Guidance for Mentally Disordered - Essay Example

Guidance for mentally disordered essay Introduction The relationship between chronic mental disorders and crime is very complex, and despite advances in psychiatric research, it is not well understood. Because there is often a considerable time interval between actual crimes committed and evaluation of mental states, diagnoses, and environmental conditions of offenders, it is quite difficult for the justice system to establish reliable relationships between crime and psychopathology. According to Teixeira, and Dalgalarrondo suggests that some offenders with schizophrenia are more likely to be violent than those in the general population even though the percentage of all social violence attributed to antisocial personality disorder, psychopath and schizophrenia is rather small, is believed to be below 10%. (Teixeira and Dalgalarrondo 2009) Although the precise percentage of offenders behind bars living with mental illness is uncertain, though there is no doubt that it exists, is significant, it is prevalence in adolescents and young adults. According to Andrews and group, mental disorders do include antisocial personality disorder and substance abuse, among 80 – 90% of offenders with mental disorder. (Andrews et al 2010) The most common diagnosed is antisocial personality disorder, which according to Golf (2006) is estimated to be as high as 60-80% of the inmates. This is because, most antisocial offenders spend most of their time in and out of corrections facilities, either in institution or community as their behaviour fails to conform to social norms. Therefore, constitutes grounds for arrest, rule breaking, deceitfulness, impulsivity or failure to plan ahead, irritability and aggressiveness, and disregard for safety of self or others. (McMurran et al 2009) Schizophrenia Schizophrenia is a chronic mental health disorder affecting most inmates that is characterised by symptoms as such hallucinations and delusions representing the positive signs while symptoms such as apathy, social withdrawal, avolition, slowness, poor self-care, indicate the negative signs. It affects approximately 0.9% of the world’s population. Schizophrenia disorder onset at adolescent or young adulthood and prolonged periods of illness without proper management and treatment the offenders eventually loses the sense of reality and experiences symptoms such as auditory hallucinations, persecutory or grandiose delusions. Also the offender my lack insight, and become unaware that having a mental illness. However, schizophrenia is believed to be a neuro-developmental disorder caused by complex interaction of both genetic and environmental factors. (McMurran et al 2009) Diagnosis The diagnosis of schizophrenia using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The DSM-IV-TR criteria for schizophrenia comprise of the following symptoms for a positive identification, which should have lasted for more than a month: Delusions, hallucinations, incoherent behaviours. Note, only one of the above is required if delusions or hallucinations is confirmed in the first place. In addition, DSM-IV schizophrenia diagnostic criteria specifically specifies that social or work dysfunction should be present and for a period of more than six months. In order to make a positive identification, the diagnosis criteria used should rule out mental disorder s associated with medical, mood, psychotic and substance abuse. (APA 2000)  Psychopath Refers to any personality disorder, not just psychopath as proposed in the diagnosis criteria for Psychopathic Personality Disorder, which is characterized by an offender with inflated ego, arrogant self-appraisal, lacks remorse, empathy towards others, deceitful and manipulative, early behaviour problems include antisocial, impulsive, poor behavioural controls and irresponsible. According the Mental Health Act, psychopath includes traits such as grandiosity, selfishness, callousness and antisocial, irresponsible and parasitic lifestyle behaviours. And most young people suffering from schizophrenia often get involved in crime earlier in life and are more likely to repeat the offence. (Mental Health Act 1983) Antisocial personality disorder Antisocial personality disorder is a type of chronic mental illness in which an offender’s thought process, and perception exhibit antisocial behaviour and become violent or destructive. Inmates with antisocial personality disorder typically have no regard for law and order; they often violate laws and rights of others because of that they are frequent visits to correction facilities and communities. They express they anger and use violent mean to acquire what they feel is rightfully theirs is total disregard of the law, and are likely to engage in substance and alcohol abuse, people with antisocial personality disorder are irresponsible, towards their work, family and society. Symptoms Antisocial personality disorder symptoms include: Disregard of law and order, manipulative, child abuse or neglect, intimidating others, aggressive or violent, plus the above mentioned signs. The peak of antisocial symptoms tends to intensify at 20s and may decrease over time. However, there is not confirmed research whether this happens because of aging or concerted efforts from the government, law enforcement agencies, communities or family support. Diagnostic criteria Antisocial personality disorder, is diagnosed using Diagnostic and Statistical Manual of Mental Disorders (DSM) which indicates that an inmate must meet the symptom criteria for this disorder in order to positive confirm the presence of antisocial personality disorder. Symptom required for a positive confirmation of antisocial personality disorder include: Be above 18 years, must have been diagnosed before age 15 with conduct disorder, which was characterized by acts such as stealing, vandalism, violence, cruelty to animals and bullying, breaking