Terrorist detainees – psychiatry or morals?

Robbins et al (Psychiatric Bulletin, November 2005, 29, 407–409) describe the mental states of a number of men detained in HMP Belmarsh without trial or charge. They all appeared to be experiencing significant levels of psychiatric morbidity. The authors go on to state that this is a result of the indefinite nature of their custodial detention, although there is no evidence to support this hypothesis in their paper. This is an important subject, and one about which psychiatrists have been silent until the authors’ contributions. My concern, however, is that this is really moral philosophy masquerading as psychiatry. What is implied in the paper is that detention without trial or charge is abominable. However, this is a moral argument plain and simple that is just obfuscated by discussion of the men's psychiatric states. It seems to be saying that because these men are unwell and made worse by being in prison, we should not put them in prison. Given the well-established and striking levels of morbidity in the ordinary prison population, one might think the same argument applied for all prisoners a fortiori. However, this all seems to miss the point. I think the situation would be just as abominable even if the authors had shown the men to have become much healthier during their time in custody. Where are the voices of psychiatrists in this moral debate about whether imprisonment without trial or charge is right? Are we unable to speak about that without a cloak of pseudoscience?

Declaration of interest

S. W. worked as a Clinical Research Fellow in Forensic Psychiatry at HMP Belmarsh between 2001 and 2002 and considers detention without charge or trial to be wrong.