Butler Committee

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The Committee on Mentally Abnormal Offenders, widely referred to as the Butler Committee after its chairman Lord Butler of Saffron Walden, was set up in 1972 by the Government of the United Kingdom. The Committee submitted an Interim Report in 1974 and published a Final Report in October 1975, proposing major reforms to the law and to psychiatric services.

Contents

Terms of reference

The committee was set up jointly by the Home Office and the Department of Health and Social Security, and given a wide remit to investigate the current law, hear the views of relevant parties, and propose reforms. The official terms of reference, which covered England and Wales, were:

(a) To consider to what extent and on what criteria the law should recognise mental disorder or abnormality in a person accused of a criminal offence as a factor affecting his liability to be tried or convicted, and his disposal;

(b) To consider what, if any, changes are necessary in the powers, procedure and facilities relating to the provision of appropriate treatment, in prison, hospital or the community, for offenders suffering from mental disorder or abnormality, and to their discharge and aftercare;

(c) To make recommendations.

Context

There had been growing criticism since the 1960s of the holding of offenders with mental disorders - from the public concerned with possibly dangerous individuals being released, from prisons who could not get psychiatric help for their inmates, and from the three national secure psychiatric hospitals experiencing overcrowding and poor conditions. [1]

In addition, in 1972, the trial of Graham Young caused huge public controversy spurring the need for a major review. Young had been admitted to Broadmoor Hospital at the age of 14 after poisoning several family members; he was released 9 years later but within months had poisoned dozens of his colleagues, killing two. [2] The case of Terence John Iliffe was also referenced by the Butler committee; Iliffe had been sent to Broadmoor in 1970 after killing his second wife but was released in 1973 with a specific warning to monitor in case he remarried; however within the year he did remarry and within days had strangled his wife. However, like Young the second time round, he was found sane at trial. [3]

In 1974 the Glancy Report recommended, as had prior reports since 1961 (the Emery Committee), that secure hospital facilities be developed in each region for psychiatric patients who were not suitable for open hospitals but did not need to go to a high secure hospital.

Lord Butler, or Rab Butler as he was widely known, was a leading Conservative politician who had been Home Secretary (responsible for crime) from 1957 to 1962, and for that reason his suitability as impartial chairman was questioned in parliament. He was at the time President of the charity the National Association for Mental Health (later renamed Mind), and Chairman of the Trustees of the charity the Mental Health Trust and Research Fund (shortly thereafter renamed the Mental Health Foundation). [4]

Recommendations

The Final Report made numerous recommendations, including for reform of the psychiatric hospital system, of forensic psychiatry, and the insanity defence.

One major recommendation has largely now been implemented - the setting up of secure psychiatric units in each region of the country.

The Butler Committee subjected the wording of the insanity defence to intense criticism, noting that the rules were "based on too limited a concept of the nature of mental disorder", highlighting "the outmoded language of the M'Naghten Rules which gives rise to problems of interpretation" and arguing that the rules were "based on the now obsolete belief in the pre-eminent role of reason in controlling social behaviour... [the rules] are not therefore a satisfactory test of criminal responsibility". [5] An additional criticism was that the defence puts the burden of proof onto the defendant, while in all other cases the burden is on the prosecution. [6] The Committee proposed reform of the law along these lines, which was largely taken up by a draft bill produced by the Law Commission in 1989; so far, however, these have both been ignored by successive governments.

The committee's alternative to the insanity defence, which it termed 'not guilty on evidence of mental disorder', has itself been criticised; for example for focusing largely on psychosis rather than the full range of mental disorders, and for assuming a causal link between such conditions and any particular actions of the individual (though acknowledging in theory that there might not be such a link in some particular hard to imagine case). [7]

The committee also suggested that psychopathy should be removed from the law and replaced with 'personality disorder'. 'Psychopathic disorder' was at that time a category in the Mental Health Act, and would remain so until being removed by amendments in 2007. The committee's report said the understanding was so varied that theories about psychopathy should 'only to be understood as reference to the particular sense in which the term is employed by the psychiatrists in question". [8]

Most of the committee's recommendations on fitness to plead were incorporated into the Criminal Procedure (Insanity and Unfitness to Plead) Act 1991, such as the requirement for expert evidence on fitness from two medical practitioners and, if found unfit by the judge, a hearing of the facts in place of a full trial. [9]

The Law Commission is still, as of 2013, consulting on and making proposals for reform of the law on 'insanity' and 'sane automatism [10] and fitness to plead. [11]

Related Research Articles

The insanity defense, also known as the mental disorder defense, is an affirmative defense by excuse in a criminal case, arguing that the defendant is not responsible for their actions due to a psychiatric disease at the time of the criminal act. This is contrasted with an excuse of provocation, in which the defendant is responsible, but the responsibility is lessened due to a temporary mental state. It is also contrasted with the justification of self defense or with the mitigation of imperfect self-defense. The insanity defense is also contrasted with a finding that a defendant cannot stand trial in a criminal case because a mental disease prevents them from effectively assisting counsel, from a civil finding in trusts and estates where a will is nullified because it was made when a mental disorder prevented a testator from recognizing the natural objects of their bounty, and from involuntary civil commitment to a mental institution, when anyone is found to be gravely disabled or to be a danger to themself or to others.

