The institutionalization of a concept

Government involvement with psychiatry creates potentially great opportunities, as hitherto neglected problems receive attention and funding. When seriously harmful behaviour is involved, however, such opportunity can be limited or lost. Parallel consideration of legal restraints on those people with serious disorder who commit harm to others seems to spill over into restraints on clinical conceptualization of the disorder, on the shape of clinical treatment programmes and even on the people who deliver treatment. Greater clarity for everyone about the individuality and variety of people with personality disorders and a propensity for serious offending will be a critical factor in avoidance of new forms of institutionalization, the dangers of which have only been hinted at in literature to date.