the law, manipulating, conning or lying, excessively irritable and aggressive, feeling no remorse no regard for the safety for self or other, impulsive and disorganized. Types of Interventions 1. Pharmacological 2. Psychological 3. Social and Occupational Pharmacological Interventions The pharmaceutical intervention for offenders with schizophrenia involves the administration of antipsychotic medication, antidepressants for depression, mood stabilisers. There is no approved medication for treating antisocial personality disorder; however, a combination of psychiatric medications may help to alleviate certain symptoms that are associated with antisocial personality disorder: the administration of antidepressant may help to improve depressed mood, anger, impulsivity, irritability or hopelessness. Mood-stabilizing could even out mood swings or reduce irritability, impulsivity and aggression. Anti-anxiety helps to reduce anxiety, agitation or insomnia. Antipsychotic may help if symptoms that include psychosis or, in some cases, anxiety or anger problems are present. However, in some cases they may increase negative behaviour. Psychological interventions Psychotherapy Psychotherapy is the major intervention that is used to treat antisocial personality, psychopath and schizophrenia disorders. The inmates are allowed to talk with prison nurse or social worker assigned to them, in order to share the burden of these mental disorders and look for proper means of managing and treating them. Cognitive-Behaviour Therapy This type of therapy helps offenders to understand how unhealthy, negative beliefs and behaviours would affect their daily activities and relations. In addition, it does over means and ways through, which they could replace those negative thoughts with healthy and positive ones and teaches them on how to relate with others. This therapy is administered to foster positive beliefs, self esteem and enable the offenders to let go of the past and plan for a better future upon release. Family Therapy Family therapy is important for released offenders, so as to help them integrate to the community, especially first time offenders require a lot of family support and their acceptance and spending time with offenders with schizophrenia, psychopath, and antisocial personality disorders to boost their self esteem and belief. Skills for family members Families with offenders with schizophrenia, psychopath and antisocial personality disorder do also require support and education on how to handle and cope with mentally ill family members, how to protect themselves from the aggression, abuse, violence and anger from offenders. Psychodynamic Therapy This is a process by which sensitization and awareness of unconscious thoughts and behaviours experienced by offenders with schizophrenia, psychopath and antisocial personality disorder to be aware of their condition, surrounding and thought process so as to adopt ways of overcoming negative thoughts and behaviours that impact negatively upon they lives.. Psycho-education This kind of therapy helps offenders to access information that would help them understand all aspects of their condition, coping strategies, problem-solving skills, and management. This allows offenders to access enough reference material upon release that they can refer to and get more information on how to manage and adhere to treatment. Social and occupational interventions Occupational Therapy A number of inmates suffering from these three mental disorders are homeless, and do have difficulties return or getting work, therefore, its recommended that any correction or community involved in rehabilitation of offenders, to provide some kind of shelter either through shelter for homeless, or encourage the family member of inmates to take them in, and while at the facilities they should be thought some kind of skills that could enable them secure an employment or form of job where they could earn their livelihood. Prevention There's no sure way to prevent schizophrenia, psychopath and antisocial personality disorder from developing in those at risk, but identifying those at greatest risk, of suffering from these mental disorder especially neglected or living in violent homes and offering them early intervention may help reduce chances of suffering from these disorders. Through the provision of early treatment, and adhering to those regimes for the long term, may prevent or control symptoms from worsening. Because most of these mental disorder are believed to have their roots in childhood, therefore, parents, guardians, caregivers, teachers and paediatricians may be able to spot early warning signs and manage or treat them early to increase the chances of alleviating the negative symptoms. Early, effective and appropriate discipline, lessons in behavioural skills, and psychotherapy may help reduce the chance that at-risk children go on to become adults with these mental disorders. Social rehabilitation After the inmates with schizophrenia, psychopath and antisocial personality disorder do their time behind bars, upon release they require to be rehabilitated into the society, therefore, this kind of rehabilitation will enable them to freely interact and work with others peacefully. According to Bartol and Bartol it is possible that persons with schizophrenia, antisocial personality disorder and psychopaths when adult they may be at risk from the time of birth to develop these disorders, these mental disorders could have effect on the nervous system that interferes with rapid conditioning and associations between crime and consequences. Because of insight, the schizophrenia, antisocial personality disorder and psychopath offenders fail to anticipate any repercussion on their actions and, hence, feel no remorse. (Bartol and Bartol 2008) Personalized intervention The repeated offenders requires specific and personalized intervention process that would enable them overcome