TREATMENT OF DANGEROUSNESS

Assessment and Treatment Of Dangerousness

Assessment and Treatment of Dangerousness

Background and introduction

This paper critically explores a newly proposed diagnostic category of 'dangerous and severe personality disorder' (DSPD) in relation to its associated terms, concepts and ramifications. The current United Kingdom (UK) Mental Health Act outlines how the UK Department of Health (DoH) plans to impact on future United Kingdom National Health Service (UK NHS) approaches to people diagnosed with personality disorder (DoH, 2001). An official perception is promoted that the 'general public' has not been protected 'adequately' from those so diagnosed (DoH, 2001, p. 2), against whom popular 'tabloid' support for pre-emptive action has been garnered (Davenport, 2001; Sawer, 2002). It is somewhat ironic that at roughly the same time as this policy's proposal, a film called Minority Report was released. Based on a short story by Philip K. Dick (1956), it describes a future society that imprisons individuals based on official prophecies of their likelihood of committing violent crime or 'precrime' (Dick, 1956). It is a'fictional' example of Castel's analysis of the nature of our current prevention strategies (interestingly pre-dating Castel's own analysis) and their particular mode of surveillance—'predetection'—which functions to anticipate/prevent undesired events (Castel, 1991, p. 288). Thus, this newly proposed public health policy (and its diagnosis of 'DSPD') is concerned with the concept of 'dangerousness' and violent behaviour. It proposes the detention of diagnosed individuals, irrespective of any offence being committed, on the basis that they pose an unacceptable level of risk of violence to the public. Thus, it resonates with social representations (e.g. Minority Report) of people considered to be 'at risk' of becoming 'dangerous' (meaning violent) in the future; as well as analyses of the shift from corrective/

therapeutic intervention to the probabilistic calculation of risk based on 'risk profiles' (Castel, 1991).

Theoretical framework

Lupton (1999) shows how the meaning of the concept 'risk' has changed over the centuries. It emerged first in the Middle Ages in relation to 'natural' dangers (e.g., storms, floods, epidemics), quite unrelated to perceptions of human fault and responsibility. In the seventeenth century it was derived from the Italian 'risco', being associated with gaming and gambling (Ayto, 1990). In modernity, 'risk' changed as it became scientized by mathematics/probability theory (Lupton, 1999, p. 6): the belief was that rational counting and ordering would redress disorder (Hacking, 1990). By the end of the nineteenth century the concept became located within the social/human realm (Lupton, 1999, p. 6), such that 'types of events can be subjected to supra-individual and political rules of recognition, compensation and avoidance' (Beck, 1992a, p. 99).

Today, 'risk' has attracted analyses across a continuum of realist to constructivist epistemological approaches (Lupton, 1999, p. 33). This paper draws on the constructivist epistemological positions in Lupton's schema by using 'risk society' (Beck, 1992b) and 'governmentality' or poststructuralist perspectives (Castel, 1991). We argue that what is understood as 'risky' or 'dangerous' about 'DSPD' is as much a product of historically, socially and politically contingent 'ways of seeing' as it is of 'objective', ...