Lousia Ovington independent investigation report ... - NHS North East

CHAPTER 2 – EVALUATION OF THE HEALTH CARE AND TREATMENT OF
LOUISA OVINGTON
74
COMMENT
The panel compared the PAI carried out at Kneesworth House with the results of the
personality assessments that were carried out at the Tony White Unit and St Nicholas’
Hospital. Her responses to the Millon Inventory when at the former were so biased
that the results could not be safely interpreted. However, at St Nicholas’ Hospital, the
responses appeared frank and open and indicated problems with antisocial behaviour
and borderline personality. She scored much higher on the behaviour and lifestyle
components of the psychopathy checklists than she did on the internal personality and
emotional factors. The psychologist at St Nicholas’ Hospital told the panel that other
information including observation of behaviour needs to be taken into account when
drawing conclusions from such inventories.
Louisa Ovington’s dramatically improved behaviour combined with the responses to
the PAI is likely to have been what lay behind the conclusion at Kneesworth House
that Louisa Ovington was not suffering from a psychopathic personality disorder.
However, at Kneesworth House she was not in a stressful situation where her
emotional control was likely to be challenged.
The final report from the psychology department was dated 20 January 2000. Whilst
this was after Louisa Ovington had been discharged from Kneesworth House, it seems
fair to accept that the assessment informed Consultant 11’s conclusion that Louisa
Ovington did not have a treatable personality disorder or mental illness. The report
stated that “psychometrics did not indicate that she met the criteria for the diagnosis
of a personality disorder”. This statement appears to conflict with the conclusion
within the PAI that antisocial personality disorder should be considered as a diagnosis.
The panel was unable to meet with the main author of the final report (Psychologist
2) but they did meet with the assistant psychologist who had worked with Louisa
Ovington. She told the panel that she now (as a qualified clinical psychologist)
does not regard the use of the PAI as very good practice. She said that she felt that
the qualified psychologists (who did not work on the same ward) who interpreted
the results should have thought more carefully about it. Her feeling about Louisa
Ovington was despite the fact that she did not seem to score within the clinical range
or high in levels of psychopathology, she was still very disturbed. She said that Louisa
Ovington had worrying anti-social traits which “were not picked up enough on”,
particularly in relation to her previous offending behaviour and that her risk of violence
was possibly not examined enough.
Consultant 9 told the panel that he would not use psychometric tests diagnostically;
he would see their use being in confirming clinical opinion. In his view, clinical
judgment would be of prime importance, not the psychometric test scores