Violence and Mental Disorders - Essay Example

Running Head: Violence and Mental Disorders Violence and Mental Disorders [Institute’s Violence and Mental Disorders Introduction When he reads in the newspaper, that a young simpleton altar boy, Aaron Stampler has been arrested with the suspicion of murder of the beloved Archbishop Rushman of a Chicago Church, Martin Vail rushes to his defence and takes the case pro-bono. This was something unusual for Martin Vail because he is usually acclaimed for representing rich clients and allowing them to trick the legal systems through exploiting loopholes and gaps within the law. However, Vail loves the public spotlight and believes that such a case would allow him to earn the desired publicity. Although, he had taken the case just for the publicity, as Vail further investigates the case, he develops sympathy for Stampler as he becomes convinced that he is innocent. His sympathy and concern for Stampler reaches at such a level that Vail is ready to fight to all extents against his former lover Janet Venable, who is acting as the prosecutor. Nevertheless, during his investigation, Vail also discovers that the Archbishop had made some powerful enemies due to his insistence on not developing and selling Church lands. Surprisingly enough, he also found out that the Archbishop was sexually abusing altar boys. Vail is tempted to submit this evidence to the court because the same would increase the sympathy for the boy, but at the same time, it will also provide him with a clear motive for murder, something which was missing from the equation of the arguments of the prosecution. Vail decides not to make this evidence public and instead, decides to question Aaron, during which Aaron continuously insists that he is innocent and does not remember anything despite the fact that he was found feeling the crime scene with blood all over the clothes. When Vail intensifies his aggressive line of questioning and mentions the sex tape, Aaron finally breaks down and suddenly transforms into a violent, rude, sociopathic personality and starts to refer himself as “Roy”. “Roy” confesses to the murder of Archbishop and cites the molestation and abuse as the reason behind the same. “Roy” also throws Vail against the wall in the heat of the moment, but when things are allowed to cool down, he transforms back to his original personality. He knows claims that he has no recollection of the events. It becomes apparent to the Vail that he is suffering from some serious mental illness. The psychiatrist examining Aaron also confirms that the Aaron is suffering from multiple personality disorder. As a child, he faced mental problems due to childhood abuse from his father and the same resurfaced due to molestation by the Archbishop. Had this information surfaced before the trial, Vail could have used the same to enter into an insanity plea, but he could not do the same now. Nevertheless, Vail cunningly plans to bring this multiple personality into limelight through triggering a violent response from Aaron by asking him questions that are likely to make him uncomfortable. Vail makes him uncomfortable with his questions but the prosecutor, Janet, puts the final nail in the coffin with her cross examination and the split personality of Ron finally emerges on the surface. After witnessing the same, the judge dismisses the jury and remands him to a maximum security mental hospital. When Vail visits, Aaron argues that he cannot remember anything that happened in the courtroom. However, during the conversation, he ends up speaking too much, something which makes it clear that he remembers the events and that the split personality was merely a drama crafted by Aaron and that there is no Roy. When Vail confronts him, Aaron finally admits to his sanity and murder of Archbishop and his girlfriend, but he argues that he did not make up the personality of “Roy” because Roy is the real “him”, but he made up the personality of “Aaron” to gain sympathy from the lawyer, jury and judge (Friedman, 2006, p. 2064). Above-mentioned is the plot for a much acclaimed Neo-Noir crime thriller movie titled “Primal Fear” but more importantly, this movie represents an interesting topic of the relationship between mental illness and crime. The movie exploits the general public perception about the link mental illness and violence to develop interest (Waldheter, et al., 2005, p. 610). Over the years, due to the media reporting, it has become easier for the public to believe that mentally ill people are more prone towards committing criminal acts, whether it is due to multiple personality disorder or antisocial behaviour. However, towards the end, it is revealed that Aaron, who was perfectly sane, despite all the childhood abuse and molestation, used this public perception to his advantage and faked a multiple personality disorder to trick the legal system into putting him into a mental facility rather than giving him a life sentence to a prison. Over the recent past, not only the media but also the academic experts have provided much evidence on the link between violent behaviour and mental illnesses that has led to a strong perception amongst the public that both of these are closely related. This paper is an attempt to explore this debate but the same would be done with the help of several case studies. The introductory section of the paper presents the case of the movie, “Primal Fear”, whereas, the main body will also comprise of some case studies. Discussion Over the years, the media has portrayed and highlighted several cases of individuals with mental illnesses and their violent acts. This strategy has gained public attention, something which maximizes the returns and profits for the media corporations, but it has titled the public opinion into believing that mentally ill people are more prone