What Are the Considerations When Designing Treatments for Mentally Disordered Offenders - Coursework Example

Mental Treatment Student’s Name Subject Professor University/Institution Location Date PSY010-3 Assessment 2: Treatment Essay According to WHO definition of health; health is a state of complete mental and physical wellness and not merely the absence of disease. Many a time the health has been centered on the physical wellness neglecting the mental bit hence providing room for the thriving of mental disorders. A broad variety of events and conditions easily propagate the development of poor mental health. Some of these conditions appear normal such as the living environment, daily workplace stresses, loss of a loved one and polluted environment among others. Though some mental disorders may be easily manifested others remain unexposed hence when manifested in the open happen s to shock the observers and hence then is when they seek relevant psychiatric care. The justice system provides leniency on individuals with compromised mental health hence the need for a mental status evaluation before normal judicial procedure is followed. The justice system has a duty to protect the health of all citizens hence has set provisions to be followed when handling individuals with mental disorders. These include order for assessment and provision of relevant treatment to the affected individuals, regulation of their behavior and frequent mental health reports until they are fit enough to appear for trial and subsequent justice. The laws are also lenient on such offenders yet are keen enough not to endanger the general population (McMurran 2009 pg 76) Mental disorders range from stress and personality disorders to severe mental illnesses hence the variation in the care and treatment needed to correct those ranges from simple therapy to complicated drug therapy and electrotherapy. The duration of existence and the precautions taken to manage the disorder is another significant factor to be considered when designing the treatment. When precautions are taken to prevent progression of the disorder, the response to the treatment therapy is often positive and encouraging. Mental disorders are caused by a broad range of factors which include physiological imbalances, physical stresses, mental status alterations, psychological trauma, physical abuse and drug abuse among others. Among the different causes, individuals respond differently to the causes hence the different responses to the therapy provided. Some individuals will cope well with the mental disorder hence it eventually resolves while other with poor coping mechanisms deteriorate into aggression and crime hence they end up in the legal arms. Treatment of individuals with mental disorders requires specific steps and procedure in accordance to the laws stipulated to control the whole program. The mental health act was instituted to ensure the patients suffering from mental conditions obtain the best of care and are treated in a manner that does not demean their personality. This was as a result of the evolutional process through which the whole field of mental health-psychiatry has gone through. These laws are also applied to mentally disordered offenders alongside the guidance of the judiciary in relation to the specific individual (Harper & Chitty 2005) pg 124). The justice system and the health care have developed several channels and levels at which the mentally disordered offender becomes a common clients hence a collaborative network is developed. The offender may be transferred to the health care system at levels such as after arrest, after a court hearing, while in remand, after imprisonment or while serving term. The main purpose of the judiciary and the health system is to assist the patient recover from their mental condition and help them integrate into the society with ease. SHIZOPHRENIA This is a chronic, severe mental condition that reduces the capability of mental evaluation. It causes mental breakdown between physiological, emotional and social leading to wrong decisions. This causes reduced level of functioning and inability to integrate the personal emotions ideas thoughts and behavior with the daily activities. The symptoms appear in young adulthood and diagnosed basing on observable behavior and reported incidences (Holloway 2005 pg 148). Among the noted causes of this disorder include the early developmental environment, genetic make-up, physiological and psychological alterations, medications and drugs and substance abuse. There are several symptoms associated with schizophrenics which include hallucinations, disorganized thoughts and speech, delusions and loss of memory. Some may displays catatonia and also be paranoid. The recent researches have tried to identify the indicative signs of an impending schizophrenia attack. The signs have been said to include social withdrawal, clumsiness, irritability and dysphoria. Whereas the symptoms are many, some have been classified as either positive or negative. The positive signs include disordered thoughts and speech, delusions; hallucinations are either tactile, gustatory, visual, audio and olfactory. Patients with such symptoms respond well to the treatment. The negative symptoms include avolition, alogia, lack of desire to form relationships, anhedonia and a flat affect, patients with such symptoms respond poorly to treatment. Diagnosis is done using the diagnostic and statistical manual of mental health (DSM 4) basing on the characteristic symptoms, level of social dysfunction and significant duration of the symptoms. Several subtypes have been identified which include, paranoid, disorganized, catatonic, undifferentiated, residual, post-schizophrenic depression and simple schizophrenia. Management of schizophrenia depends on the location of the patient; most schizophrenics are admitted under the involuntary provision by the mental health act. The main drug treatment is by use if antipsychotic medications alongside other social interventions such as family therapy, behavioral therapy and community