Sir: I agree with Petch (Psychiatric Bulletin, June 2001, 25, 203-205) that an undue emphasis on dangerousness may not serve to protect the public. Indeed, it may actually do more harm than good by increasing the stigma of mental illness.

For example, the recent Government White Paper (Department of Health, 2000) expresses a desire to reduce the stigma of mental illness but, in the next paragraph, it talks of the “toll of homicides” by those with mental disorder. There is no recognition of the excellent work that mental health services routinely provide. Instead, the focus is on rare, mostly unpredictable tragedies, not on the disasters that services have averted. Policies appear to be influenced by media rather than scientific evidence: the proportion of homicides by those with mental illness, for example, has fallen since the introduction of community care (Reference Taylor and GunnTaylor & Gunn, 1999).

According to Government proposals, there will be a statutory duty to divulge patient information to non-clinical third parties, for example the police and housing associations. This will undermine patients' confidence and trust. The concern is that those who pose the greatest danger to others, may be the ones who become most motivated to avoid contact with services.