to violence. In the case of this movie, Stampler was not mentally ill, but he knew that if he were to pretend that he was mentally ill, then it would not be troublesome for the jury and the judge to link him with murders. However, it will earn him the sympathy of the judge to be kept alive and within a maximum security prison or mental hospital rather than like a prisoner. The fact is that mentally ill individuals deserve sympathy and care of the public, as argued in detail later in the paper, however, such portrayals force the general public to view them as unworthy of sympathy and as ticking time bombs who should be “kept away” and “fixed”. The fact is that majority of the population of mentally ill population does not inflict major harm on others, but there have been a few cases which the media has highlighted substantially in the past and link them with the mentally incapacity of the killers (Neria, 2009, p. 415). When in the year 2007, Seung Hui Cho went on a killing spree; he ended up killing 32 innocent and defenceless students along with injuring 17 others, after which he killed himself as well, the media found them with a huge case to influence the perceptions of the public about the mentally ill. As soon as the shooting ended, the media officials focused their attention on the mental history of Cho. They reported that it was during his middle school that he was diagnosed with selective mutism, blunted affect, social anxiety, major depressive disorder also known as recurrent depression or clinical depression. Quite clearly, he was amongst those rare children suffering, which made unfit for even the most rudimentary common social settings and day-to-day activities. He did receive treatment, underwent therapy and received special education support until he reached the junior year of his High School (Alez, 2012, p. 85). Furthermore, due to mental condition and speech difficulties, he was a victim of constant bullying through his educational career. Even when during the 24 month period that he spent at Virginia Polytechnic Institute and State University, he showed several instances of abnormal and antisocial behaviour. For example, during his first year, two female stalkers lodged a complaint against him saying that he was stalking and harassing them. After a detailed investigation, Virginia Special Justice clearly stated that he was mentally ill and need immediate help. However, the school administration and school teachers continued to accommodate him so that his reputation could remain intact and he could graduate, which might open the doors of a normal life for him (Agger & Luke, 2008, p. 75). Important here to note is the fact these negative portrayals of mentally ill by the media have in turn deterred the mentally ill people from “coming out” and telling people about their mental condition. Rather than actively seeking help from medical professionals, they prefer concealment because if they “come out” or reveal their mental situation, they fear that they would be isolated from their social circles for the rest of their lives. It is highly likely that the same was the case with Cho, where rather than seeking mental help, he preferred to hide his condition from the rest of the world, even when it was apparent to everyone that he was in dire need of mental help and treatment. In the case of this movie, Stampler knew that the moment the world believes that he is mentally ill, they would send him to a hospital or a maximum security prison, but he would not face death sentence, something which he used to his advantage (Roy, 2010, p. 524). After Cho’s shooting, the media argued that a child with such severe mental illnesses and distorted perception of reality should not have been let into school in the first place but the Virginia Privacy Laws restricted school administration’s ability to make his mental health public (Worth, 2008, p. 247). As early as when he was three years old, signs of his abnormal and bizarre behaviour became apparent, but his mother did not seek therapy for her son until it became mandatory from educational institutions and continued to rely heavily on support from churches (Alez, 2012, p. 85; Agger & Luke, 2008, p. 75). The media also used this case to argue that these people are afraid of the real world and they would do anything to prevent themselves from facing the music. For example, the experts on the media argued about Cho that he was too afraid to go into the real world of money, jobs, stress and responsibilities, he decided to kill himself, but before that he also killed several “rich kids” and “deceitful charlatans”, who he saw as responsible for his condition. Surprisingly enough, in his fantasy, he compared himself to Jesus and the saviour of the weak and oppressed and opposed to the wealthy (Neria, 2009, p. 415). The movie the same as the cause of Stampler’s split personality because he had spent a significant amount of time in the Church under the Archbishop, while he was being sexually harassed. Although, the harassment was painful, it was comprehensible for the world that Stampler developed his split personality to face the world beyond the Church (Hagan, 2010, p. 87: Worth, 2008, p. 247). Nevertheless, the point here is that over the past few years, the debate between the possible link between mental illness and violence has been the focus of several debates and discussions. The relationship between mental illness and violence has a significant impact on clinical practice and public opinion, which in turn forces the policymakers to incorporate the same into the mental health and public health policy (Hagan, 2010, p. 87). As mentioned earlier, over the past few years, many researchers have been able to successfully conclude that violent behaviour and mental illnesses are strongly correlated. Douglas et al (2009) concluded that a