<span class="mw-page-title-main">M'Naghten rules</span> Guideline governing legal pleas of insanity

The M'Naghten rule is any variant of the 1840s jury instruction in a criminal case when there is a defence of insanity:

that every man is to be presumed to be sane, and ... that to establish a defence on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing what was wrong.

<span class="mw-page-title-main">Psychiatric hospital</span> Hospital specializing in the treatment of serious mental disorders

Psychiatric hospitals, also known as mental health hospitals or behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative identity disorder, major depressive disorder and many others. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short-term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent confinement of patients who need routine assistance, treatment, or a specialized and controlled environment due to a psychiatric disorder. Patients often choose voluntary commitment, but those whom psychiatrists believe to pose significant danger to themselves or others may be subject to involuntary commitment and involuntary treatment. Psychiatric hospitals may also be called psychiatric wards/units when they are a subunit of a regular hospital.

Antisocial personality disorder is a personality disorder characterized by a limited capacity for empathy and a long-term pattern of disregard or violation of the rights of others. Other notable symptoms include impulsivity and reckless behavior, a lack of remorse after hurting others, deceitfulness, irresponsibility, and aggressive behavior.

<span class="mw-page-title-main">Broadmoor Hospital</span> High security hospital in Berkshire, England

Broadmoor Hospital is a high-security psychiatric hospital in Crowthorne, Berkshire, England. It is the oldest of England's three high-security psychiatric hospitals, the other two being Ashworth Hospital near Liverpool and Rampton Secure Hospital in Nottinghamshire. The hospital's catchment area consists of four National Health Service regions: London, Eastern, South East and South West. It is managed by the West London NHS Trust.

<span class="mw-page-title-main">Political abuse of psychiatry in the Soviet Union</span> Misuse of psychiatry for political purposes in the Soviet Union

There was systematic political abuse of psychiatry in the Soviet Union, based on the interpretation of political opposition or dissent as a psychiatric problem. It was called "psychopathological mechanisms" of dissent.

<span class="mw-page-title-main">Forensic psychiatry</span> Subspeciality of psychiatry, related to criminology

Forensic psychiatry is a subspeciality of psychiatry and is related to criminology. It encompasses the interface between law and psychiatry. According to the American Academy of Psychiatry and the Law, it is defined as "a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.

Park Elliot Dietz is a forensic psychiatrist who has consulted or testified in many of the highest profile US criminal cases, including spousal killer Betty Broderick, mass murderer Jared Lee Loughner, and serial killers Joel Rifkin, Arthur Shawcross, Jeffrey Dahmer, Ted Kaczynski, Richard Kuklinski, the D.C. sniper attacks, and William Bonin.

<span class="mw-page-title-main">Hervey M. Cleckley</span> American psychiatrist (1903–1984)

Hervey Milton Cleckley was an American psychiatrist and pioneer in the field of psychopathy. His book, The Mask of Sanity, originally published in 1941 and revised in new editions until the 1980s, provided the most influential clinical description of psychopathy in the twentieth century. The term "mask of sanity" derived from Cleckley's belief that a psychopath can appear normal and even engaging, but that the "mask" conceals a mental disorder. By the time of his death, Cleckley was better remembered for a vivid case study of a female patient, published as a book in 1956 and turned into a movie, The Three Faces of Eve, in 1957. His report of the case (re)popularized in America the controversial diagnosis of multiple personality disorder. The concept of psychopathy continues to be influential through forming parts of the diagnosis of antisocial personality disorder, the Psychopathy Checklist, and public perception.

Psychopathy is a mental health condition characterized by persistent antisocial behavior, impaired empathy and remorse, and bold, disinhibited, and egotistical traits. Different conceptions of psychopathy have been used throughout history that are only partly overlapping and may sometimes be contradictory.

In the law of England and Wales, fitness to plead is the capacity of a defendant in criminal proceedings to comprehend the course of those proceedings. The concept of fitness to plead also applies in Scots and Irish law. Its United States equivalent is competence to stand trial.

<span class="mw-page-title-main">Psychopathy Checklist</span> Psychopathy scale

The Psychopathy Checklist or Hare Psychopathy Checklist-Revised, now the Psychopathy Checklist—revised (PCL-R), is a psychological assessment tool that is commonly used to assess the presence and extent of the personality trait psychopathy in individuals—most often those institutionalized in the criminal justice system—and to differentiate those high in this trait from those with antisocial personality disorder, a related diagnosable disorder. It is a 20-item inventory of perceived personality traits and recorded behaviors, intended to be completed on the basis of a semi-structured interview along with a review of "collateral information" such as official records. The psychopath tends to display a constellation or combination of high narcississtic, borderline, and antisocial personality disorder traits, which includes superficial charm, charisma/attractiveness, sexual seductiveness and promiscuity, affective instability, suicidality, lack of empathy, feelings of emptiness, self-harm, and splitting. In addition, sadistic and paranoid traits are usually also present.

