Mental Illness & Crime Key Issues & Debates (part 1)

Dr Ann Henry

Forensic & Applied Cognitive Psychology

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Lecture overview

 Quiz on mental health awareness  Legal definition of sanity/ insanity  Mental Health Act 1983  Stigma & Mental Illness  Crime & Mental Illness

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http://www.youtube.com/watch?v=2WSyJgydTsA

ONE FLEW OVER THE CUCKOOS NEST (1975) IN 1963 OREGON, RANDLE PATRICK "MAC" MCMURPHY ( JACK NICHOLSON ), A RECIDIVIST ANTI-AUTHORITARIAN CRIMINAL SERVING A SHORT SENTENCE ON A PRISON FARM FOR STATUTORY RAPE OF A 15-YEAR-OLD GIRL, IS TRANSFERRED TO A MENTAL INSTITUTION FOR EVALUATION. ALTHOUGH HE DOES NOT SHOW ANY OVERT SIGNS OF MENTAL ILLNESS , HE HOPES TO AVOID HARD LABOR AND SERVE THE REST OF HIS SENTENCE IN A MORE RELAXED HOSPITAL ENVIRONMENT 3

A Mental Health Awareness Quiz

1.

Are mental health problems inherited/ 2.

3.

4.

5.

Violence towards others is a symptom of which mental illness?

35-50 year-olds show the highest incidence of suicide – True or False?

People who talk about suicide are not likely to go on to do it – True or False?

Men are more likely than women to attempt suicide – True or False?

Quiz continued

6. What proportion of people are known to experience mental health problems? Is it (a) 1 in 8, (b) 1in 4 or © 1 in 6?

7. What percentage of GP consultations are for mental health problems? (a) 30% (b) 50% or (c) 25%?

8. Drugs such as cannabis and ecstasy can increase the risk of panic attacks, anxiety disorders and psychotic episodes – True or False?

Quiz cont’d

9. At what age are mental health problems most likely to occur?

10. In a MIND survey of people who currently have a mental health problem: (a) what percentage of said they had been abused or harassed in public? (b) what percentage claim to have been teased or harassed at work?

11. What are the three main stereotypes by which people with mental health problems are portrayed in the media?

http://www.youtube.com/watch?v=lQKs169Sl0I

SILENCE OF THE LAMBS 1991 (ANTHONY HOPKINS) HANNIBAL LECTER IS INTRODUCED IN THE 1981 NOVEL

RED DRAGON

AS A BRILLIANT PSYCHIATRIST AND A CANNIBALISTIC SERIAL KILLER .

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Mental Health Act (1983)

• • England and Wales Guidelines for the care and treatment of mentally ill individuals • Mental illness according to the Mental Health Act 1983:

“mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind”

Key Terms and Legal Issues

• Insanity • Mental illness • ‘Legal insanity’:

“ The term is a social and legal term rather than a medical one, and indicates a condition which renders the affected person unfit to enjoy liberty of action because of the unreliability of his behaviour with concomitant danger to himself or others. The term is more or less synonymous with mental illness or psychosis. In law, the term is used to denote that degree of mental illness which negates the individual’s legal responsibility or capacity”

(Black’s Law Dictionary, 1990)

•

Legal Prerequisites of Crime

To be found guilty of a crime one must have not only carried out the act of crime but have

intended

to commit that crime (1) Actus Reus

The accused caused the particular act in question. That that behaviour was voluntary…they had criminal intent, were exercising free will and can be held responsible for their actions

(2) Mens Rea

Relates to the state of mind the accused was in at the time that the act was committed, that is, did the accused intend to commit the crime, and did they understand what the consequences of their actions might be?

•

Legal Pleas

1. ‘Not guilty by reason of insanity’ (NGRI)

Courts apply the ‘McNaghten rule’ – Principle 1: that every man is presumed sane until proven insane – Principle 2: It must be proved that, at the time of the crime, the accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature of the act, or not to know that he/she was doing wrong

2) Diminished responsibility

(Homocide Act 1957)    Must be proof of ‘substantially impaired mental responsibility’ Difficult to define psychologically Examples  Mentally incompetent to stand trial or unfit to plead  Sufficient ability to follow court proceedings  Ability to comprehend the details of the evidence  Ability to understand the meaning and implications of the charges  Ability to instruct lawyers effectively



Stigma

 originates from ancient Greece to denote a physical brand or mark applied to social outcasts (e.g. Slaves, traitors)  Or to indicate devalued social status (Goffman, 1963)  Today, stigma carries a more psychological connotation

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Stigma & Mental Illness (1)



Hinshaw (2007, 2008)

argues that over the past 60 years, there has been increasing attention paid to stigmatisation of mental illness (along with homelessness and substance abuse).

 Label of mental illness promotes rejection and suboptimal social interactions.