meta-analysis of 204 studies and concluded that mental illnesses increased the odds for violence by 49-68 percent (p. 679). Joyal et al (2007), while conducting a review of 22 different studies conducted in the past two decades concluded that mental illnesses such as schizophrenia resulted in a significant increase in the risk of violence even in the absence of any history of substance abuse. However, the study also remarked that only 5-15 percent of the major violent crimes were committed by people suffering from mental disorders (p. 33). Fazel et al (2010) conducted a longitudinal study with more than 3700 individuals with bipolar disorder, 8.4 percent of the sample committed violent crimes as compared to the 3.5 percent of the general population within Sweden (p. 931). Fazel et al (2009) investigated with a sample of slightly over 8000 individuals diagnosed with schizophrenia and found out that 13.2 percent of these people committed at least one violent crime as compared to the same figure of 5.3 percent for the general population of Sweden (p. 2016). Taylor (2009), based on her analysis of the psychiatric literature from 1970 to 2007, stated that one can irrevocably conclude that one can easily conclude that there is a strong link between violence and psychosis (p. 647). Arseneault et al (2000) also concluded that individuals with schizophrenia and associated disorders were 2.5 times more likely to be violent in the last twelve months as compared to the control group within the study. The researchers conducted this study with 961 adults in New Zealand. Furthermore, the study also highlighted the fact that substance abuse could drastically increase the risk of violence amongst these people (p. 979). In a similar study conducted in Spain, Arango (1999) studied 63 in patients suffering from schizophrenia and concluded that the severity of their illness and their disillusion with their illness were the best predictors of their risk at violence (p. 493). A ten-year longitudinal study conducted in Sweden with over 1000 mentally ill patients released from hospitals that they were four times more likely to have a criminal record as compared to the general population (Belfrage, 1998, p. 145). Nevertheless, the problem with several of these studies is that they have incorrectly labeled or implied a moderately strong correlation as causation. In fact, the media also has done the same. With a few cases of mentally ill people engaged in violence, the media has concluded a cause and effect relationship between mental illness and violence, when such a small sample does not even allow to infer a moderate coorelation. Elbogen & Johnson (2009), in a recent quantitative study, reach the conclusion that the common perception that serious mental illness is a strong predictor of future violent behaviour is fundamentally flawed. Nevertheless, the researchers did find out a moderate correlation between reported violence and mental illness, but the evidence suggests that this is merely a correlation and a cause and effect relationship, as perceived by the general public (p. 152). There are several other factors associated with mentally ill people such as history of substance abuse, environmental stressors, juvenile detention, poverty, unsuccessful personal lives, victimisation, domestic abuse and others, which share a cause and effect relationship with violence. However, the multivariate analysis undertaken by the researchers did identify that coupled with substance abuse/dependence problems; severe mental illness emerges as a robust predictor of future violent behaviour. The researchers reached this conclusion after analysing longitudinal data from the year 2001 to 2003 with more than 34000 respondents, which were considered to be the representative of the national US population based on the data from the census of the year 2000. It was a two-wave face to face survey conducted by the National Institute on Alcohol Abuse and Alcoholism and data used was conducted as a part of a country wide survey conducted by National Epidemiologic Survey (p. 154). Fazel et al (2009) focus greatly on Schizophrenia, which is a severe psychotic condition. Studies reveal that 1 percent of the population is likely to suffer at least one episode of schizophrenia, which is likely to lead toward delusion or hallucinations. The researchers acknowledge the fact due to the reporting by media in the recent past, the general perception is that there is a strong link between mental illnesses and violence. However, several mental health experts and organizations strongly believe that this a myth for which there is no conclusive empirical evidence. On the other hand, the researchers that have taken the liberty to research this topic have come up with different conclusions, which have further heated up the debate without any conclusions or agreements. The researchers decide to solve this problem through conducting a systematic literature review with a meta-analysis of 20 different credible and reliable studies from 1970 to February 2009 (p. 105). These studies have an aggregate sample size of over 18000 different individuals. The study found out that a man suffering with schizophrenia was almost four to five times more likely to commit a violent act than any other man in the general population. However, a women suffering from the same mental disease was 8 times more likely to commit such an act. More importantly, the researchers were also able to uncover that the risk of violence in people suffering from mental illness and substance abuse was similar to the risk violence in people with substance abuse and no mental illness. In fact, the risk of violence in people with substance abuse problems but no mental illness was higher than the risk of violence in people with only mental illness. Therefore, the researchers concluded that