Scott, Susie, 1977-, Jones, D. (Debbie), Ballinger, Rachel, Bendelow, Gillian, 1956- and Fulford, K. W. M.. (2011) The slide to pragmatism : a values-based understanding of 'dangerous' personality disorders. Health Sociology Review, Vol.20 (No.2). pp. 157-171. ISSN 1446-1242

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Abstract

This paper reports on a qualitative study of UK mental health practitioners' experiences of working with the contested condition, dangerous and severe personality disorder (DSPD). Our interviews focused on the issues of treatability, risk assessment and decision-making in multi-disciplinary teams. We discuss the approach of values-based medicine (VBM) as a useful framework for interpreting the data: respondents cited both explicit values (based on occupational training) and implicit values (based on personal beliefs and subjective perceptions). There was evidence of conflicting values - within individuals, between occupational groups, and between individuals in occupational groups - which led to widespread uncertainty and caution about whether and how those with 'dangerous' personality disorders could be treated. These disputes were resolved by a 'slide to pragmatism', whereby practitioners, reluctantly acknowledging their own empowerment in the process, sought to make whichever choice was least risky for their own professional reputation, and most pragmatic, given the resources available.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Personality disorders -- Great Britain, Mental health services -- Great Britain, Dangerously mentally ill -- Treatment -- Great Britain, Dangerously mentally ill -- Care -- Great Britain, Evidence-based psychiatry -- Great Britain, Psychiatry -- Philosophy
Journal or Publication Title:	Health Sociology Review
Publisher:	eContent management
ISSN:	1446-1242
Date:	June 2011
Volume:	Vol.20
Number:	No.2
Page Range:	pp. 157-171
Identification Number:	10.5172/hesr.2011.20.2.157
Status:	Peer Reviewed
Publication Status:	Published
URI:	http://wrap.warwick.ac.uk/id/eprint/38698

Data sourced from Thomson Reuters' Web of Knowledge

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