profession's remit to any deviant behaviour, however disagreeable, is a slippery slope - at the bottom of which lies the extinction of effective mental health services.

The absurd conclusion is that we should become the main agents for policing violence in all its forms.

The very concept of personality disorders is controversial, and their categorisation merely reflects an attempt to understand some of the more problematic behaviours of the human condition. Unfortunately, lack of public understanding confuses bad behaviour with mental illness, with the inevitable result that those who suffer from treatable conditions - such as schizophrenia or manic depression - endure prejudice wholly unacceptable for any other groups.

In many instances they are demonised in the same way as those who commit heinous crimes that receive wide publicity and generate outrage. This is the most dangerous legacy of the fatuous soundbites we are now witnessing, but other potential consequences are also deeply worrying.

There is a major recruitment and retention problem in mental health, particularly in the psychiatric profession; it has become an increasingly unpopular thing to do. To heap yet more public vitriol on a beleaguered section of the medical profession, on the basis of a facile interpretation of fundamental problems confronting society, is to abdicate the responsibility of government for cheap short-term gain.

The result is that shocking headlines will continue into perpetuity. We need an informed public debate about the nature of mental illness, mental health services and criminality, but making public pronouncements and policy decisions without providing accurate and detailed information is unacceptable.

Mr Straw says that 20 years ago psychiatrists managed people with psychopathic personality disorders differently. Perhaps he should read the report of Lord Butler's committee (produced about 20 years ago), which clearly recommended that dangerous, aggressive psychopaths should be dealt with in prison and only treated in hospital where a previous mental or organic illness was known or suspected, and that there was an expectation of therapeutic benefit from hospital admission.

It seems that our politicians have done nothing to move things on from then, yet they blame one of the professions for their own failings and inadequacies.

Dr H W Griffiths

Medical director/consultant psychiatrist

Northumberland Mental Health trust