the challenges they do face out there upon release, bearing that in mind the correction offices, nurses, social worker and other mental health professionals involved in the rehabilitation of inmates, should use the following methods for specific condition: First, if the inmate consumes alcohol or any other drug his/her treatment should be tailored to address the substance abuse first before any other interventions are given. Secondly if the offender has anger management issues, he/she should be thought on how to control anger through training. Third, if the offender has family members they should be involved in his treatment, and over support to the offender. Fourth, before the offenders is release from the correction facility he/she be assisted to search for a job be either giving a referral or vocational training that would enable the offender search for employment. Fifty, the offender then should be given psychotropic medication. Sixty, the offender upon release would require shelter and financial support, these should be provide at least until the offender would pick him/herself up. Seventy, lastly the offender should be provided with other clinical services to address symptoms such as hallucination, and violent fantasies. In addition, the inmate should be given psychosocial rehabilitation/skills-based training on a broad range of skills that important in vocational and interpersonal functioning, and specialized case management through the use of Assertive Community Treatment and intensive case management. Finally, be provided with supervised treatment and management that through community facilities to enhance his adherence to medication and prescribed behaviour through conditional release and outpatient commitment have demonstrated value in reducing violence risk. (Carson and Bull 2002) Conclusion The majority of offenders with schizophrenia, psychopath, and antisocial personality disorder experience additional risk factors such as alcoholism, drug abuse and living in antisocial or disorganized communities with no social supports that mediate or interact with these mental disorders to aggravate their conditions. There should be more focus on women inmates, because they experience they suffer the most than their male counterparts and these mental disorders are under diagnosed among young female offenders. According to Canter and Youngs, the profile of offenders with schizophrenia, psychopath and anti social personality disorder adduced before a court of law, usually it is not accepted as evidence and encase it does it is overturned on appeal making it more difficult to diagnose these mental disorder and over treatment. However, with the evolution of Investigative Psychology as lead to the profiling of offenders actions, which also evaluates of their actions over time so as to understand their psychological and mental status to establish the cause of their behaviour to confirm whether the inmates do distorted deliberately or accidentally there psychotic behaviour in order to get lighter sentences. This has revolutionized correction systems in many countries where the justice system employs the services of psychiatrist, social worker and nurse in the management and rehabilitation process especially on the first time offenders. (Canter and Youngs 2009) it should also be understood that inmates suffering from schizophrenia, psychopath and antisocial personality disorders even if individual do not commit crimes their mental status is often a hindrance to their involvement in cognitive-behavioural interventions, and must be addressed as a pre-requisite or a companion intervention in their day to day management. According to Hiday (2006) the other major factors that contribute to violence among offenders with mental disorders are alcohol, substance abuse, victimization, and community disorganization, which are often associated with crimes and violence general population. Because of these offenders with serious mental disorders are likely to spend most of their time behind bars for violent behaviour, vandalism and stealing. (Crocker et al 2005) And according to Teasdale offenders with serious mental illness are likely to be victims of both violent and non-violent crimes, because of their vulnerability, homelessness, unemployed, alcohol and substance abuse. They do respond violently in situations where they feel a sense of victimization. Therefore, corrective measures should be undertaken to diagnose these mental conditions and treat or manage them earlier enough to prevent them from committing crimes, and help them to lead a normal and productive life. (Teasdale 2009) Reference list Andrews, D.A., Bonta, J, (2010) The Psychology of Criminal Conduct (5th ed) American Psychological association (2000) the diagnosis of schizophrenia using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Bartol, C. R and Bartol, A. M. (2008) Criminal Behaviour. NJ. Pearson Education, Inc Canter, D and Youngs A. (2009). Offender profiling and the analysis of criminal action. Investigative psychology: UK: Wiley & Sons. Carson D and Bull R (2002) Handbook of Psychology in Legal Contexts, John Wiley & Sons Crocker, A. G., Drake, R. E., Mueser, K. T., Clark, E. E., Ackerson, T. H., McHugo, G. J., & Alterman, A. I. (2005). Antisocial personality, psychopath and violence in persons with dual disorders: Criminal Justice and Behaviour, 32(4), 452-476. Hiday, V.A., (2006) Putting community risk in perspective: A look at correlations causes and controls. International Journal of Law and Psychiatry 29(4), 316–331. McMurran, M. (2009) Forensic Mental Health. NJ: Willan. Ogloff, J., (2006). Antisocial Personality Disorder. Aust N Z J Psychiatry, 40(6-7) 519-528 Teasdale, B. (2009) Mental Disorder and Violent Victimization. Criminal Justice and Behaviour. 36(5), 513-535 Teixeira, E H and Dalgalarrondo P, (2009) Violent Crime and Dimensions of Delusion: Am Acad Psychiatry Law. 37, 225–31 Read More

