Psycholegal Contexts and Insanity

Question 1

What is Diminished Responsibility?

Answer 1

If a judge considers there is Diminished Responsibility they may reduce sentences i.e. Murder > Manslaughter.

On a charge of murder, it shall be for the defence to prove that the person charged is by virtue of this section not liable to be convicted of murder.

A person who but for this section would be liable, whether as principal or as accessory, to be convicted of murder shall be liable instead to be convicted of manslaughter.

The fact that one party to a killing is by virtue of this section not liable to be convicted of murder shall not affect the question whether the killing amounted to murder in the case of any other party to it.

Question 2

R v Byrne (1960)

Answer 2

Patrick Byrne was 27 years old when he murdered Margaret Brown (21).
He mutilated the body under the influence of ‘irresistible impulses’ beyond his control.

The defence plead under the Homicide Act Diminished Responsibility provision.

Court upheld the plea, and whilst the sentence type and length remained unchanged (life in prison), his conviction changed Murder>Manslaughter.

“Abnormality of mind” was accepted as a state of mind so different from that of ordinary human beings that a reasonable man would term it abnormal.

Question 3

R v Vinagre (1979) – the limits of the law.

Answer 3

Vinagre suspected murdered his wife on believing she was having an affair.

Pled diminished responsibility due to ‘Othello Syndrome’(Pathological jealousy – not a recognised mental health condition)

Court upheld the plea (sentence 7 years manslaughter), with significant caution. Court of Appeal : Lord Lawton considered evidence ‘flimsy’ and unfair to the victim.

Revision to the Homicide Act was needed.

Question 4

Homicide Act 1957– amendment in Coroners and Justice Act 2009

Answer 4

“Where a person kills or is party to a killing of another, he shall not be convicted of murder if he was suffering from an abnormality of mental functioning which -

Arose from a medical condition

Substantially impaired the ability to do one or more of i) understanding the nature of their own behaviour, ii) form a rational judgment and iii) exercise self-control.

Provides an explanation for the person’s acts and omissions in doing or being a party to the killing.”

Question 5

What is not Diminished Responsibility?

Answer 5

What is the difference between voluntary and involuntary behaviour?

Issues of ‘Self-control’ and ‘Rational thought’ that are inherent to Benthamite, ‘classical’ criminological theory.

[Rational Choice Theory -> Preference = Benefits – Costs]

Question 6

R v Tandy (1989)

Answer 6

Defendant had alcohol dependency issues. Killed her 11 year old daughter by strangulation. Defendant was under the influence at time of offence - had drunk nearly a bottle of vodka, more than her usual drinking

Convicted - however DR attempt was unsuccessful - the appellant had demonstrated in her evidence that she had exercised control over her drinking.

She also able to stop drinking at 6.30 pm on the day of the killing despite the fact that the bottle was not yet empty.

Question 7

R v Wood (2009)

Answer 7

Defendant had alcohol dependency issues. Killed a man performing an unwanted sex act Defendant was not under the influence of alcohol at time of offence

Convicted - however successful DR appeal.
In part because Judge mislead the jury – “these observations implied that unless every drink consumed that day by the appellant was involuntary, his alcohol dependency syndrome was to be disregarded” – which misrepresented alcohol dependency diagnosis.

Question 8

R v Stewart (2009)

Answer 8

Defendant had alcohol dependency issues. Killed a man in a fight.
Convicted - however successful Diminished Responsibility appeal.

In part because Judge mislead the jury about the nature of alcohol dependency.

Question 9

Diminished Responsibility and Insanity

Answer 9

The legal system still uses the term insanity.

Diminished Responsibility law is focused on a particular point in time (state).
Insanity is when someone shows impairment near-permanently (trait)
Use of ‘insanity’ in legal contexts has a long history –
Evidence in early Muslim, Roman, Hebrew and Greek laws.

