Skip to main content Accessibility help
×
Home

Contents:

Information:

  • Access

Actions:

      • Send article to Kindle

        To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

        Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

        Find out more about the Kindle Personal Document Service.

        Authors' reply
        Available formats
        ×

        Send article to Dropbox

        To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

        Authors' reply
        Available formats
        ×

        Send article to Google Drive

        To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

        Authors' reply
        Available formats
        ×
Export citation

We are unsure whether Dr Wilson is suggesting that zero tolerance guidelines should not be applied to people who have a mental disorder or whether they should be abandoned altogether.

If the former, he perpetuates the stigma of mental illness and the public perception that psychiatrists are responsible for all actions of people receiving psychiatric treatment. Public attitude may affect people's volitional capacity (Mele, 2004). The view that all violent behaviour by users of mental health services is a manifestation of illness may therefore be anti-therapeutic by leading people to minimise their own sense of agency. If Dr Wilson is suggesting that the policy should be abandoned altogether, he is perpetuating the notion that people have unfettered rights to receive services. Our view is that this is not the case and that the rights of competent adults should be upheld in association with their observance of their duties.

Although we share Dr Wilson's concerns about the complexities of capacity assessments, ultimately it is these dichotomous judgements that determine whether people can consent to treatment, be allowed to take the consequences of self-harm or drug addiction and whether they go to jail or hospital for crimes they commit. If we reject the determinist stance that all actions by people with mental illness are undertaken because of their mental illness, it is hard to imagine a better way than by the assessment of their capacity to take responsibility for those actions in question.

Mental health workers, like prison officers, inevitably have to work with people who are aggressive and violent. It is appropriate that violence by prisoners should result in their freedom being further restricted. We believe that in addition to criminal prosecution, limiting or withdrawal of services may provide a similarly appropriate response to violence by capacitous users of mental health services.

Mele, A. R. (2004) Action: volitional disorder and addiction. In Philosophy of Psychiatry: A Companion (ed. Radden, J.), pp. 7888. New York: Oxford University Press.