treatment. The prognosis is often good depending on the symptoms. Patients suffering from schizophrenia are often offenders hence the common link between the justices system and the mental health unit. Paranoid schizophrenics have often committed crimes in response to the delusion hence the need for restriction and mental status evaluation. Bipolar disorder; this is a mental illness that interferes with the normal human behavior which causes mood swings which alternate between being overly happy with anxiety, confidence and an urge to do a lot to sudden sadness, anger irritation disgust and loss of morale to interact with the familiar environment. This sudden change from happiness to sadness gave thus the name between the two poles ‘bipolar’ since there is no lucid interval between the two cycles. The anger is what causes one to be unruly and have similar character to that of a depressed man due to withdrawal from public relations. The person with this disorder presents with two phases ; mania phase in which one is anxious, happy, overly excited, hyperactive, restless rapid speech, poor concentration, increased sex drive, altered sleep pattern as the person has no desire to sleep, sudden decision making like resignation without prior notice, misuse on credit, making big unattainable plans, optimistic, dispatchment of ideas without reconsideration or having a second thought, poor judgment and can lead to drug abuse and excessive alcohol intake. This may lead to destruction of relationships and severe tiredness due to excessive working. The second, depressive phase is characterized by social withdrawal, excessive tiredness, hopelessness, self-accusations of most tragedies, confusion, irritability, worthlessness, frequent crying which is uncontrollable, insomnia, attention deficit, anger, sadness, rage, pessimistic, fury, loss of self-esteem, loss of appetite, poor mental evaluation night mares and these can lead to suicidal thoughts and if worsens it leads to hallucinations and delusions. At times the two phases may occur at the same time and causes one to have racing thoughts which have high risk of contribution of suicidal action due to feeling of incapacitation to meet a personal set target in the series of ideas leading to anxiety, guilt rage agitation thus thoughts of death. Complication of this disorder may be social, psychological, economical and behavioral which may be self-injury through cutting burn mutilation, harm, spontaneous abortion and suicide due to panic. These patients are in denial and when they are depressive they tend to feel hopeless, worthless seek weapons or pills to use in committing suicide as they withdraw from friends. This is because the find it hard to share out their thought and death may occur if not observed. Whey they become mania they may tend to accuse those around of crimes. This can change to anger and brutality ending up the life of a loved one. Stress may trigger desire to get whatever he or she wants despite the consequences and this can be through violence. Use of illegal drugs and substance abuse can lead to hyperactive and multiple mental ideas which can make one lethal and if any one opposes his ideas may be eliminated by cold murder. Some medications may trigger mania such as morphine caffeine codeine and anti-depressant drugs which can make one kill another to get them due to over dependence. If the patient develops the mixed mood swings he may end up fighting with the seniors at the place of work due to misunderstanding of the ideas or due to correction of a mistake done at the place of work (Hodgins & Muller-Isberner 2001 pg. 165). When the depression and the mania takes charge while at the place of work may lead to improper signing of legal company documents and this can lead to swindling of the company assets or he may tend to misuse the company resources unknowingly leading to fraud thus jailed. If it is an adolescent at school may lead to poor performance and if explained a concept by a friend may aggravate fight leading to death or fracture. This may also lead to starting fire at a building in the assumption of experiment or may even burn another fellow. Mismanagement of personal finances through reckless spending may lead to theft due to unaccountability of the money. The adult may get into alcoholism and stress mismanagement may lead to fights at the drinking centers hence they land into law breaking and committing offences. Over time, scholars, psychiatric and psychologists have tried to develop treatment regimens for mentally disordered offenders hence suggesting several approaches. In this assignment, I will discuss the several treatments in relation to the different conditions. Behavioral therapy; this is a therapy focused on external, observable traits and behavior. The therapy is aimed at developing and improving the interpersonal skills of the offenders and their social skills undermining the unexpressed part of their behavior. In the event of educating the offenders on the appropriate means to behave, they acquire social skills alongside problem solving skills. This ensures the antisocial behavior of the offender is altered positively for them to suit well in the society (Bartol & Bartol 2008 pg 234).  