Offenders with Mental Disorders

lecturer 2
by
Dr. Saima Arzeen
 Overview
• Introduction
• The potential effect of mental
disorders on free will and
responsibilities
• the relation ship between crime
and mental disorders and the role of
media
• the link mental disorders and crime
• Age and crime curve
• how mental disordered offender are
treated in criminal justice system
 Introduction

• In the song “Who Killed Davey Moore?” Pete Seeger outlines the death of a boxer.

Each verse portrays the excuse of a different party to the match: the referee, the

promoter, Davey Moore’s manager, the opposing boxer, and the audience. We are that

audience.

• Instead of watching a boxing match, we watch as hundreds of thousands of mentally

ill offenders go untreated or inadequately treated. Mental health professionals, as a

group, are reluctant to go into jails and prisons to serve the needs of this population

and are perhaps more reluctant to bring such patients into their offices and clinics for

treatment. We share the societal fear of this group, no matter the lip service we pay to

treating persons with the most serious mental illnesses.

 Conti…
• Many people who come before the
courts on criminal charges are
either:
• Suffering from a mental illness or
impairment
• Have suffered from mental illness in
the past

• Criminals dealing with a mental

illness or imparment are dealt with
under the Mental health ( criminal
procedure ) act 1990.
 Mental disorder offender ( MDO)
• Is a key topic in forensic psychology
Categories of mental
• This phrase (MDO) is a legal term that disorders offenders

described “ individual who have offended and

experience a diagnosed sever psychological
disorder.
Personality disorders (
• These are the individuals who have been Mental illness
Antisocial personality
(schizophrenia)
diagnosed with one or more of the following disorders)
disorders.
Learning disabilities (
• mental ilnness intelligence or social
• Personality disorders functioning)

• Learning disabilities
• Why it hard to determine whether there is a
link between mental illness and Violence ?
 Free will and responsibility
if a disorder inhibits an individual’s ability to know “right” from “ wrong them an individual can’t be responsible for their own

actions.

However, when an individual knowingly engages in a criminal act, in the eyes of the law they should be punished.

An individual ‘s act to be determined by either biological or social environment factors , the individual should be treated rather

being punished .

 a number of studies have confirmed that mental illness and mental health issues are often under diagnosed by the prison system .

90% includes less serious mental health problem , such as depression & anxiety disorders that are also very common in the

general population

Only 10 % have serious illness or problems

 Crime , Mental disorders and the Media

• The media has significantly influenced how the public perceived mentally disordered offenders and people with mental

illness in general. (people think that all mentally ill people commit crime ).

• It promotes a stereotypes that people with mental health problems are dangeours , based on individual cases that have been

“Hyped UP” like Noor mukadam case or javed Iqbal .

• for example ,generalizing one usually violent case to all individuals diagnosed with disorders such as schizophrenia

• Approximately 68% of crime reported by media where the culprit has a mental disorder are focused around

serious ,murderous & sexual crimes.

• There is often over representation of negative depictions of the mentally disordered with “danger to others” & “criminality”

being the most popular terms.

 Cont..
• For example: The London evening standard ( cheston, 2010)prints a story with the head lines “ Violent

schizophrenic freed to kill younger father at a party” and stated that “ A schizophrenic knife man was freed to

kill a gentle young father. "which creates fear around this word and its associations ,leading some people to

believed that all “schizophrenics” behave in this way .

• Recent films such as shutter island ( 2010) and classic Films such as Silence of the lambs( 1991) & One Flew

over The Cuckoo’s Nest ( 1975), have suggested that mental disorders can be related to acts of violence .

• It is easy to see from this example how this type of headlines can create fear of people , with mental disorders.

• When crime statistics actually show that individuals with schizophrenia are highly unlikely to attacka random

stranger and are more likely to attack a attendent or family members.

 The link : Mental Disorder and Crime
• Not every individual diagnosed with mental disorder engages in violent and criminal activity .

• Furthermore , not every individual that engages in violent and a criminal activity has a mental disorders.

• There were a number of individual who experienced mental health issues and did not report violent and illegal

behavior .

• Although , there may be an increased incidence of violent behavior associated with some forms of mental

disorders , not all people with mental disorders behave violently.