In English law:
“A man that is totally deprived of his understanding and memory, and doth not know what he is doing, no more than an infant, than a brute or a wild beast, such a one is never the object of punishment”
– Rex v Arnold, 1724

Question 10

What is Insanity?

Answer 10

Insanity is a functional legal term (never used in medicine/psychiatry)

Why do we have it?
Considered ‘unfair’ to punish those with diminished capacity. (we punish based on ‘just world’ and rational choice assumptions)

Punishment is purposefully retributive (what if no criminal intent?) and a deterrent (what if someone cannot understand the deterrent as that – because they do not conceive their behaviour as criminal)?

Criminal responsibility is based on allocated Mens rea (a guilty mind) to an offender (not applicable to all those with MHCs)

Question 11

History of insanity

Answer 11

James Hadfield shot King George III on ‘orders from God’ (1800).

This is the peak of the ‘enlightenment’ era (medicalisation of mental health) and few people believed Hadfield genuinely heard the voice of God.

During treason trial it was considered that Hadfield was delusional due to head injury on battlefield. Physicians argued this in court in a pivotal role for medicine.

Hadfield was acquitted due to being under the influence of insanity.
‘Not guilty by reasons of insanity’ (NGRI) becomes a term

The current precedent is based on the M’Naghten Rule (1843)

Daniel M’Naghten tried to kill PM Sir Robert Peel but missed, killing Peel’s assistant, Edward Drummond.

M’Naghten defended himself by saying he felt persecuted/stalked by the ‘Tories’.

Again, doctors testified at the trial, with nine medical experts arguing that M’Naghten had ‘paranoid persecutory delusions’

Question 12

Current use of Not Guilty by Reasons of Insanity (NGRI)

Answer 12

Public perception of NGRI is overwhelmingly negative - Perlin (1997)

NGRI is seen as a ‘loophole’ or ‘refuge’ or ‘technicality’.

However it occurs in only 1% of US cases and is only successful 25% of the time (see Kirshner & Galperin, 2001).

Most often used in non-homicide offenses (2:1 ratio, Perlin, 1997)

Question 13

Outcomes of Not Guilty by Reasons of Insanity (NGRI)

Answer 13

Consequences for NGRI – only 1% go ‘free’ (Silver et al., 1994)
84-95% are hospitalised (Silver et al., 1994)
Most US states have an automatic sentence of 60-days of committal into a hospital.

New York re-arrest rates are markedly different (Miraglia & Hall, 2011)
After prison: 42% Females / 56% Males
After committed to Hospital:2% Females / 14% Males

Question 14

Summary

Answer 14

We have Diminished Responsibility law (Homicide Act, 1957) for moments of psychopathological behaviour (i.e. States)

We have Not Guilty by Reason of Insanity law (based on the M’Naghten rule, 1843) for long time inability to understand right from wrong (i.e. Traits)

All this law is based on rational choice psychology/criminology –there is a ‘guilty mind’: mens rea

Question 15

Do mental health issues/mental disorders relate to crime?

Answer 15

Lots of press coverage link mental health concerns to offending behaviour (Corrigan, 2005)

Many popular TV shows/films feature the link between MHCs and criminal justice (implicitly and explicitly)

In 2006 a national survey reported:
60% of people thought schizophrenia diagnoses increase risk for violence
32% of people thought depressions diagnoses increase risk for violence.

Question 16

Depression

Answer 16

Swedish population study – 1,796,908 people (Fazel et al., 2015)
Over 3 years, 3.7% of depressed men and 0.5% of depressed women violently offended.
Depressed individuals were 3.0 times more likely to violently offend than matched, healthy, adults.

