Mental Disorder and Crime Interrelations - Essay Example

?Mental Disorder and Crime The question for this paper is whether there is a relationship between mental disorder and crime. The answer to this question is complex because there are some situations that it may seem that there is a relationship between mental illness and crime, but the research does not always support this idea. It is this researcher's opinion that mental illness does increase the likelihood that someone will commit a crime. Definition of Mental Disorder and Crime ‘Definitions of mental illness are notoriously difficult to draft. If they are framed too narrowly they deny services to people. If they are too broad they may result in unnecessary intervention’ (Wilson, 1995 as quoted in Healthcare Education Services, 2006). This quote from Wilson suggests the complications that mental health carers and the courts have when they attempt to apply a definition to mental illness. There is a distinction made between mental health and mental disorder. According to Healthcare Education Services (2006) mental health and mental illness have often been used interchangeably as 'mental health refers to thoughts, feelings, and actions of the individual, all aspects of life, including social, physical, spiritual and emotional, affect it' (p. 6). The term mental disorder implies that he person has a mental illness and also has some sort of disability and has often been used as a legal definition for a variety of mental illnesses. The Department of Health (2004) defines mental disorder as ‘an impairment of, or a disturbance in, the functioning of the mind or brain resulting from any disability or disorder of the mind or brain’ (p.3). This definition was refined from the original bill that was drafted in 1983 and said that mental disorder was, ‘…mental disorder means mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of the mind’ (as quoted in Healthcare Education Services, 2006, p. 7). All of these statements are how agencies will define mental disorder but the courts have their own definition. The Crown Prosecution Service (2010) defines mentally disordered offenders as 'a person who has a disability or disorder of the mind and has committed or is suspected of committing a criminal offence'. This definition will cover a variety of mental disorders and it can be relevant to the individual's fitness to plead guilty or not guilty, their sentencing or disposal, or the decision for the prosecutor to divert the sentence or prosecute the individual (The Crown Prosecution Service, 2010). This is the definition will be the one used for this paper because it is the one that comes from the courts. Definition of Crime The definition of crime is complex because its definition will relate to the individual's offense. Sammon (n.d.) states that the word crime is difficult to define because it covers a variety of acts that have nothing in common necessarily except that they are punishable by law if they are carried out by an individual. The easiest definition comes from the Oxford Dictionary (2011) which describes crime as a noun and defines it as 'an action or omission which constitutes offence and is punishable by law'. A crime can be anything from shoplifting to murder. Each offence has its own definition in the court system. This is a simple definition and will be used in this paper to refer to generic crimes. Crime and General Mental Disorders The challenge for both of these definitions is the fact that everything about them is dependent on the circumstances in each situation. Many people believe that a defence that states that an individual who has a mental disorder should be excused for committing a crime because at the time of the crime, they had a mental breakdown due to a mental disorder. However, the empirical evidence does not support this idea. Sirotich (2008) reviewed several studies about crime and violence to see whether there is a correlation with mental illness. He found that most of the literature suggests that the best predictor of whether someone will commit a crime is if they had committed prior violence and whether they had criminality in their history. Also, if the individual had a history of delinquency prior to adulthood they were more at risk of committing a crime in adulthood. He did find that the literature supported that crime in people with mental disorders often arose from their parent's criminal history. In other words, if the parents had committed crimes, the person with a mental disorder would have a history of 'violent recidivism' (Sirotich, 2008, p. 175) and if parents were alcoholics or drug abusers, the mentally ill offender would have more of a chance to also be violent. This literature reflects an idea that those with mental illness may be predisposed to crime. Carabellese, Vinci, and Catanesi (2008) gave evidence of a case study of five young men who raped and murdered an eight year old girl. The boys captured the victim, raped her, then covered her body with branches and set it on fire when she was still alive. The only motive in the case was that these boys wanted to sexually molest the little girl. The main perpetrator, an 18 year old boy named Mario (not his real name) was found to be "mentally retarded with schizoid personality disorder" (p. 1450). None of the boys had prior criminal histories, and it was shown that they had little resources, did not have long standing relationships, had little schooling and were employed in manual labour. The only relationship the five men had with each other was that they all went to the same video arcade. Once they formed the group, they went around their town looking for mischief. This mischief escalated from small crimes to acts of violence and anti-social behaviour, which were the issues that led to the rape and murder. When the boys were assessed, Mario was the only one of the