although, there is a correlation between mental illness and violence, as someone with psychosis is twenty times more likely to kill someone, but this risk is even higher for these people when they develop substance abuse problems (p. 100). Furthermore, since the focus of the public policy remains at decreasing violence, therefore, the policymakers should also focus on people with substance abuse problems, regardless of their mental health history (Friedman, 2006, p. 2064). Large & Nielssen (2011) also conduct a systematic literature review and meta-analysis of nine different studies with the aim to explore the rate of violence within people that have experienced first episode of psychosis, which is usually the first stage of schizophrenia. Based on the data available to the researchers, nearly 35 percent of these patients had committed any violence. Almost 17 percent of these patients had engaged in serious population and only 0.6 percent reported cases of severe violence. Furthermore, the data also revealed that violence was strongly correlated with involuntary treatment, hostile affect, mania, substance use, poor educational record of lower levels of education and moderately correlated with younger age, male sex and duration of the untreated psychosis. Therefore, the study ended up concluding that almost one third of the population, which is a significant segment of this population, committed an act of violence before admitting themselves for treatment. Although, there is an incidence of people who had committed a violent action injuring another person as well, violent acts that could lead to serious or permanent nature are uncommon to this population (p. 209). If the evidence of from this study is correct then the same translates into the fact that the strong link between violence and mental illness is merely a propaganda or myth because more than two thirds of the mentally ill people appear to be completely non violent and only 6 in every 1000 people from this population commit any such action which could lead to hospitalisation or permanent injury (Swartz, et al., 1998). Conclusion In the light of the evidence presented in this paper, it is understandable to conclude that rather than stigmatising mental illness, which is likely to be counterproductive, unethical and illegal, the policymakers should focus on staging interventions specifically on preventing substance abuse (Waldheter, et al., 2005, p. 610). Interestingly enough, there is evidence which suggests that outcomes for people suffering from schizophrenia largely depend upon the cultural settings. For example, a research conducted by the World Health Organization reveals that over 40 percent of the people suffering from schizophrenia in industrialised countries ended up with severe impairments; whereas, this figure was less than 25 percent for developing and underdeveloped countries, which lacked advanced healthcare facilities (Labuschagne, 2001, p. 99). Although, there is no empirical evidence in this regard, experts appear to concur with the theoretical evidence that societal and cultural predispositions towards mental illnesses remain instrumental in defining the fate of these patients. In many advanced countries, as mentioned earlier, the media has stigmatised mental illnesses and the general perception is that it destroys the person and renders them useless to the society, or even worse, makes them a threat to the society (Oldham, 2011, p. 13). The constant negative portrayals of mentally ill people by the media force these people to engage in a battle, where they pretend to be normal. However, in most conditions, these people fail to find any success in self-healing because a person with mental illness has to seek help from friends and colleagues but their denial and concealment only makes their condition worse and reduces the chances of them getting appropriate treatment. Several people, who have battled with mental illnesses, after recovering, recall their experiences as so depressing and crushing because people, even the closest of friends and family members, disown them. In contrast, in several developing and underdeveloped, where medical science is still not the common tool of reasoning and logic for the masses, majority of the population sees such mental disorders as a temporary episode where the person is possessed by evil spirits (Swartz, et al., 1998). Although, the idea of being possessed by evil spirits is irrational and illogical, it does pave the way for the friends and family members of the patients to extend their support and care, as they hope that the person would soon recover from the same. Family members and friends continue to encourage such people to live their normal lives and even support marriages and employment for these people (Noffsinger & Resnick, 1999, p. 685). Some experts even believe that the real cause behind mass murders is not mental illnesses but income inequality and poverty. Empirical evidence from several sources reveals that income inequality is strongly correlated with incurrence of violence and murders. When the gap between the rich and the poor increases, without any immediate hope of the shortening of the gap, the trust deficit increases, this in turn, forces people to engage in heinous acts (Waldheter, et al., 2005, p. 610). References Agger, B., & Luke, T. W. 2008. There Is A Gunman On Campus: Tragedy and Terror at Virginia Tech. Rowman & Littlefield Pub Incorporated. Alez, G 2012. The Virginia Tech Massacre: Everything You Need to Know about the Incident Including the Attacks, Perpetrator, Legal Aftermath, and More. Websters Digital Services. Arango, C., Barba, A. C., González-Salvador, T., & Ordóñez, A. C. 1999. Violence in inpatients with schizophrenia. Schizophrenia Bulletin, Volume 25(3), pp. 493-503. 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