Question 17

Four key points on the l.ink between MHC and crime

Answer 17

The vast majority of people with MHCs are not violent. (Steinwachs, Kasper & Skinner, 1992)

There are heightened numbers of people with MHCS in arrest and incarceration rates compared to population. (Skeem, Manchak & Peterson, 2010)

Risk factors to offending behaviour within the group of people who have MHCs are the same as those who do not have MHCs

The danger to ‘public’ posed by violent individuals who have MHCs are relatively low – risk to MH personnel and families is higher (Solomon et al, 2005)

Question 18

Cluster A

Schizophrenia-like ‘eccentric

Answer 18

Paranoidpersonality disorder
Schizoidpersonality disorder
Schizotypalpersonality disorder

Question 19

Cluster B

Emotional/Erratic

Answer 19

Antisocialpersonality disorder (ASPD)
Borderlinepersonality disorder (BPD)
Histrionicpersonality disorder
Narcissisticpersonality disorder

Question 20

Cluster C

Emotional/Anxious

Answer 20

Avoidant(or anxious) personality disorder
Dependentpersonality disorder
Obsessive compulsivepersonality disorder (OCPD)

Question 21

Personality Disorders: Cluster As - Presentation

Answer 21

Prevalence:
Paranoid (PND) PD – 0.5 to 2.5% gen pop (higher in males)
Schizoid(SZD) PD - <1% gen pop (higher in males)
Schizotypal(SZT) PD – 3% gen pop (higher in males)

Symptoms:
PND-suspicious/conspiratorial disposition, sees hostility/contempt
SZD-emotionally cold/in-intimate, dispassionate, prone to fantasy
SZT-social anxiety/avoidance, discomfort around others

Elevated engagement with most types of violent crime.
Nearly 1 in 3 with a Cluster A Dx have conducted vandalism or threats

Question 22

Personality Disorders: Cluster Bs - Presentation

Answer 22

Prevalence:
Antisocial (ASPD)– 1-5% gen pop (higher in males-terminology?)
Borderline(BPD)– 5-6% gen pop (higher in females)
Histrionic (HPD)– 2-3% gen pop (higher in females)
Narcissistic (NPD)– 1-6% in gen pop (higher in males)

Symptoms (quoted):
ASPD- remorseless aggression, lack of empathy, learning issues
BPD- distorted identity, chaotic interpersonal life, abandonment issues
HPD- dramatic, flirtatious, overly emotive, sexually provocative
NPD- excessive self-admiration, fragile identity, manipulative

Elevated engagement with most types of violent crime.
Nearly 4 in 10 with a Cluster B Dx have conducted vandalism or threats

Question 23

Beyond medical ASPD: Psychopathic personality

Answer 23

APSD is the attempt to put a consensus on psychopathy into the DSM/ICD.
In the end ASPD and Psychopathy are similar but distinct.

Psychopathy is now largely understood as three things according to Patrick, Fowles, & Krueger, (2009) that vary naturally as personality traits):

Boldness – confidence & fearlessness, AKA Fearless Dominance / low Neuroticism
Meanness – callousness & manipulation, AKA Coldheartedness / low Agreeableness
Disinhibition – restlessness & externalising AKA Self-centred Impulsivity / low Conscientiousness

Question 24

Biology

Answer 24

Related to the so-called ‘Warrior Gene’ - Monoamine Oxidase A (MAOA)

MAOA has a role in regulating serotonin and catecholamines.
In some mutations of MAOA there is diminished/problematic functioning of anxiolytic hormones, which is known to relate to aggression and lack of anxiety.

But this is not simply a permanent genetic effect. Many studies highlight how MAOA increases risk of ASPD development in those under exposure of other risk factors

Question 25

Summary

Answer 25

Cluster A and B personality disorders have been related to criminal behaviour

Some of Cluster B i.e. ASPD have been directly related to criminal behaviour – in part due to the Boldness (lack of anxiety – i.e. MAOA), Meanness and Disinhibition (related to PFC)

However, overall mental health and crime relationships are nuanced and due to many other factors. i.e. potentially incidental peak diagnosis rates.

Most mass offenders do not have mental health conditions and those who have mental health conditions are most likely to hurt themselves and those immediately around them compared to strangers (if they offend)