Misdiagnosed, mismanaged, mistreated: personality disorders and the Mental Health Act.

Abstract

The Mental Health Act perpetuates the harmful and misguided detention of individuals with personality disorders. The outdated practice lacks ethical, legal or clinical justification. Coercion is mistaken for care, and detention often exacerbates distress, retraumatises patients and increases suicide risk. Despite its promises, the new Mental Health Bill fails to address these systemic failures, continuing the cycle of risk-driven, defensive psychiatry. It is time to abandon compulsory detention for this patient group, redirect resources toward evidence-based, relational interventions, and move toward a capacity-based, trauma-informed legal framework that aligns with contemporary psychiatric understanding of these conditions and fundamental human rights.