five who was found to have psychiatric problems. Mario's lawyers tried the insanity plea, but the judge and expert witnesses stated that Mario was capable of understanding that what he was doing was wrong. It was shown that the crime that he committed was not due to his mental incapacity necessarily, because he understood that what he did (or was about to do) was wrong. This case study shows that there is a relationship between mental disorder and crime, but that this does not mean that the individual is incompetent to stand trial or to understand what they are doing. Newman and Ghaziuddin (2008) studied Asperger syndrome using professional studies that had been conducted over time. They particularly used MEDLINE and CINAHL databases, Cochrane database of systematic reviews, textbooks and any related resources in order to find all published articles about Asperger syndrome and incidences of crime. They were looking for specific information as to why an individual with this syndrome was committing crimes and using violence. They used a broad definition of crime that encompassed "murder, attempted murder, assault and/or battery, sexual assault, arson, stalking, robbery" (p. 1849) and any crime that involved violence against a person. Out of 72 publications, they found that only 17 publications and 37 individual cases met their criteria; six of the cases did not show a clear mental disorder. The results of the study showed that only 11 cases showed that the individual had a definite psychiatric disorder. This case showed that although the individual had a mental disorder, it did not necessarily mean that they were any more violent than someone who did not have the disorder. Another study by Spila, Makara, Kozak and Urbanska (2008) linked child abuse with mental disorders in adult life. The researchers randomly chose British adults between the ages of 18 and 24 to examine the issues of this link between child abuse and mental disorders. They chose a total of 124 individuals, 56 who had been receiving psychiatric treatment in a mental health facility. The mental disorders they were being treated for ran the gamut from anxiety disorders to schizophrenia. Many were in the categories of depression, anxiety and schizoid personality disorders and general personality disorders. They used the Early Trauma Inventory (ETI) (self-report version) developed by a team of doctors at Emory University School of Medicine. The ETI was used because they could break the experiences of the patients down to the intensity of each kind of abuse that the patients experienced. The authors acknowledged that there were some limitations of the study due to the small size and to the fact that memory may not have been accurate in all cases. The results of the study showed that the patients they studied experience much more violence in their early years than a control group that was used. This study links abuse to later psychopathology in adults, however, the study did not give an understanding of whether the individuals committed crimes in each situation. There are many studies that link child abuse as a common component of why an individual commits violence in later life. Thompson (2008) studied the effects of gender on crime and mental illness to better understand the correlation between these two factors. Thompson was particularly interested in the "gendered relationships between depression, substance abuse and crime" (p.1). She used the data from the 2004 National Household Survey on Drug Use and Health (NSDUH) which focused on individual 12 years old and older. The research was centred on the behaviour within the last 12 months of the participants' lives, emphasizing current factors that would show why the individuals committed crimes. There were several significant findings from this study. Some of the findings include: 1. The use if an illegal drug within the past year significantly increased the individual's ability to commit crime, especially among women. 2. If they used drugs in the past, they were more prone to sell drugs and this was true for both men and women. If women used drugs in the past year, they were more prone to engage in assault crimes. 3. Individuals who were depressed committed more crimes than those who were not depressed. Depression is a risk factor for women and it can also cause them to commit assault. 4. If an individual self-medicates to treat their depression by using illicit drugs, they will be more prone to commit crimes. 5. Antidepressants in treatment programs "seems to" increase crime rates in younger adults, but in older adults they "seem to" reduce crime (p. 4). The author of this study concluded that treatment with antidepressant for offenders who were depressed worked better for older, more emotionally mature adults than it did for younger adults. This may mean that studies should be done to find age appropriate treatments in the future. These studies show that there is a definite link between mental illness and the commitment of crime, and it seems that the more severe the mental illness, there is more risk that a crime will be committed. There does seem to be a gap in these studies however, because there does not seem to be a specific reason why they are more at risk, only that mental disorders do have a specific link to crime. Elbogen and Johnson (2009) studied the results of two specific cases, that of Seung Hui Cho, the man who killed 32 people and wounded others, who was found to be the killer in the Virginia Tech killings in Blackburg, Virginia and Robert A. Hawkins, who killed eight people at Von Maur department store in Omaha, Nebraska. The news reports showed that both men had received psychiatric intervention which made the public demand to know how their mental illness had caused them to commit these crimes. Another question was whether mental health officials could have seen this happening