Persistent harmful practice in forensic psychiatry; causes and cures

Dr Brian Thomas-peter1

1Entelic Consulting, Bowen Island, Canada

This paper considers the history of Public Inquiries and investigations of untoward incidents in forensic psychiatric services and asks why they have been largely ineffective in producing change. The lessons fail to travel even short distances within national borders, but even worse, they often do not embed in the service within which they occur. The influences of managerialism, empirical autocracy and professional protectionism have combined to strangle reform of particular institutions, but the wider impact has been the erosion of professional and ethical standards, and transparency of process. Unwittingly we have allowed continuing and persistant harm to those receiving services; a subject of my last contribution to ANZAPPL in 2017. In 2018 I identify the key variables that must be addressed if the future is to be different. This will consider political, ethical, managerial and operational changes that must lead the way in changing service attitudes towards the vulnerable, such that social justice and public safety become evident and indivisible in every decision concerning the safe care of those involved with the law and psychiatry.


Brian A. THOMAS-PETER, Ph.D., FRSA, MBA, M.Clin.Psychol, B.Sc.(Hons),  has worked as a Psychologist since 1975 in the UK, Australia and Canada.  He established the first Forensic doctoral program in Australia in 1993 and was instrumental in the first Doctoral program in the UK in Birmingham.  As Chief Supervisor of Forensic Psychology for the BPS he open the door for Forensic psychologists to be employed in the NHS.  He has designed, delivered and managed treatment services, provided expert evidence in major trials and advised major Inquiries in the UK and Australia.  He chaired the Joint Ministry Working party that led to new services to personality-disordered offenders in the UK.  In 2008 he became Executive Director of Forensic Psychiatry for Oxfordshire/Buckinghamshire, and in 2010 became Provincial Executive Director of Forensic Psychiatry in British Columbia, Canada.  He was Honorary Professor at Birmingham University for 11 years, and now works and writes independently, recently publishing his first novel, ‘The Last Truth’ (Unbound 2016).

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