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

CHAPTER 3 – OUTLINE OF MENTAL ILLNESS AND PERSONALITY DISORDER
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beyond the remit of general psychiatric services. This contention has been challenged
over recent years, particularly since the publication of “Personality disorder – No
longer a diagnosis of exclusion” by the Department of Health in 2003. This document
provided guidance on the identification, assessment and treatment of personality
disorder within general mental health and forensic services and aimed to ensure that
people with personality disorder, who experience significant distress or difficulty as
a result of this, were acknowledged to be part of the legitimate business of mental
health services.
Louisa Ovington first came into contact with mental health services in 1993, when,
aged 15 years, she was assessed by Consultant 1. She found no evidence that Louisa
Ovington was suffering from a mental illness, such as post traumatic stress disorder
which could have been expected given Louisa Ovington’s past history. Consultant 1
also considered whether Louisa Ovington had a conduct disorder. Psychiatrists tend
not to diagnose children and adolescents as suffering from personality disorders,
because the patterns of behaviour that characterise people with personality disorders
are “longstanding and deeply entrenched” – which cannot be said to be the case until
adulthood. However, the behaviours exhibited by persons diagnosed in adulthood
as suffering from antisocial personality disorders usually begin in childhood and these
children are often diagnosed as suffering from a conduct disorder. (The corollary is not
true: not all children with conduct disorders go on to develop antisocial personality
disorders).
Consultant 1’s opinion was that Louisa Ovington did not suffer from a conduct
disorder. Over the ensuing years, Louisa Ovington’s mental health was repeatedly reevaluated
by the different psychiatrists with whom she came into contact. There was
considerable debate about whether she was suffering from a mental illness, from a
personality disorder, or from both. Between 1995 and 1999, when she was admitted
to Hartlepool General Hospital three times and to the Royal Edinburgh Hospital once,
the professionals were trying to determine whether or not her psychotic symptoms
were due to her misuse of illicit substances or to her suffering from an enduring
illness such as schizophrenia. However, during her more protracted admissions to the
Tony White Unit at the Durham County Hospital and Cuthbert Ward at St Nicholas’
Hospital, Newcastle, the professionals became increasingly convinced that whilst
Louisa Ovington might at times suffer from psychotic symptoms (whether induced by
an illness or by the use of illicit substances) her fundamental mental disorder was a
personality disorder.
Louisa Ovington was transferred to Kneesworth House Hospital for treatment of
her personality disorder. However, she underwent a further series of psychological
assessments there, the conclusion of which was that the degree of her personality
traits was insufficient to define her as suffering from a personality disorder. In addition,