mental illness and offending

Question 1

what is a mental illness

Answer 1

variety of psychological conditions in which there is a characteristic disabling and distressing impairment in some aspect of the psychological functioning of the individual

Question 2

what is the mental health act 2007

Answer 2

mental disorder defined as “any disorder of the mind”

mentally disordered people who commit offences should receive specialist mental health treatment rather than being punished

personality disorder

mental illness

learning disabilities

autism spectrum disorders

eating disorders

Question 3

why is there a discrepancy between the number of people in prison with a mental health disorder compared to outside of prison?

Answer 3

confounding factors
1) socio-economic status
2) diagnostic bias
3) public perceptions

Question 4

what 5 sections is the the DSM-V broken up into?

Answer 4

axis 1 = clinical disorders
axis 2 = personality disorders, mental retardation
axis 3 = general medical conditions
axis 4 = psychosocial and environmental problems
axis 5= global functioning

Question 5

what is schizophrenia (DSM)?

Answer 5

complex mental illness in which sufferer has problems differentiating real experiences from unreal experiences, has problems thinking logically about issues and to behave as others do in social situations

Question 6

what is the DSM criteria for Sz

Answer 6

delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, negative symptoms (e.g., avolition) etc

Question 7

what is a general personality disorder

Answer 7

an enduring pattern of inner experience that behaviour deviates markedly from the norms and expectations of the individuals culture. manifested in two or more of:

• cognitions
• affectivity
• interpersonal functioning
• impulse control

Question 8

what is antisocial personality disorder (DSM)

Answer 8

characterised by persistent disregard for the rights of others and violations of these rights. sufferers are considered deceitful and manipulative

term not applied to persons under 18 years of age

• failure to conform to social norms
• deceitfulness
• impulsivity
• irritability
• reckless
• lack of remorse

Question 9

DSM diagnostic bias

Answer 9

violence as a diagnostic criterion
- DSM 1: 2% diagnoses included violence as diagnostic criterion
- DSM 3: 47% categories listed violence as a characteristic

Question 10

what is the circularity in the diagnosis of mental illness

Answer 10

why do people commit terrible crimes of violence?
->
because they are psychopaths
->
how do we know they are psychopaths?
->
because they commit terrible crimes of violence
->

Question 11

how does the media shape public belief of dangerousness of mentally ill

Answer 11

become more negative after highly publicised violent incidents involving the mentally ill

Question 12

link et al

Answer 12

compared mental health patients to never treated community residents

mental health patients had higher rates of violent and illegal behaviour

difference was explained by psychotic symptoms

Question 13

Swanson et al

Answer 13

community sample

those who said they engaged in violent behaviour
- 4x Sz or major affective disorder
- 14x substance abuse
- 17x mental disorder and substance abuse

Question 14

Hodgins

Answer 14

study of 15000 people

men: 50% with major mental disorder were criminal

women: 19% of mentally ill were criminal

risks were somewhat greater for violent than non violent crime

Question 15

what is co-morbidity

Answer 15

presence of a disease or condition additional to the one of primary interest and the resulting effect combined

mental illness often has co-morbidity with alcoholism/drug use

Question 16

possible explanation of why there may be a link between mental illness and crime

Answer 16

the mentally ill are more likely to be victims of crime than other people

Question 17

clinical aspects of violence

Answer 17

factors other than mental illness that affect the likelihood of violence

mental illnesses are not always associated with violence in the same way

mental illness not an invariant feature of a person’s life

command hallucinations: voices instruct person to do a certain act (possibly a crime)

Question 18

smith and Taylor

Answer 18

study of male Sz sex offenders
- 94% had delusions/hallucinations at time of offence
- 51% of these, delusions were just coincidental and had no bearing on attack
- 18% gad delusions that appeared to be directly related to the sexual attack

Question 19

McNeil

Answer 19

previous history of violence is the best predictor of future violence

gender is a poor predictor of violence in the mentally ill

being victimised increases the risk of acting violently

caregivers and nurses are at greatest risk of violence

poor social networks associated with violence

homelessness associated with violent behaviour

availability of weapons increases risk

Question 20

responders to offenders with mental illnesses

Answer 20

• criminal justice system
• medical services such as hospitals
• voluntary services
• communities
• family

Question 21

what is the interplay between the criminal justice system and the medical systems

Answer 21

problematic individuals will be diverted into one or the other depending on the capacity there is in the medical system

Question 22

what happens at end of sentence?

Answer 22

parole board will consider
- behaviour in prison
- plans upon release
- likelihood of reoffending
- danger to public
- reason for prison sentence
- previous offences
- what judge said at sentencing
- victim impact statement