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A Review of the "Mental Illness" Definition Might Prevent Crime
An anonymous reader writes "Following a BBC report showing abnormal variation in the number of people taken into police custody with mental health problems, concerns have been raised about the legal definition of "mental illness". Prof. Steve Fuller argues that a much sharper legal distinction is required to ensure criminals with mental disorders are not released without appropriate treatment. Fuller distinguishes between two cases: a 'client', who pays a therapist and enjoys a liberal, level-playing field in face-to-face interactions, and a 'patient' who is being treated by a doctor for a particular disorder. If the former relationship cannot be established due to person's mental state, then the latter one should be enforced. Thus, Fuller calls for 'a return to institutions analogous to the asylums of the early 19th century.'"
have an audience for this?
Need more mental health centers not prisons with 23/7 lock down
...who decides. We've all exhibited behavior at one time or another that could be interpreted as antisocial, and with our paycheck-to-paycheck lifestyle and less institutional family connections, it's very possible that someone involuntarily committed may find literally all of their worldly possessions gone when they come out. Such involuntary confinement could be used when someone in authority finds something otherwise noncriminal to be abhorrent. There are numerous examples of countercultures throughout our fairly recent history that were investigated by the authorities, and it was bad enough without those people having to particularly worry about involuntary confinement attributed to supposed mental illness.
Who decides, what they can compel, and how that person's life is managed while they're institutionalized are all very, very important factors in if it's even possible to use involuntary medical-based confinement or not.
And that doesn't even begin to address costs. While I don't care for it, it's possible for prisons to get some return on their costs by using prison labor to do things that don't really pay the prisoners but do pay the prison. If someone's committed for what's supposed to be a mental illness problem, it's doubtful that using that person for profit for the institution would really be possible.
Do not look into laser with remaining eye.
It is my understanding that you get punished once for being a criminal. With a so called diagnosis associated with you for whatever reason, sensible or not, that type of personal information probably be used against you for life.
Apropos of nothing, let me ask a question.
Can people be cured of mental health problems?
I recall a study comparing the rates of people getting off drugs while on psychotherapy with those getting off drugs on their own.
I also recall a study where completely sane people were checked into a mental institution (under a false name, as a test case) with instructions to pretend symptoms for awhile, but then pretend to be completely cured. Their status was never set to "cured", rather it was "condition, under remission".
So have there been any studies showing that mental health treatment is effective, or is psychotherapy more akin to lie detectors and phrenology?
(A related question, is there good sensitivity between the various mental health diagnoses with different treatments? Meaning, if the condition A treatment is different from condition B, is there a sharp, easily-recognized distinction between the symptoms for A and B?)
I think Prof. Fuller should be in therapy. If he disagrees, it must be because he's "not in the appropriate mental state to operate in such a relationship", in which case his need for treatment "may need to be legally enforced.”
I've read that statistically, schizophrenics are more likely to be victims of violence, from people who misunderstand their behavior (stand your ground *cough*) than to commit violence...
So, who should be locked up?
(too early in the damn morning to try and look up a cite.)
Are we responsible for the crimes we commit? If we are mentally ill, then surely we're not responsible. And if we're not responsible, then surely we need to have another "protected class" of people defined to prevent harassment, discrimination and unjust punishment. What they are attempting to do is reduce and even remove freedoms and rights which are both natural and constitutionally guaranteed. I'm not going to say that mentally unstable people should have access to dangerous things such as cars, knives, heavy bludgeoning devices and especially not firearms. If someone is indeed a "danger to society" we need to be serious about it -- very serious and very consistent. To deny someone their rights such as the right to self defense while at the same time not affording them appropriate protections under the law to compensate creates an extremely unfair situation.
Wouldn't this open the door to the government having people institutionalized simply because they're politically inconvenient? Say, someone is arrested for taking part in a political protest, are "diagnosed" as having some sort of vague mental disorder, refuses "counseling" to "cure" the condition, and is then compelled to "treatment" for it, effectively imprisoning them, medicating them, until they change their opinions? Isn't this the same shit that happens all the time in China to citizens merely demanding that the law be enforced? Do we really want to go there?