 Legal restrictions & discriminatory practices as evidence of restricted life opportunities for people with mental disorders (Corrigan et al. 2004)

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Stigma & Mental Illness (2)



Stereotype

 “A cognitive ‘shorthand’ to describe a given social group, which may contain a germ of truth but which is likely to lead to rigid characterizations of group members”.

 (Hinshaw, 2008, p.369)

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Stigma & Mental Illness (3)



Prejudice

 literally ‘prejudgement”...term refers to negatively tinged affective responses to out groups (Hinshaw, 2008).

 In groups & out groups...concept drawn from Social psychology & work of Tajfel (1978, 1981) e.g. Catholics/ protestants, black/ white etc.

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Stigma & Mental Illness (4)



Discrimination

 the limitations on the rights of out groups or those who are socially castigated. The behavioural component of stigmatization which go beyond cognitive stereotypes and affective prejudices (Hinshaw, 2008).

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Stigma & Mental Illness (5)



Hinshaw (2008)

defines

mental illness

as  “referring to a wide variety of categories of deviant, dysfunctional behavioral and emotional patterns, subject to variegated definitions but constituting hugely impairing conditions for individuals, families, and societies at large” (p. 369).

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Stigma & Mental Illness (6)



Dangerousness



“

rampant stereotype of people with mental illness, often promoted by public media, is that they are chronically violent and dangerous; this belief may underlie stigmatising attitudes”  (Hinshaw, 2008. p.369).

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Stigma & Mental Illness (7)



Wang et al. (2005)

 claim that the stigma of mental illness causes delays in help seeking for treatment because of ignorance, shame and other by-products of stigma.

 Historically, demonic views of mental illness have been linked to moral judgements & extreme castigation.

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Stigma & Mental Illness (8)

  In contrast to demonic views, religious and/or moral views of mental illness have promoted ‘care and compassion’ as well as ‘hope and rehabilitation’ in regard to reform through out history.

 Historically, disease-orientated views of mental illness have provided more positive and less blameworthy responses within western society.

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Stigma & Mental Illness (9)

 However,

Frank & Glied, (2006)

argue that closing down overcrowded mental hospitals in the past 50 years has inadvertently fostered homelessness and created problems in some community-based facilities.



Not on my back door step attitude?

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Stigma & Mental Illness (10)

 Social distancing is affected by person’s behaviour  Negative attitudes to mentally ill persist, especially in terms of direct social contact  Education campaigns have led to greater understanding of mental illness but not impacting on social distancing  Perception of mentally ill as dangerous is increasing.

Martin et al. (2004) 23

Stigma & Mental Illness (11)

   

Effects of Negative Attitudes...

Finzen’s [1996 in Schulze 2003] - ‘second illness’ ‘

Spoiled identity’

[Goffman 1986]

Process of stigmatisation

   Identification of certain behaviour within the individual Attributing behaviour to ‘mental illness’ Labelling person ‘mentally ill’  Triggering negative schema of the mentally ill [stereotype]  Responding to person in line with the stereotype

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Stigma & Mental Illness (12)

        

Consequences of stigmatising mentally ill (Hinshaw & Stier, 2008)

Social distancing Social rejection and exclusion Loss of compassion and empathy by   Health Professions [Rossler et al 1996] Police /Legal System [Lamb & Weinberger 1998] Negative discrimination Employment [Glazier 1998] Accommodation, mortgages and financial services Prejudice against family – eg. Children bullied in school [Adler & Wahl 1998] Self fulfilling process – self stigmatisation

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http://www.youtube.com/watch?v=0G7PgMdirio

ME, MYSELF & IRENE (2000) COMEDY AFTER MANY YEARS OF CONTINUOUS ABUSE BY THE PEOPLE AROUND HIM, HIS ANGER BUILDS UP AND CHARLIE DEVELOPS A RUDE AND VIOLENT SPLIT PERSONALITY NAMED HANK, CAUSED BY "ADVANCED DELUSIONARY SCHIZOPHRENIA WITH INVOLUNTARY NARCISSISTIC RAGE ". AS HANK, HE GOES AROUND RETALIATING AGAINST ANYONE WHO HAS ACCOSTED HIM — AND EVEN HARMS THOSE WHO REALLY HAVEN'T. A PSYCHIATRIST PRESCRIBES A MEDICINE TO KEEP HANK SUPPRESSED 26

Mental Illness & Crime (1)



Howitt (1998b)

highlights that mental illness means different things in law & in psychology  Under English law, mental illness is not a technical phrase (see the Mental Health Act 2007 weblink on blackboard) for further details.

 In 1857, Dr John Gray suggested that serious mental illness is associated with attempted or actual homicide (cited in Turner, Brace, Motzkau, Briggs & Pike, 2009)

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Mental Illness & Crime (2)

 Mass media propagated the idea of criminals being mentally ill.