and prevented it. Elbogen and Johnson's study examined three issues: 1) the risk factors that may predict violent behaviour, 2) whether a history of severe mental disorders in an individual could predict future violent behaviour , and 3) how different risk factors may predict different types of violence (p. 153). There were several issues that Elbogen and Johnson found to be true. Many of their subjects had been diagnosed with schizophrenia (10.87%), bipolar disorder or major depression. Another portion of their study (9.4%) was diagnosed with concurrent mental disorders and substance abuse. A total of 41.68% of their sample had a life-time diagnosis of substance abuse/dependence and severe mental disorder. They found some of the risk factors for violence included younger males, with less high school education, who had already been in the system for juvenile detention, who had perceptions that there were hidden threats from other people and who had divorced or separated within the last year, were more prone to violent behaviour. When substance abuse was indicated, the risk factors included younger males, who were from lower income backgrounds, had a history of violence, history of physical abuse from a parent, were victimized in the past and unemployed, but looking for work. Their study showed that there were more individuals with a history of mental illness (33%) with history of violence, than those without a history of mental illness (14%). Which suggested that any severe mental illness that was present increased the probability that the individual would commit a violent act. Specific Mental Disorders and Crime In the beginning aspects of this report, the researcher examined current research into general mental disorders and crime. This section will examine the literature on specific mental disorders and how they are related to crime. The premise is to see whether specific mental disorders have a higher incidence of crime than others. One of the many disorders that are specific to crime is schizophrenia. Often, the person who is schizophrenic experiences chronic psychotic episodes. As a result, they may have illogical thought processes, will withdraw from reality and will experience hallucinations and/or delusions (Healthcare Education Services, 2006). Munkner, Haastrup, Joergenson, and Kramp (2009a) studied registered patients in a psychiatric facility in Denmark who were registered between a specific time period. They were interested in discovering the types of offenses that were done by those with schizophrenia and to understand whether those with schizophrenia committed crimes more frequently than those without schizophrenia. They found that 41% of those registered had committed at least one offence. Women had committed five percent of these crimes and they were more prone to those offences that were non-violent. They also found that those with schizophrenia were more prone to some type of crime than those who were not schizophrenic. In another study, Munkner, Haastrup, Joergenson, and Kramp (2009b) found that criminality rates were higher for schizophrenics than for offenders in the general population. The purpose of this study was to examine schizophrenic patients who had spent time in a psychiatric facility for their first psychotic episode. Fazel and Grann (2006) studied the impact of severe mental illness on crime. They also took information from their health registry and found patients who were diagnosed with severe mental illness between the ages of 15 through adult. They found that out of 98,092 patients who were in the psychiatric hospital between the years 1988 to 2000, 6,510 had committed at least one crime. Out of the 6,510, 6.6% had violent convictions (Fazel and Grann, 2006). The authors concluded from this information that the majority of violent crimes in this instance were committed by people with schizophrenia or other sever mental disorders. Also, if those reviewed had been put into mental institutions indefinitely, the crime rate would have most likely have been reduced to 5.2% (Fazel and Grann, 2006). This study supports the idea that there is a connection between mental disorder and crime, and it clearly shows that those individuals with schizophrenia are more at risk for committing a crime than those without a mental disorder. Another mental illness that this researcher examined was personality disorders and crime. According to the Mayo Clinic (2009) "a personality disorder is a type of mental illness in which you have trouble perceiving and relating to situations and to people." This is a very broad definition, and it covers narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder. What is interesting is that personality disorders seem to be associated with those perpetrators who commit sexual crimes. Dudeck et al. (2007) researched personality disorders because they wanted to understand the risk factors that were involved with this mental illness. The literature before their study basically stated that there is a correlation between sexual offences and personality disorders, but they did not describe the risk factors. Their study took place in a forensic hospital and they studied 55 men between the ages of 18 and 65 years old. The results of their study showed that seven out of nine sexual offenders had narcissistic personalities but in non-sexual offenders , only three out of 32 had narcissistic personality disorders (they were screened on several assessment tests Dudek et al., 2007, p. 499). The factors that contributed to the sexual offences were very traumatic and negative childhood experiences, early sexual abuse, and most had been entwined in a cycle of violence. Blackburn (2007) also studied personality disorders and crime. Blackburn wanted to study various studies of psychopathology to see which personality disorders emerged as showing criminal behaviour. For