Are YOU using the TOOL, or is the TOOL using YOU? Think about it!
I do not think that having mental problems in Great Britain is a good idea: http://www.dailymail.co.uk/news/article-2516270/Pregnant-woman-unborn-baby-girl-forcibly-removed-caesarean-social-workers-obtain-court-order-suffered-mental-breakdown.html
They've sent her to the hospital, drugged her, cut her baby out of her and gave away the baby of this italian mother for adoption in the UK because even though she is on medication and made a full recovery she might one day have mental problems again. The baby will not even grow up in italy.
Just wow.
"Preventing" crimes is not justice. Locking up innocents to "prevent" them from committing crimes is essentially the opposite of justice.
Also, note what they're preventing: "crimes". Not violence or any action that harms anyone. "Crimes" encompasses all manner of disobedience toward authority, regardless of whether that authority is legitimate. Example: Man faces felony charge over trimming shrubs. Not a crime: DEA locks up a student, forgets about him for 4 days with no food or water.
On one hand, as you say, criminals could exploit a wider definition of insanity to get a lighter sentence, on the other hand, authorities can use it to incarcerate troublemakers without having to take them to a court, because they obviously need treatment for their "sluggish schizofrenia".
AccountKiller
Very bad.
"If any question why we died, Tell them because our fathers lied."
I'd agree if the old Asylum system hadn't be abused in such horrific ways in the past. The exact same thing would happen again. I think the one thing we've learned from our current system is that people with mental illness can usually lead happy productive lives. There's even growing evidence that the "voices" schizophrenics hear are actually beneficial for them (their psyche is trying to express itself) and our forced treatment and mistreatment of those afflicted does far more harm than good. We need to find better ways to help the mentally ill, but locking them up and forcing treatment just harms them further. If we had treatment centers that were more like elderly hospice care, then maybe. But we'd be right back to cinder-block buildings and padded rooms as soon as someone got a bill.
Ah, yes, Comrade! Those of us true to the Collective have always known that the Hooligans and Reactionaries had something wrong in their heads! Probably from a vodka deficiency or something.
I, for one, welcome this! It's time we lock away all the dissidents until they learn to love Big Brother -- er, I mean, Dear Leader.
In times of universal deceit, telling the truth gets you modded -1 Troll
Careful. The legal definition of insanity is in place to prevent people from exploiting the definition to get away with crimes.
The definition is largely "do you know that what you did was wrong."...
"Well, not wrong. Illegal, sure, but not wrong in any moral sense."
Now what?
How inappropriate to call this planet Earth, when clearly it is Ocean.
I think that's enough Internet for today...
Seriously... you need to turn off the TV, turn off the radio, and the Internet for awhile. Go camping or something, just get away from the self-force-feeding of so much negativity.
Do not look into laser with remaining eye.
Do you honestly think that an effective counter argument? Really?
In the context of a court, right and wrong is legal and illegal.
So they are a distinction without meaning in this instance.
Your move.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
I know, on /. we don't need to. But it seems to me that the point that the Fuller appears to be making is that the current environment (presumably in the UK where he practices) is that a very large number of people are diagnosed with "mental illness" which is fine if they are continuing to be largely functional, seeing a therapist of their choosing, etc. The problem is that when someone is arrested the question of "mental illness" has two different dimensions ... is the person legally responsible for their actions (the legal dimension) vs. is the person undergoing treatment (or has ever undergone treatment).
People who are not responsible for their actions are a tiny minority. But IF someone has been identified as not responsible for their actions, why are they left roaming the streets? That isn't fair to them or to society.
Admittedly, there is always the question of "who is to say" and that begs the question to appropriate due process (clearly, it shouldn't just be some random doctor or family member has nominated them for commitment). And clearly there were abuses in the past. I don't think Fuller is the first to notice that the current situation is arguably worse (fraction of homeless people who are seriously ill ... of course, that begs the question of whether their mental condition caused the homelessness or the other way around :).