 In 1909,

The Maniac Cook,

movie showed the mentally ill as homicidal maniacs.

 In modern cinema, this is portrayed by ‘

Psycho, Silence of the Lambs

etc...can you think of any others?

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Mental Illness & Crime (3)

 According to public opinion surveys, mentally ill people such as ‘schizophrenics’ are seen as unpredictable and dangerous (Turner et al. 2009)  Hence, the media might shape the public’s beliefs about the dangerousness of the mentally ill.

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Mental Illness & Crime (4)



Angermeyer & Shulze (2001)

analysed a German tabloid newspaper (

Bild-Zeitung

) with daily sales of 11 million copies. The largest proportions of stories about the mentally ill concerned murder, multiple murder, physical injury/ grievous bodily harm, attempted murder, rape/ sexual abuse, multiple infanticide and infanticide.

 Also, highly publicised violent incidents involving celebrities and mentally ill people (Monica Seles, 1993, Jill Dando etc.).

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Mental Illness & Crime (5)



Shaw et al. (1999):

Based on 500 homicide cases in 1996-97, for whom psychiatric reports were obtained, the levels of mental disorder were:  44% had a record of mental disorder at some time in their life.

 14% had symptoms of mental illness at the time of the offence.

 8% had had contact with mental health services in the year before the offence.

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Mental Illness & Crime (6)

 Hiday et al (2001) found that mentally ill people are more likely to be the other people.

victims

of crime than     They interviewed mentally ill people in a psychiatric unit. Some of them had substance abuse histories.

In the 4 months before being interviewed, 27% had been

victims

of any sort of crime.

8% had been the

victims of violent crime.

22% had been

victims of non-violent crime.

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Mental Illness & Crime (7)



Confounding factors

 Maybe mentally ill people have to cope with more taunts?

 More women are assessed with mental illness.

 Social class...if they lose their job & have no money/ home etc.

 Violence is mentioned as part of symptoms for antisocial personality disorder & borderline personality disorder.

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Mental Illness & Crime (8)

 DSM (Diagnostic & Statistical Manual)  In 1952, in DSM-I, only 2% of listed disorders involved violence.

 In DSM-II (1968) this increased to13% of disorders.

 In DSM-III (1980) this increased to 47% (Harry, 1985).

 After 1980, more links between mental illness and violence (Link, Andrews & Cullen, 1992).

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Mental Illness & Crime (9)



Confounding effects of medication

 Side effects of some psychiatric medication can lead to violent behaviour.

 Some tranquilising drugs with neuroleptic effects can make users more aggressive.

 Hence, perhaps it is not the mental illness, but the medication that is causing the violent behaviour?

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Mental Illness & Crime (9)

 Hodgins (1997) argues that 3 different types of evidence support the association between

major mental illness and criminality.

 Those who develop major mental illness tend to have higher levels of criminality.

 Could be that police detect mentally ill offenders more easily i.e. Offend in public, don’t flee the crime scene, more likely to confess.

 Co-morbidity with alcoholism & drug abuse.

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Mental health problems in prison (Singleton

et al

., 1998; 2000)

Prisoners General population Psychosis 6-13% 0.4% Personality disorder Neurotic disorder Drug dependency Alcohol dependency 50-78% 40-76% 34-52% 19-30% 3.4-5.4% 17.3% 4.2% 8.1%

Useful references Bilic, B. & Georgaca, E. (2007). Representations of 'mental illness' in Serbian newspapers: a critical discourse analysis, 186.

Qualitative Research in Psychology , 4, 167 Blackburn, R. (2007). Personality Disorder and psychopathy: conceptual and empirical inverstigation, Psychology, Crime & Law.

13 (1), 7-18.

Bartlett, A. & McGauley, G. (2010) eds. Forensic mental health: concepts, systems and practice , Oxford, Oxford University Press. Farrington, D.P. (2004), Criminological psychology in the twenty-first century, Criminal Behaviour and Mental Health, 14 , 152-166.

Howitt, D. (2006). 2nd ed. Pearson. Introduction to Forensic and Criminal Psychology , Harlow: Junginger, J. (2006). Stereotypic delusional offending, 24 , 295-311. Behavioral Sciences and Law , McMurran, M., Khalifa, N. & Gibbon, S. (2009). Willan Publishing.

Forensic Mental Health , Devon: Sigurdsson, J.F. Gudjonsson, G.H. & Peersen, M. (2001). Differences in the cognitive ability and personality of desisters and re-offenders: a prospective study among young offenders, Psychology, Crime and Law , 7 , 33-43.

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Next week…

 Monday…Mental Illness & crime Part 2  Different types of mental illness & crime  Tuesday…  Violent & Sexual Offending (part 1)

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