The focus on overt and measurable behavior provides avenue to determine progress or regress in the offender. Though effective on one part, it has its own weaknesses. These include the minimal use of the therapy for offenders in the past hence its popularity among therapies for them is poor even with perfect results of improvement. In addition, the main weakness of this therapy is that with its focus on the overt it undermines the covert hence offenders who are introverted will tend to go through it successfully only to commit an offence again (Hollin 2004 pg, 176). Cognitive behavioral therapy This is a therapy that is centered on the fact that thoughts and cognitions are significant in the causation, maintenance, treatment and the eventual prognosis of the mental disorder. This put into phase the interplay between cognitive and behavioral aspects of an individual. This has been in use over time for mentally disordered offenders and its efficacy confirmed. This therapy has often be used to address both the overt and covert aspects of behavior. It strives to raise the thresholds to which the antisocial behavior comes to play. It helps to minimize the causes or stimulants to a given anti-social behavior such as aggression. It employs behavior modification principles of reinforcement, modeling, shaping and time outs along cognitive aspects of challenging of distorted thoughts and improvement of cognitive thoughts (Canter 2008 pg 214). The strengths of this therapy include the fact that it addresses both the cognitive and behavioral aspects of the patient hence improving the clients ability to cope with situations and improve their anger management skills, producing a better adapted and well socialized individual. This eventually empowers the offender on better tools of conflict resolution and how to control and correct unconventional and distorted beliefs. Some of the fall outs of this therapy include its failure to address other but related needs of the offender such as the specified crime that was committed hence it leaves the offender at a mix up as to whether what they did was wrong or not. This leaves room for more crimes as the crime was not focused on in the whole period of the therapy. The lumping together of offenders regardless of the crime they committed tends to undermine the whole need for the therapy as the crime is not considered hence the relationship between the mental disorder and the crime is not established. Dialectical behavioral therapy This is a therapy formulated for women with borderline personalities before it was adapted for use in the general population. The main goal of this therapy is to assist clients to be able to develop a life they are proud of using their own belief pattern. This is achieved by striking a balance between the treatment stages and the development of the disorder. The therapy empowers the patients to be able to detect the symptoms and the means to manage them even before the therapist arrives. The therapist in this case is a collaborator and a personal friend who wants to see the offender lead a better life and become a better adjusted individual (Jackson 2008 pg 130).  Strengths of this therapy include its efforts to promote stress coping mechanisms and strategies which is a significant aspect of rehabilitation. It is also centered on resolving life threatening behaviors hence minimizing the prevalence of destruction and damages among the offenders the stress on individual initiative in management of their mental process and behavior hence the result is long lasting (Hollin, 2004). Among the limitations are its inability to focus on a specific disorder hence cannot be used specifically for a specific group of offenders. It also fails to address the specific crime committed hence chances of the crime recurring are high. Therapeutic community This is a set up bases on the idea that some people are offenders due to the fact that they cannot interact well in the community. This community provides optimum environment for such people to live and learn how to interact and take responsibility in the community. The setup is composed on residents who include staffs and offenders. It bases on the principle that work and responsibility in the community are an important aspect of interactions and responsibility. It provides a living–learning environment for the clients. The therapy is focused on the role played by positive peer influences in behavior formation and regulation (McMurran 2009). Among the strengths are that it allows the offender the chance to be able to learn how to interact positively with the real environment hence make choices. It has also been noted that it can be used to handle a specific disorder. The limitations include the fact that though it exposes the client to real life situations, it fails to provide the offender with relevant tools and skill to handle the difficulties and the criminal behavior hence it has been accorded to offer more corrective measures than just tools. In addition, further research is needed to ascertain the means to correct more specific offenders using the same therapy. References McMurran, M. (2009). Forensic Mental Health. NJ: Willan. Hollin, C. (2004). The Essential Handbook of Offender Assessment & Treatment. Chichester: Wiley. Bartol, C.R. & Bartol, A.M. (2008). Criminal behavior: A psychological approach, 9th ed. USA: Pearson Education. Canter, D. (2008). Criminal and Investigative Psychology. London; Oxford University Press   Canter, D., & Youngs, A. (2009). Investigative psychology: Offender profiling and the analysis of criminal action. UK: Wiley & Sons. Davies, G., & Beech, A. (2012). Forensic psychology: Crime, justice, law, interventions. UK: Wiley & Sons Hodgins, S., & Muller-Isberner, R. (2001).  Violence, crime and mentally disodered offenders: Concepts and methods for effective treatment and prevention.  Canada: Wiley & Sons. Harper G and Chitty C (2005). The impact of corrections on re-offending: A review of ‘what works’. (3rd Ed). London: Home Office.   Hollin, C. (2004). The Essential Handbook of Offender Assessment and Treatment. Chichester: Wiley.    Holloway K et al (2005). Systematic review of criminal justice and treatments programmes in reducing drug-related crime. London; Home Office   Holmes, D.A. (2010). Abnormal, clinical & forensic psychology. UK: Pearson education. Howitt, D. (2002). Introduction to forensic & criminal psychology, 3rd ed. UK: Pearson Education Huss, M.T. (2009). Forensic psychology: Research, clinical practice, and applications.UK: Wiley & Sons. Canter, D., & Youngs, A. (2009). Investigative psychology: Offender profiling and the analysis of criminal action. UK: Wiley & Sons. Jackson, R. (2008). Learning forensic assessment. UK: Routledge. McMurran, M, Khalifa,N, & Gibbon, S. (2009). Forensic menatl health.  USA: Willan. Van Wormer, K. (2010). Working with female offenders: a gender sensitive approach.  USA: Wiley & Sons Read More

