The objective of this article is to familiarise mental health professionals and lay readers with the rather colourful and disdainful history of psychiatry, particularly the political abuses of mental health legislation. The debate about legislative changes (including legislation for ‘dangerous severe personality disorder’ in the UK) often seems arcane and unnecessary until set in the context of these historical abuses of the mental health system. Some psychiatrists have abused power in general. For example, although the war crimes for which Radovan Karadžić is currently standing trial do not arise from his psychiatric practice, it is salutary to note that he is far from being the first psychiatrist to be accused (or convicted) of crimes against humanity. However, Thomas Szasz controversially argued that there is something inherent in psychiatry, particularly the power to restrict liberty, that tends towards abuse if not regulated by the legal or political system. In the past, there have been abuses of psychiatrists’ powers to detain people, but these have been instigated at the direction of governments such as that in Nazi Germany (leading to genocide of mentally ill people) and the USSR (where political dissidents were detained with a diagnosis of ‘sluggish schizophrenia’).