Atascadero State Hospital, formally known as California Department of State Hospitals- Atascadero (DSHA), is located on the Central Coast of California, in San Luis Obispo County, halfway between Los Angeles and San Francisco. DSHA is an all-male, maximum-security facility, forensic institution that houses mentally ill convicts who have been committed to psychiatric facilities by California's courts. Located on a 700+ acre grounds in the city of Atascadero, California, it is the largest employer in that town. DSHA is not a general purpose public hospital, and the only patients admitted are those that are referred to the hospital by the Superior Court, Board of Prison Terms, or the Department of Corrections.

<i>The Psychopath Test</i> 2011 book by Jon Ronson

The Psychopath Test: A Journey Through the Madness Industry is a 2011 book written by British author Jon Ronson in which he explores the concept of psychopathy, along with the broader mental health "industry" including mental health professionals and the mass media. It spent the whole of 2012 on United Kingdom bestseller lists and ten weeks on The New York Times Best Seller list.

The following outline is provided as an overview of and topical guide to psychiatry:

<span class="mw-page-title-main">Mental health in Russia</span>

Mental health in Russia is covered by a law, known under its official name—the Law of the Russian Federation "On Psychiatric Care and Guarantees of Citizens' Rights during Its Provision", which is the basic legal act that regulates psychiatric care in the Russian Federation and applies not only to persons with mental disorders but all citizens. A notable exception of this rule is those vested with parliamentary or judicial immunity. Providing psychiatric care is regulated by a special law regarding guarantees of citizens' rights.

Psychopathy, from psych and pathy, was coined by German psychiatrists in the 19th century and originally just meant what would today be called mental disorder, the study of which is still known as psychopathology. By the turn of the century 'psychopathic inferiority' referred to the type of mental disorder that might now be termed personality disorder, along with a wide variety of other conditions now otherwise classified. Through the early 20th century this and other terms such as 'constitutional (inborn) psychopaths' or 'psychopathic personalities', were used very broadly to cover anyone who violated legal or moral expectations or was considered inherently socially undesirable in some way.

AH vs West London Mental Health Trust was a landmark case in England, which established a legal precedent in 2011 when Albert Laszlo Haines (AH), a patient in Broadmoor Hospital, a high security psychiatric hospital, was able to exercise a right to a fully open a public mental health review tribunal to hear his appeal for release. The case and the legal principles it affirmed have been described as opening up the secret world of tribunals and National Health Service secure units, and as having substantial ramifications for mental health professionals and solicitors, though how frequently patients will be willing or able to exercise the right is not yet clear.

<span class="mw-page-title-main">Jürgen Müller</span>

Jürgen Leo Müller is a German medical specialist for neurology and psychiatry. He is a professor for forensic psychiatry and psychotherapy at the University of Göttingen as well as chief physician for forensic psychiatry and psychotherapy at the Asklepios Clinic in Göttingen. His particular scientific interest lies in the empirical research of forensically relevant disorders with a particular focus on personality disorders, psychotherapy as well as violent and sex offenders. In addition to that he places special emphasis on the usability of empirical techniques to responding legal questions.

<span class="mw-page-title-main">Herschel Prins</span> British professor of criminology (1928–2016)

Herschel Albert Prins (1928–2016) was a British professor of criminology. His career spanned over 60 years in work pertaining to forensic psychiatry, and his appointments included positions at the universities of Leeds, Loughborough, Leicester and Birmingham. His roles included HM probation inspectorate, parole board engagement, and involvement in mental health review tribunals and the mental health act commission. He worked with people with malicious activity, antisocial and disinhibited behaviour, unusual sexual deviations and people who behaved dangerously.

References

  1. ↑ Seminars in Practical Forensic Psychiatry: Introduction by Derek Chiswick. Published 1995. ISBN   0 902241 78 8. (full text via Royal College of Psychiatrists).
  2. ↑ Seminars in Practical Forensic Psychiatry: Introduction by Derek Chiswick. Published 1995. ISBN   0 902241 78 8. (full text via Royal College of Psychiatrists).
  3. ↑ Offenders, Deviants or Patients Herschel Prins, Routledge, 4 Jan 2002
  4. ↑ Debate in Parliament about the case (Hansard, HC Deb 29 June 1972 vol 839 cc1673-85).
  5. ↑ Clarkson, Keating & Cunningham. Criminal Law: Texts and Materials. 2007, ISBN   978-0-421-94780-1
  6. ↑ Jones, Timothy (1995). "Insanity, automatism, and the burden of proof on the accused". Law Quarterly Review (Sweet & Maxwell) 111 (3). ISSN   0023-933X p.475
  7. ↑ Law Commission: Insanity and Automatism Supplementary Material to the Scoping Paper 18 July 2012. Pg 178-183
  8. ↑ Federman, C. Holmes, D. Jacob, JD (2009) Deconstructing the psychopath: a critical discursive analysis Cultural Critique, 72
  9. ↑ Manifest Madness: Mental Incapacity in the Criminal Law Arlie Loughnan, Oxford University Press, 19 Apr 2012
  10. ↑ Law Commission website: Insanity and Automatism.
  11. ↑ Law Commission website: Unfitness to Plead
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