Among the different causes, individuals respond differently to the causes hence the different responses to the therapy provided. Some individuals will cope well with the mental disorder hence it eventually resolves while other with poor coping mechanisms deteriorate into aggression and crime hence they end up in the legal arms. Treatment of individuals with mental disorders requires specific steps and procedure in accordance to the laws stipulated to control the whole program. The mental health act was instituted to ensure the patients suffering from mental conditions obtain the best of care and are treated in a manner that does not demean their personality.

This was as a result of the evolutional process through which the whole field of mental health-psychiatry has gone through. These laws are also applied to mentally disordered offenders alongside the guidance of the judiciary in relation to the specific individual (Harper & Chitty 2005) pg 124). The justice system and the health care have developed several channels and levels at which the mentally disordered offender becomes a common clients hence a collaborative network is developed. The offender may be transferred to the health care system at levels such as after arrest, after a court hearing, while in remand, after imprisonment or while serving term.

The main purpose of the judiciary and the health system is to assist the patient recover from their mental condition and help them integrate into the society with ease. SHIZOPHRENIA This is a chronic, severe mental condition that reduces the capability of mental evaluation. It causes mental breakdown between physiological, emotional and social leading to wrong decisions. This causes reduced level of functioning and inability to integrate the personal emotions ideas thoughts and behavior with the daily activities.

The symptoms appear in young adulthood and diagnosed basing on observable behavior and reported incidences (Holloway 2005 pg 148). Among the noted causes of this disorder include the early developmental environment, genetic make-up, physiological and psychological alterations, medications and drugs and substance abuse. There are several symptoms associated with schizophrenics which include hallucinations, disorganized thoughts and speech, delusions and loss of memory. Some may displays catatonia and also be paranoid.

The recent researches have tried to identify the indicative signs of an impending schizophrenia attack. The signs have been said to include social withdrawal, clumsiness, irritability and dysphoria. Whereas the symptoms are many, some have been classified as either positive or negative. The positive signs include disordered thoughts and speech, delusions; hallucinations are either tactile, gustatory, visual, audio and olfactory. Patients with such symptoms respond well to the treatment. The negative symptoms include avolition, alogia, lack of desire to form relationships, anhedonia and a flat affect, patients with such symptoms respond poorly to treatment.

Diagnosis is done using the diagnostic and statistical manual of mental health (DSM 4) basing on the characteristic symptoms, level of social dysfunction and significant duration of the symptoms. Several subtypes have been identified which include, paranoid, disorganized, catatonic, undifferentiated, residual, post-schizophrenic depression and simple schizophrenia. Management of schizophrenia depends on the location of the patient; most schizophrenics are admitted under the involuntary provision by the mental health act.

The main drug treatment is by use if antipsychotic medications alongside other social interventions such as family therapy, behavioral therapy and community treatment. The prognosis is often good depending on the symptoms. Patients suffering from schizophrenia are often offenders hence the common link between the justices system and the mental health unit. Paranoid schizophrenics have often committed crimes in response to the delusion hence the need for restriction and mental status evaluation.

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