I'm far from sure that I agree with Fuller, but the vast majority of the comments seem to be missing his core argument.
the problem is that the medical model is nowhere effective at understanding, diagnosing and treating mental disorders as the physical medicine disciplines. already many people get diagnosed and forced onto a drug therapy route, which doesn't treat the disorder, inhibits their learning, awareness and motivation to the point that they become unable to seek out effective avenues, and the psychiatrists just up or change the drugs and ignore their ineffectiveness. people get trapped in a life of legally enforced drug dependence that benefits only pharmaceutical companies. people who make suggestions like in the article believe that the medical model and standard therapies are more effective than they are. people will.get unwell, forced to take treatments that don't work for the rest of their lives, and just be a drain on the taxpayer, being unable to work, and being able to do little other than blowing their state benefits on tobacco and alcohol. the people who make such suggestions have no experience of actually being a mental patient, nor how ineffective typical medical treatment is. this is the unfortunate reality of mental health, where successful recovery happens in spite of the system, not because of it, and successful methods that are not profitable to pharmaceutical giants are seriously underfunded even when reported in the literature. end rant. sent from a mobile, so apologies for typos.
John_Chalisque
I spent 25 years in the mental health system regarded as a seriously bipolar person. Turns out it was caffeine and to a lesser extent chocolate and a host of medicines that was causing the effect. I've been 5.5 years now symptom free. Never forget to eliminate environmental causes for mental and physical health issues!
The definition is largely "do you know that what you did was wrong."
A very large number of people in prison are there for things that every thinking person knows are not wrong.
Give me Classic Slashdot or give me death!
Just because you get arrested and taken to the police station does NOT make you a criminal. Being convicted of a crime is what makes you a criminal. So far the summary is just plain wrong and makes me wonder if the article is any better.
The police arrest a lot of people that they end up letting go, whether or not charges are brought up against them later. None of those people are criminals, unless they have been previously convicted of a crime.
Be seeing you...
From my experience, the idea that we need regress back to using "asylms" for unstable individuals is completely backwards.
I suffer from bipolar disorder type 1, and had a recent manic episode almost a year ago right after moving to a new state. A major problem with bipolar is that the individual isn't aware of how disfunctional they are once they're in the thick of it.
Before my episode was in full swing, my family and I tried to get myself voluntarily commited to a spych ward for treatment. To be admitted you have to go through the ER system. The only problem is that most ER's in urban centers are completely swamped and patients suffering from mental illness are given last priority. So basically you end up with a mentally unstable individuals stranded in the waiting rooms across the country waiting for a bed. Then, if you get a bed in the ER, you will have to wait however long it takes for a room to open up in the spych ward. They will not medicate you, because they don't have the authority to treat you without a proper psych evaluation, which you can't get until your in a spych ward.
So what happened to me in the end was that the ER was too stimulating for my manic brain and was making me dysphoric(dangerously grumpy) from being in an environment that was the opposite of therapeutic. So I would have to leave the hospital to maintain what sanity I had left. This happened in two different ERs. I was in the waiting rooms for an average of 6 hours.
Two days later, my mania was worse than imaginable and my significant other couldn't do anything till my behavior became dangerous enough that he could contact social services to have me involuntarily committed to the very same psych ward I tried to get into 2 days earlier. It was a 72-hour hold. And since my partner was the one that committed me, I had to go to court against him to be released by the state once I was coherent.
An absolute nightmare. Before they consider committing people to asylums, the medical system needs to drastically improve the availability of mental health services in these kinds of situations.
When I was young, during my first episode, at the Stanford hospital I waited more than 24-hours in the ER without any treatment before they had a bed available upstairs. And once I got in the ward, it was the weekend so they didn't have any treatment services available other than throwing sedatives at me until a psychiatrist could prescribe the proper medication.
As someone with major mental illness who also spent time in gaol for a heinous crime, this is a terribly thorny issue. Due to the trend of "community based care", many patients stuff up their meds, and so end up committing crimes. As there is a lack of proper care facilities, we end up incarcerated in prison. This is a hell of a scary place for anyone, let alone someone with mental illness. Prison Mental Health is a joke, as it concentrates on the use of Seroquel for behaviour management, and there is absolutely no focus on life skills or therapy. Furthemore, prison officers are not mental health nurses, yet in the facility I was incarcerated in, about 2/3 of inmates were on psych meds.
