Mental Health and Risk of Offending

Despite the fact that not all the people with serious mental health problems are never violent, the involvement of mentally ill people in incidences of mass violence have become an alarming issue in the United States and other nations in the world hence calling for an urgent response. Data from opinion polls shows that an average of 48 percent of the American adults blames the mental health systems for violence in public especially the mass shootings which have been of great concern in the states (Fazel, & Grann, 2006). When there is an incident of gun violence, as it has been a common thing in America, mental health disorder is blamed as being the cause. This puts the rights and freedoms of up to a quarter of the citizens with mental health conditions in jeopardy.

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A major concern for any concerned entity and authority is to ascertain whether psychiatric patients pose dangers to the members of the society. Notorious crimes which have been committed by people with mental illnesses are often wheeled by the media in order to give weight to such fears and hinder the functionality of policies such de-institutionalization of patients with psychiatric disorders (Fazel, & Grann, 2006). Criminal and civil laws by advocating for confinement of psychiatric patients adds weight to the belief that mentally ill people are dangerous as did criminology and forensic psychiatry by giving generalizations based on dramatic, violent acts committed by the mad people. Mental health organizations challenge stereotyping of mentally ill people as a threat to individuals and the community.

The US National Mental Organization (1987) claim that mentally ill people pose no more crime threat than other members of the local community. It is, however, ironical when the central tenet of mental health and risk assessment casts doubt on such statement.

In order to examine the correlation between violent offending and mental disorder it is important to understand what mental disorder is this is a behavioral and psychological aspect that strays from the typical of persons considered to be of normal mental health causing impairment in their functionality in terms of perception, memory and even emotions. There is a distinction between somatic psychoses such as Alzheimers dementia and functional psychoses such as schizophrenia and effective psychosis; and neurotic disorders which are characterized by anxiety, depression and obsessive-compulsive disorder (Wallace, et al. 2004). In particular, based on the case of violence focus is put on schizophrenia which comprises a group of disorders with a characteristic disturbance of thought which causes delusions and perceptions that results in hallucinations and other hyper symptoms, and emotion which brings about blunted effect and damaging symptoms. Schizophrenia is termed as the most devastating disorder a human being can ever experience. It affects both male and female equally and occurs at approximately 1 percent of a given population.

Violent crimes are intentional acts of aggression towards fellow human beings and anything susceptible to harm. In humans, this is a violation of criminal laws. Among the prime violent crimes are manslaughter, murder, and robbery, aggravated assaults which are aimed at producing bodily harm or even death and rape. Before making any conclusions on the relationships between violent crimes and mental disorder, one should consider various studies on different criteria for violent offending. Apparently, literally, it might seem very easy to deduce if there is a relationship between mental disorder and violent offending (Fazel, & Grann, 2006). However, investigations on the possibility of such relationships have been hampered by difficulties in methodologies. It is not very likely to come up with the asymptomatic relationship between the two as it is with the common cold and sneezing.

One of the ways of identifying the relationship is by use of the arrest rates emanating from violent behaviors. In this, the comparison between the arrests rates of the county Department of Los Angeles for Mental Health Patients against the other part of the remaining county adult population. The likelihood of psychiatric patients to be arrested for violent was 1.7 times more than the other group (Putkonen, et al 2003). This review found out that there is an increased patient versus the non-patient arrest rates. Problems in most cases arise with the interpretation of the evidence of studies on arrest rates. The community comprising the general members of the public are not an adequate control group from the discharged psychiatric patients from public hospitals. Hospitalization of such patients may have been due to their violence.

Therefore the best way to predict future violence is by use of the past violence. Additionally, police arrests may influence the rates due to bias based on age, sex, race or social status. Criminalizing mental disorder takes away patients from medical care system to criminal justice system. Field study carried out by the Teplins in 1984 found out that those people who show signs of mental disability were more likely to be put under arrest than those with no mental disorders, even when the intensity of the offence is kept constant. And in another study, it was found that former violent offenders who have been released from the hospital are more likely to be re-hospitalized again than being re-arrested. On the other hand, if violence is an indicator of mental disability, then the offenders will be diverted into criminal behavior psychiatrization (Putkonen, et al. 2003).Therefore hospitalization and arrest become correlated. The more one become involved in violent crimes the more he/she will be labelled as being mentally ill, which might result in the clientele for the psychiatric health care system.

Investigating violent behavior independently from arrest and a conviction can be a better method to study the relationship between mental illness and violence offending. Even though violent behavior is not same as violent offending, there is a possibility of similarity in etiology. Psychiatric reports show retrospective information pertaining the behavior of the patients days and even weeks before their admission (Fazel, & Grann, 2006). The results cannot be generalized readily to the entire population of psychiatric patients dwelling in the community since violence had probably started just before their admission and maybe various exaggerated parties having their own motives.

What about their violent behavior during their stay in the hospital?

Approximately, about 17 percent of the patients attacked another person physically within their first week of hospitalization (Soyka, 2000). However, such result does not give a concrete evidence as to answer the question of whether this was only limited to mentally ill patients other than the non-mentally ill patients in psychiatric clinics. This should also be accompanied with effects of the administered medication on violent behavior.

Highly rated acts of violence by mentally ill people affect not only the public but also the psychiatric experts. Clinicians are always under pressure of assessing their patients for any potential act of committing violence. Though it is quite simple to make generalizations on relative risk assessments, it is not possible to give a prediction on individuals behavior and specific violence acts given that such a person can be perpetuated by hyper emotions to commit such offenses. During their sessions with the clinicians, the patient could be calm, thoughtful and maybe guarded thereby coating any signs of violent Intentions (Soyka, 2000). Even if the patient openly expresses any signs of aggression towards someone, the relative risk of committing the offense is still under the significant influence of the life conditions and the clinical environment.

In conclusion, there are no tangible evidence that points out direct relationship between violent offending and mental disorder. However, the contribution of mental disorder to violent offending in the community is not arguable against. Although research has shown that psychotic conditions are correlated to violence, though such symptoms are rare and are in no way significant as community breakdowns, and similar factors caused by illegal/violent behaviors. Increased rates of violent behaviors among the psychiatric patients are likely to be caused by the few who possess long-term and severe psychotic conditions such schizophrenia which has a characteristic predominant disorder. Although civic education and campaigns claim that mentally ill people are just equally capable of committing violent crimes as those who are not mentally ill, equal caution should always be taken upon the common stereotype of psychiatric patients as violent and unpredictable offenders.

References

Fazel, S., & Grann, M. (2006). The population impact of severe mental illness on violent crime. American Journal of Psychiatry, 163(8), 1397-1403.

Wallace, C., Mullen, P. E., & Burgess, P. (2004). Criminal offending in schizophrenia over a 25-year period marked by deinstitutionalization and increasing prevalence of comorbid substance use disorders. American Journal of Psychiatry, 161(4), 716-727.

Putkonen, H., Komulainen, E. J., Virkkunen, M., Eronen, M., & Lonnqvist, J. (2003). Risk of repeat offending among violent female offenders with psychotic and personality disorders. American Journal of Psychiatry, 160(5), 947-951.

Soyka, M. (2000). Substance misuse, psychiatric disorder and violent and disturbed behaviour. The British Journal of Psychiatry, 176(4), 345-350.