View article

The question of whether a person is ‘mad’or ‘bad’is not a new one and has concerned thinkers, policy-makers, judges and doctors throughout history. However, changes in mental health and the prison service since the nineteenth century have accentuated the ‘mad or bad?’debate and led to a profound shift in the way people with mental health problems are treated legally and judicially (see Chapter 2 for an overview of historic developments). At the heart of this debate is the relationship between personal responsibility, accountability and criminal behaviour, culminating in the question: should someone with mental health problems be considered as fully responsible and culpable for their offences? From a legal perspective, the issue might seem clear and straightforward at first sight. In the UK, and other Western countries, an offender’s inability to distinguish between right and wrong and to form intent, due to a lack …