In many respects, the old 19th century model of asylums (i.e. secured hospitals) could well be a better way to reduce recidivism, and to help patients learn to manage their disease and life. Prison certainly doesn't help - I came out more unstable than when I went in, as well as being traumatised by the rapes, stabbings and suicides.
Yes, prison is a consequence of action, but for those who commit a crime when unwell, but fail the test for diminished responsibility (it can be hard to prove you didn't know you were doing wrong, let alone deal with how you might know that society/law judges your actions wrong, but due to delusional thinking you think you're justified in your actions) it usually only makes things much worse. Hence the suicide rate in prison and amongst parolees.
Just like everything else involving the State, they have their own legal redefinition of the words "right" and "wrong", in order to make sure things like morality or logic don't get in the way of convicting people. M'Naghten rules.
Liberty in your lifetime
That flies in the face of hundreds of years of law and right into the bizarro world of zero tolerance.
Say someone puts a tiny baggie of pot in your car ( or it just falls from their pocket. You had no idea it was there at all. Doesn't matter, that'll be a year for you. You possessed it and your state of mind (total unawareness of it) is no excuse.
The definition is largely "do you know that what you did was wrong."... So if a talking banana told you to do it, it doesn't really matter. You knew it was wrong and chose to do it anyway. You should have ignored the talking banana.
"I did ignore it, but then it produced a National Security letter saying I had to do it and that I wasn't allowed to tell anybody."
"I see. Case dismissed."
Try that in court... it should be fun.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
They are called Banks
Good response, brilliant insight. Thanks for that!
I have to disagree... If I get strep or pneumonia, they give me a z-pack and bam, it magically goes away. If I have a broken finger, they give me vicodin and bam, I magically don't care about the pain (though yes, the finger itself just takes time to heal). If I have insomnia, they give me ambien and bam, I can magically sleep again. When my knees or hips eventually wear out, they give me new ones and bam, I magically get to walk for another 20-30 years. And keep in mind that many of our "magic bullets" work on a larger scale and longer term scale - Vaccination, water sterilization, sewage treatment, annual physicals, etc.
Wow - great response. Thanks for that!
Well then lets just define legal and illegal as "whatever you think or feel at the moment"... what could possibly go wrong?
Obviously we need laws that are static and not subject to the whims of any person at any time whenever convenient.
If you're saying we have too many laws or that we've made a lot of things illegal that shouldn't be illegal... then I totally agree with you. But the problem is that laws are passed through a political process and many of the political factions like those laws.
Our current system of government thrives on playing people off against each other to make sure that no one gets what they want. You have faction A and faction B and while both factions want things they also want to frustrate the other factions. As a result, you can pass laws no one likes so long as the other faction doesn't like it either.
How to get out of this box? Two ways.
1. One party where there are no opposing factions. That doesn't mean there aren't other factions. They just don't oppose any government action what so ever. Imagine a government where it was illegal to be a republican or a democrat but not illegal to be a democrat or republican. That's basically what happens. Often the whole thing is run by some strong man like a putin or a chavez... and anyone that disagrees disappears.
2. Limit the power of government so much that it isn't worth fighting over for most of the factions. They are ultimately fighting over money and power. If you limit the power of government so it isn't useful for those purposes then you avoid the problem entirely.
Those are your choices.
Door 1 or door 2 or "this." Pick one.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
Yes, rebels without a clue that should be put away
... of the many (former )criminals in the West that have been released back to the society, some of them were released solely based on the political reasons ~ such as they were of the "under privileged group" and so on
And once they were released back to the society they commit crimes again, and again, and again
Although I've been an American citizen for more than 3 decades, as a person whose origin was not from the Western nation, I can NOT understand why on earth the Western society is more willing to put more innocent people on the harm's way than locking up those crazy fuckers?