Schizophrenia disorder onset at adolescent or young adulthood and prolonged periods of illness without proper management and treatment the offenders eventually loses the sense of reality and experiences symptoms such as auditory hallucinations, persecutory or grandiose delusions. Also the offender my lack insight, and become unaware that having a mental illness. However, schizophrenia is believed to be a neuro-developmental disorder caused by complex interaction of both genetic and environmental factors.

(McMurran et al 2009) Diagnosis The diagnosis of schizophrenia using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The DSM-IV-TR criteria for schizophrenia comprise of the following symptoms for a positive identification, which should have lasted for more than a month: Delusions, hallucinations, incoherent behaviours. Note, only one of the above is required if delusions or hallucinations is confirmed in the first place. In addition, DSM-IV schizophrenia diagnostic criteria specifically specifies that social or work dysfunction should be present and for a period of more than six months.

In order to make a positive identification, the diagnosis criteria used should rule out mental disorder s associated with medical, mood, psychotic and substance abuse. (APA 2000)  Psychopath Refers to any personality disorder, not just psychopath as proposed in the diagnosis criteria for Psychopathic Personality Disorder, which is characterized by an offender with inflated ego, arrogant self-appraisal, lacks remorse, empathy towards others, deceitful and manipulative, early behaviour problems include antisocial, impulsive, poor behavioural controls and irresponsible.

According the Mental Health Act, psychopath includes traits such as grandiosity, selfishness, callousness and antisocial, irresponsible and parasitic lifestyle behaviours. And most young people suffering from schizophrenia often get involved in crime earlier in life and are more likely to repeat the offence. (Mental Health Act 1983) Antisocial personality disorder Antisocial personality disorder is a type of chronic mental illness in which an offender’s thought process, and perception exhibit antisocial behaviour and become violent or destructive.

Inmates with antisocial personality disorder typically have no regard for law and order; they often violate laws and rights of others because of that they are frequent visits to correction facilities and communities. They express they anger and use violent mean to acquire what they feel is rightfully theirs is total disregard of the law, and are likely to engage in substance and alcohol abuse, people with antisocial personality disorder are irresponsible, towards their work, family and society.

Symptoms Antisocial personality disorder symptoms include: Disregard of law and order, manipulative, child abuse or neglect, intimidating others, aggressive or violent, plus the above mentioned signs. The peak of antisocial symptoms tends to intensify at 20s and may decrease over time. However, there is not confirmed research whether this happens because of aging or concerted efforts from the government, law enforcement agencies, communities or family support. Diagnostic criteria Antisocial personality disorder, is diagnosed using Diagnostic and Statistical Manual of Mental Disorders (DSM) which indicates that an inmate must meet the symptom criteria for this disorder in order to positive confirm the presence of antisocial personality disorder.

Symptom required for a positive confirmation of antisocial personality disorder include: Be above 18 years, must have been diagnosed before age 15 with conduct disorder, which was characterized by acts such as stealing, vandalism, violence, cruelty to animals and bullying, breaking the law, manipulating, conning or lying, excessively irritable and aggressive, feeling no remorse no regard for the safety for self or other, impulsive and disorganized.

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