this study, narcissistic personality disorder and histrionic personality disorders showed that they were more related to criminal behaviour than some of the others. The study was not conclusive as to what exactly happened differently for some personality disorders than others. Bonnie (2010) gives the account of a fictitious case study in which a woman rammed her car into another person's car because she was angry. The case study was used by a psychiatrist to say that a plea of insanity may or may not be relevant in this case because she knew that what she was doing was wrong. What Bonnie found was that many states have taken personality disorders out of the legal definition of mental illness. Therefore, in order to help the individual the courts would have to prove that there were other challenges that the individual had in order to look at her mental state when she rammed the car. In this case study, it was difficult to understand exactly what they had attempted to prove. It seemed that they were on the side of using personality disorders as an aspect of mental illness, but this diagnosis was difficult to prove when looking at the individual's impairment. There are many times when a crime is committed when the perpetrator had a mental disorder and other issues that influenced what they did. As an example, McDermott, Quanbeck, and Frye (2007) researched the idea that substance abuse may be a factor in committing a crime for people with bipolar disorder. They found that not only was substance abuse a factor in criminal arrest, but that women were disproportionately arrested with bipolar disorder and substance abuse. They concluded that when women engage in substance abuse and they are bipolar, that they are more prone to be arrested for a crime. In another study, Baillargeon et al. (2009) examined repeat incarcerations in populations that had mental disorders. They examined 79,211 inmates who were serving a sentence between September 1, 2006 and August 31, 2007. They looked six years before to see whether some of these inmates had been incarcerated prior to these dates. They were able to identify this information by studying medical information systems. The results of the study showed that those inmates who had major psychiatric disorders were at increased risk for repeated incarcerations. They found that the inmates who were most at risk were those with bipolar disorder. They made the recommendation that there should be intervention programs for inmates with bipolar disorder with the intention to reduce recidivism. Grann, Danesh, and Fazel (2008) add to this discussion with their historical cohort study of 4828 offenders in Sweden. The offenders were given sentences between 1988 and 2001, and then followed for five years after they were incarcerated. The results of the study showed that a third of the sample offended in violent ways in the follow-up years. Again, substance use and bipolar disorder were seen as more prone to committing a violent crime than other mental disorders. A contributing factor to mental disorders and crime seems to be that the individual had a history of abuse when they were growing up. Also, they may have fell victim to others who mistreated them because they had a mental disorder. McFarlane, Schrader, Bookless, and Brown (2006) studied the incidences of victimization of those with mental disorders to determine whether this was a problem for those with Post Traumatic Stress Disorder (PTSD) and what they called adverse outcomes (p. 1010). Their study observed 130 inpatients in psychiatric hospitals who had various psychiatric conditions. Their conclusion was that this population was vulnerable and could be taken advantage of very easily because of their mental disorder. When this research read this study, it seemed that when people are vulnerable and have a mental disorder, they can be prone to committing a crime when they have others influencing them. With the onslaught of PTSD episodes, this may create more difficulty for an individual who had committed a crime, and they could possible commit the crime during a PTSD episode. Conclusion In the beginning of this research paper, the question was whether there was a relationship between mental disorder and crime. This researcher said that there was definitely a relationship between mental disorders and crime. The literature supports this issue. The challenge for courts and for defence attorneys is that most of the time, these it may not be as easy to prove that a person who has a mental disorder does not have the capacity to understand right or wrong, which is one of the ways that an insanity plea can be entered into. Reading the literature on this issue relied on many viewpoints about this issue. Some disorders like major depression, schizophrenia and Asberger's Syndrome had direct relationships to crime. However, personality disorders were not considered by some of the literature to qualify as a mental disorder because it was a mood disorder rather than a cognitive disorder. In other words, the individual's ability to know right from wrong was not hindered by the personality disorder. Another issue that seemed present in the literature was whether an individual with a mental disorder is able to enter into an insanity plea. In most cases, the literature supported that just because someone had a mental disorder, it did not automatically allow them to make an insanity plea. This shows that this is a very complicated issue and judges and attorneys must see these cases on a case by case basis. In today's society, it seems that there are more people who are committing crimes and some television shows would have the audience believe that the majority of people in prison have some type of mental illness. This may be true but it is not the reason that they committed the crime necessarily. 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