I mean, who cares if they were from the "under-privileged groups"? Who cares if they were from "broken family" ? Who cares if they were being "abused" before they commit their crime ?
Why is the human rights of the criminals that MUCH MORE IMPORTANT than that of their victims ?
That is the ONE THING that I can never understand, despite having to live in the West since the early 1970's.
Muchas Gracias, Señor Edward Snowden !
Sure. A great nation though, definitely in the argument for top five all time. Largely settled by the outcasts, prisoners, and the general detritus of other nations (fist-bump Ozlanders) with a population that has a predilection to shortcuts and a questionable moral compass, America has more than a few citizens from a lineage seemingly predisposed to risk-taking. You do realize the founding fathers would've been hung for treason if the Redcoats had won the war.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
In a perfect world. not this one
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
While Fuller admits this may seem extreme, he also believes that such an approach would “send much clearer signals to society about the status of the ‘mentally ill’, a category whose current vagueness will otherwise continue to contaminate public life and interpersonal relations.”
wow... sounds like this guy wants to start internment camps. scary stuff.
Anons need not reply. Questions end with a question mark.
" You should have ignored the talking banana."
"I did ignore it, but then it produced a National Security letter saying I had to do it and that I wasn't allowed to tell anybody."
"I see. Case dismissed."
"The court is now entering a closed session. You are charged with violating the Patriot act by openly talking about a National Security letter."
AccountKiller
One thing that the BBC article highlights for me, is the need for police training in this area. I believe that most police officers lock up a mentally ill person because they don't know what else to do with them. Giving the police basic mental illness triage training would make both the mentally ill and the officers lives easier.
Do you honestly think that an effective counter argument?
No, of course not. But it sort of baffles me how Americans (or the entire English-speaking part of the world?) do not differentiate between wrong and illegal, and I wonder what would happen if I accepted that an act was illegal but did not agree that it was wrong. Would it be important to my questioners that I say that I did something "wrong" (rather than just illegal)? Would the they even understand the difference?
How inappropriate to call this planet Earth, when clearly it is Ocean.
You're just proving his point. You need to stop taking in all that shit 24/7 and go fucking relax.
For large sets, this will be our guide even unto death, for the LORD will work for each type of data it is applied to...
I do actually... I just didn't bother making that distinction in that sentence.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
That comment sounds awfully violent, quite incoherant, and just generally unhealthy. Perhaps you should seek help at one of our many mental health facilities...I mean whether you want to or not....it's for everyone else's safety after all...
Who doesn't like Aldous Huxley? My post should be moderated up to "funny."
There is a cure for your daughters condition. Have a Doc prescribe her around 40 MG of Dexedrine a day, combined with a high dose of an SNRI (Wellbutrin or Effexor XR).
Considering you have ADD and the fact that it IS without a single doubt hereditary, there's a pretty strong chance that her "condition" has been diagnosed as a personality trait rather than what it really is (a neurological deficit).
ADD in girls is usually of the inattentive type and most therapists will overlook it and label her currently poor coping skills as a personality disorder.
I cannot stress you enough that therapy alone will only bring her more frustration and in return only exasperate her condition.
Therapy alone is worthless.
You will never ever "Cure" someone who suffers from ADD without treating the underlying neurological condition.
(That and might want to get your nephew off of the goddamn lithium, geodon or whatever ilk they're pushing him.)
perpetually dwelling in the -1 pits
Umm, she does have ADD (combined type), but that's trivial to manage, and is managed. As for coping skills, after years in treatment, including full-time residential treatment (after multiple serious suicide attempts), she has excellent coping skills when she chooses to use them. Keep in mind you're talking about someone who has not just a few but essentially all of the classic BPD symptoms, and in a fairly extreme form. Much of my life for the last several years has been focused on keeping her alive. She's been diagnosed by many different practitioners independently, and the only hesitation was that nearly all of them refused to issue an actual diagnosis of BPD until she became an adult. Until then it was always "extensive traits associated with BPD", or words to that effect. And while I don't recall if Dexedrine has ever been in the mix of medications, she has been on Wellbutrin. It helps some.
What's the basis of your expertise?
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