Mental Illness and Crime Flashcards
Public perception of MI and violence
Attitudes to mental health should improve by increasing public health literacy - done through anti-stigma programmes
Endorsing biological causes for MI may add to stigma and increased social drift - infixable
People can view those with MI as detached and dehumanised
Need to start programs early - can make modest change
The Guide Cymru
new anti stigma program that measures knowledge, stigma to others, anticipated stigma, self-stigma, good MH behaviour, willingness to seek help
As knowledge increases, good MH increases and self/other stigma decreases
Examine the number of patients with a psychotic illness in criminal settings and compare to controls
People with psychotic illnesses are over-represented in prisons
Violence can be used to define an illness - lead to over-representation and more readily diagnosed
People with mental illness may be more likely to be sent to prison, e.g. could have better outcomes if sent to correctional facility
People with mental illness can have differences in age/social status which can affect odds of being in prison
Examine violence records of clinical patients with and without psychotic illness
Violence is often used to define MI again and contributes to being a clinical inpatient, rather than the MI itself
Proportion of people in a community who become violent and psychotic
Overlap in definitions which are prone to bias
Cross-sectional data that doesn’t inform of causal relationships - other confounding variables
Social drift and substance abuse to cope with MI could lead to higher risk for violence exposure
Examine discharged patients’ violent crime rates
Ethical concerns of releasing potentially dangerous people
Already been institutionalised - often get there as they have been violent in the past
Potential confounds
Age - younger
Gender - mostly male
Social class - typically lower
Institutionalism - typically spent a lot of time in them
Social issues - more likely to experience social drift which increases exposure to substance, little support and criminality
– when controlling for these confounds, mental illness and violence has a weaker relationship - but controlling for these neglect that they are inherently interlinked and could create the risk for each other - still predictive?
Bonta et al. - recidivism
Criminal history was strongest predictor of violence
Clinical variables were smaller
VRAG - MI + risk
Diagnosis of schizophrenia a predictor
Harris - discharge + crime
7 year follow up
found negative relationship between schizophrenia and reoffending from clinic for very violent offenders
BUT most offenders in this were psychopaths - who have high recividism rate so would look smaller in comparison if comparing the whole group
Total birth cohort - Arseneault et al.
No selection bias
Ongoing study of birth cohort in one year in Dunedin
Looked at violence through self report and crime stats
Measured personality and presence of MI
Substance and alcohol abuse mostly increased chance of offending
Schizophrenia was 2.5x more likely to be violent
- moderated by delusions of excessive threat
Threat-Control/Override (TCO)
Threat - believe that people want to inflict harm on them
Control/override - things that control one’s behaviour - e.g. justification of violence due to the perceived threat
Schizophrenia - Negative symptoms
Flattened affect
Reduced speech
Lack of initiative
Positive symptoms
Delusions
Hallucinations
Disorganised speech
Link et al. - Delusions and TCO
Self-report of violence over past 5 years
Self-report and psychiatric interviews to assess mental illness
Found increased rates of violence and weapon use associated with TCO symptoms
