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Mentally Disordered Offenders: Managing People Nobody Owns
Reviewed by EDWARD M. OPTON, JR., PH.D., J.D.
Am J Psychiatry 2000;157:1534-1534. doi:10.1176/appi.ajp.157.9.1534
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Edited by David Webb and Robert Harris. New York, Routledge, 1999, 173 pp., $85.00.

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What do the British do with (and to) those who are both bad and mad? Like their American cousins, they largely don’t know what to do, say the authors of this Festschrift for Herschel Prins, former director of the University of Leicester School of Social Work. Ten contributors, all influenced by Prins’s humanistic and eclectic approach, tackle the perennial conundrum: when to treat, when to punish. Often, Webb and Harris report, we—our society in general, its official caretakers in particular—"get this hopelessly wrong, reflecting all manner of cultural and penological muddle-headedness." Even those mentally disordered offenders who are not confined "find that the far from tender mercies of ‘community care’ do little to address their needs for treatment and support" (p. 2). "Community care," writes Harris, is largely a "set of aspirations," a euphemism for what could be "more accurately designated ‘pass the parcel’ " (p. 10). Michael Preston-Shoot is equally disappointed: he says that community care is "a failing policy [with] inadequate resources…deeply flawed, confused and fragmented" (p. 73).

In two typical sentences, Webb sums up:

Management implies the coordination of resources and service provision and the shaping of policy in order to meet desired objectives.…It need not necessarily refer to direct involvement with individual offenders. (p. 162)

Indeed, one meets hardly any individuals in this volume. Mentally disordered offenders appear mostly in the abstract, as if from afar—a gray, undifferentiated mass. If schizophrenia and dementia require different management, the reader will not learn about it here. Delusions, paranoia, alcoholism, depression, fear, anger, anxiety, hope, and recovery are terms that have their uses but, with rare exceptions, not in this book. Perhaps most surprising, the authors have virtually nothing to say about sex or violence, although sexual and violent crimes provide a high proportion of the men (and a few women) whose management is the book’s subject. "One size fits all" is not the motto of Herschel Prins or his students, but it does tend to be the unwritten rule of institutional life, and it is a theme of this book to a greater degree than its authors may have wished.

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