Depressed? You need 15 months in a lock-up

After her hellish treatment, a woman is fighting the diagnosis of personality disorder. Adam James reports.

Five years ago, Deborah Tallis was compulsorily detained in a secure psychiatric unit. She spent 15 months in "absolute hell", cooped up with patients who had committed murder, sexual abuse or other acts of violence. One patient tried to strangle her with a bootlace.

While detained, Tallis, who had severe depression, was held down and forcibly injected with powerful sedatives. She was also locked in a hospital room for 21 hours a day to stop her frequent attempts to escape.

Eventually, she was diagnosed with personality disorder (PD) - a controversial diagnosis often reserved for supposedly untreatable "psychopaths". PD has become the subject of debate following government plans to allow the indefinite detention of psychopaths deemed a risk to others.

Tallis, 41, describes herself as "almost there" in terms of recovery. A PhD student at Anglia Polytechnic University, her research work focuses on patients with PD and raises questions about the validity of the term as a label. She asks whether it has become a meaningless catch-all category for some psychiatric patients.

"The problem with me was depression, but the hospitals did not know how to manage me. That was why I was diagnosed with a borderline personality disorder," she says. "I expected to be helped when I went into hospital. But I was not. I needed support."

Tallis, who has presented her views to mental health professionals and leading forensic psychiatrists, has found that many people diagnosed with PD have experienced abuse or trauma.

"About 80 per cent of people with the personality disorder diagnosis have experienced childhood abuse - this is something that should be addressed. Such patients should not be diagnosed with personality disorder and regarded as untreatable," she asserts. "In my opinion, there need to be more alternatives to medication."

Tallis believes "complex post-traumatic stress disorder" might be a more appropriate diagnosis for these PD patients. This would recognise that past experience is a key factor in the behaviours - such as aggression and self-harm - associated with a PD diagnosis and would lead to counselling and support.

One of her interviewees left prison without being given any help apart from medication, Tallis says. "Suicidal, and out of pure desperation, he went and committed arson on his house. I do not condone his behaviour, but I can understand it."

Fortunately, Tallis herself now has people who listen to her needs. She has a good relationship with her GP, social worker and her latest psychiatrist. "When someone is not well, they need someone to be kind and understanding, not a bully," Tallis says.

Tallis, who has spent four years on hospital wards because of mental health problems, had completed an MSc in the neurophysiological basis of behaviour at the University of East London before her first admission. She was determined to continue her research despite being told by doctors that she would never work again.

Indeed, she is perhaps the only academic to have attended job interviews while being an in-patient in a secure psychiatric ward.

She was offered two interviews and, after insisting that she should go, she was escorted by nurses. During one, while they sat in the cafeteria waiting for her, an interviewer conveyed to Tallis his doubts about her mental health knowledge. "I thought to myself: how little you know!" Tallis says.

For Tallis, the real turning point was the attempt made on her life while in hospital.

Although feeling depressed and suicidal, she started telling medical staff she was feeling fine. "To get out of the hospital, I had to play [the hospital's] game and say what staff wanted me to say. In a way, being strangled saved my life." Nevertheless, Tallis still feels the sensation of being strangled whenever she is under stress.

Although still fighting for compensation for what happened at the hospital, she has some understanding of her assailant's circumstances. "After he attacked me in the hospital, I asked him why he did it. He told me that he was due to be discharged and was scared of leaving the institutionalised security of the hospital.

"He was sent to Rampton, and I feel sorry for him. He is still locked up and probably is the same now as he was then. I feel we have all been failed by the system."