• More recent studies showed that one out of every 20 violent offences is committed by individual with mental

health problems
 Mental illness and crime
• Mental illness capture the psychotic based disorder which features in DSM -5

• The psychotic categories of illness appears in varying severities

• Among them the most severe being schizophrenia ( paranoid )

• Paranoid schizophrenia is the one of the most commonly diagnosed psychotic based

mental illness ; affecting 1 % of population.

• According to DSM -5 violence is considered to be an associated features . This

means that violence is not compulsory diagnostic features of schizopherina . An

individual can be diagnosed with schizophrenia without having been or ever

becoming violent in nature

 THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH,2007)
(cited Swanson etal )

• They described two possible pathways by which individual with schizophrenia may become

violent:

1. one of possible linked to preexisting conditions such as antisocial conduct in childhood ,

regardless of the presence of psychotic symptoms which may be linked to violent behavior.

2. the second pathways is characterized by the psychotic symptoms of schizophrenia that

could led an individual to become violent.

• however, NIMH also recognized that violence is also associated with alcohol, drug abused ,

unemployment, living with family or in a restricted setting ,recent arrest or recent

involvement with the police .

 Personality Disorders and crime
• Offenders can be categorized as mentally disordered due to Personality disorders

rather than a mental illness .

• The most obvious example of personality disorders that is often linked to

criminality is antisocial personality disorders (APD).

 Cont..

• It is important to note that personality disorders that start to develop in

childhood or early adolescence and continue to develop into adulthood

• Consequently, personality disorder are stable & deeply engrained .

• Among those psychopaths is often associated with criminal or

antisocial behavior , and it is highly likely that an individual

considered to be a psychopaths could also be classified as having

APD.

• However, the majority of individuals with APD are not psychopaths.

 Intellectual & Developmental Disabilities

• IDD known as learning disabilities , may impair an individuals’ level of

intelligence & ability to interact with the society ( what is know as adaptive

functioning) .

• Low intelligence is linked with delinquency & adult criminality , with a

particularly increased prevalence of arson & sexual offending

• Offender with intellectual , development disabilities respond well to treatment

• E.g., in a social skill intervention for individual with intellectual and

development disabilities convicted of arson , no participants had reoffended at

12 month follow up.

 Autistics spectrum disordered (ASD)
• In particular , they are thought to be overrepresented in criminal
justice system, being as much as 7 times more likely to come into
contact with police than the general population .

• This can be a problem for high functioning ASD’s suffers , who

typically have reasonably level of intellect, but may have difficulties
in communication and understanding.

• Therefore when ASD’s come into contact with police; they cant
communicate , lack of understanding of situation and may not able
to understand the consequences of their actions ; which inturns
results in their failure to negotiate criminal justice processes.
Age and crime rate curve
 Fitness to plead or not
• The high court rule come up with 3 parts.
• 1. the presumption that the defendant is sane & responsible for their acts are not fit to

plead .

• 2.the defendants must have been suffering “ under a defect of reason or from disease of

defect of reason or from “disease of the of the mind” found not to be guilty than the may

plead

• The defendant must not know the nature and quality of the act he was doing or if he did

know it , that he did not know what he was doing was wrong.”
 MDO treatment & assessment
• The mental health act ( 1983) specifies rules and safeguards for the treatment
and protection of patients . This provides legal definitions od disorders and
criteria for compulsory hospital admission, meaning that if assessed ad
suffering from major mental disorders an offender will be diverted to a forensic
secure unit.
• In 2007,a new mental health act was published that individual more on the
protection of the public.
• The care unit for dangerous and violent individuals' ( like schizophrenia, history
of antisocial behaviour or substance abuse) .
• MDO are managed and treated by multidisciplinary teams ( psychiatrists,
psychologists, social work , occupational therapist, security staff)
• Interestingly ,reoffending rates for thos released from secure unit are low as
compared to prisons, despite the otenserious nature of the original offense
What happen when mentally ill offenders
place in supermax prison

• They are more

likely to disrupt
prison operation
• High restrict
environment may
worsen their
mental illness
 Treatments of in the secure units

• For young and adults MDO , following

disorders are treated :
• Conduct disorders
• ADHD
• depression, anxiety
• PTSD
• ASD
• Psychotics
• Substances abused

Treatment of some specific crime

 Juvenile homicides
 Sexually abusive behavior
 Fire setting
How to quickly prioritized high risk
offending
• LSI-R
• LS/CMR
• YLS/CMI-2.0
• LS/RNR