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Introduction
The potential for psychiatry to be perceived as an agent of social control has a long history associated with the development of the asylum, as well as playing a continuing role in involuntary treatment and the medicalisation of social deviance ([9] Conrad, 2007). The process of medicalisation can be seen to depend on the relationship between professionals, and the extent to which definitions of the problem are contested ([20] Malacrida, 2004). The introduction of specialised diagnostic systems (DSM, ICD) and the Mental Health Act (1953) in the mid twentieth century coincided with the civil rights and anti-psychiatry movements, amid debates about the origin of social problems and the social construction of diagnostic labels ([19] Maden, 2007; [21] Manning, 2006). Psychiatric practice has continued to be subject to social constructionist critiques ever since, but more recently from within psychiatry itself ([3] Bracken and Thomas, 2006).
In addition to the tensions between care and control, many psychiatric diagnostic categories are highly controversial and are in the process of being redefined for the latest versions of the two major classification systems: The International Classification of Diseases (ICD-11) published by the World Health Organisation, and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The objectivity of the DSM and ICD classification systems is under intense debate and scrutiny ([27] Sartorius, 2010), and given further emphasis by the growth of the values-based medicine movement ([12] Fulford, 2002).
Section 136 (s136), dangerousness and vulnerability
The assessment of the degree of perceived dangerousness and/or vulnerability poses enormous dilemmas to the various agencies involved in the invocation of all sections of the Mental Health Act which result in involuntary treatment, including s2, s3 and s135, but especially so in the case s136, which is the focus of this study. Sectioning generally requires shared decision making between Approved Mental Health Professionals or AMPHs who are usually social workers, clinicians (usually forensic psychiatrists) and police, who may operate with different models and knowledge bases ([8] Colombo et al. , 2003) Police in England and Wales are empowered under s136 of the Mental Health Act 1983 to detain people in public places who are deemed to be a danger to themselves or others and remove them to a "place of...