Are people with mental health problems at increased risk of violent offending?

Introduction

A longstanding discussion has existed before and still continuous to exist regarding the connection between mental violent and disorders along with other criminal behaviors. About five decade ago, there has been an accord among psychics, criminologists, and researchers with regard to any evident of associations between psychics disorders and offending remained due to the bewildering impacts of social dislocations that often go with disability and disorder. As early as the 15 century BC Socrates, the Greek philosopher, is articulated to have affirmed that a low rate of crime in Athens pointed to a low mental disorder rate in the city. Fear of violence concerning people with mental illness remains prevalent and impacts on the way society perceives and treats these individuals (Huw Williams et al., 2010). This paper tries to find the answer to the question “Are people with mental health problems at increased risk of violent offending?” This is done through a review of the various literatures on violence and mental illness with aiming at elucidating whether there is an association between these two aspects. At the same time as higher violence rates have been established among psychic individuals, the majority of studies have faults, and their outcomes are supposed to be perceived with care.

Discussion

The relationship between mental illness and violence is often made mainly in the media. It remains significant for the recognition of this issue as it remains unsupportive as it supports myths and generates stigma. Psychiatric cases can be seen as dangerous irrespective of either there is of there is not any violent risk. Many types of research that have made an effort in the establishment of whether there is a connection between psychiatric cases and violence have based on the mental illness that incorporates schizophrenia. Fazel, Singh, Doll & Grann (2012) outlines that approximately one percent of individuals will have schizophrenia at one point in life. This condition remains a complex disease and individuals present with various symptoms as well as at various levels of severity (Fazel et al., 2012). However, there is evidence that schizophrenic cases present with an increased violence risk compared to the wide-ranging populace (Large & Nielssen, 2011). On the same note, there is a considerable variation with regard to the extent of risk. Most of the studies ascertain the fact that most people with schizophrenia will by no means be violent. On the other hand, individuals with ASPD (Anti-Social Personality Disorder) show an increased violence risk. This is on the ground that violent or criminal behavior is employed in the diagnosis of ASPD, thus, making it linked to higher risk (Fazel et al., 2012). In arrests study in over a decade ago schizophrenic individuals or associated psychosis, as well as previous history, (MacPhail & Verdun-Jones, 2013), established that the incidence of whichever co-occurring condition amplified the arrests risk for all offense types. This research concluded that criminal clinical management and risk evaluations in this people should base on co-occurring ASPD along with substance use disorders besides management of the severe psychiatric disorder (Fazel et al., 2012). Numerous studies have acknowledged an association between the previous violent oppression of the psychiatric individuals with the violent criminal. The psychics are considerably more likely to be casualties of violent as well as non-violent offenses, for various grounds that incorporate their symptoms, alcohol abuse and homelessness (Markowitz, 2011).

Other studies on the relationship between schizophrenia and increased risk of violent offending have been conducted on prison inmates. In spite of the challenges of unstandardized diagnoses along with the frequent lack of assessment data with the public, there is proof that an over-representation of schizophrenic individuals among offenders. This is evidently shown by Burke (2010) in his study that they conducted with the use of validated diagnoses among male criminals imprisoned in South London. The researcher found out that 9% of frequently imprisoned male criminals with non-fatal violence along with 11 percent of deadly violence were schizophrenic. However, this represented considerably higher prevalence than the public would have anticipated it for the very similar region (Burke, 2010). Similarly, Baillargeon et al. (2010) in their study that involved a comparison of the prevalence of schizophrenic individuals and the general population found almost similar results. The prevalence among those jailed was 300 percent that of the general population (Baillargeon et al., 2010). On the other hand, Van Dorn, Volavka & Johnson (2012) in their study that involved 693 homicide criminals in Finland noted that schizophrenia was directly linked to violence on homicide criminals (Van Dorn et al., 2012). Similar results were found by Kesic, Thomas and Ogloff (2010) in their research on serious offenders in Victoria County, Australia. They reported that with schizophrenic cases were 400 percent more likely to be jailed of interpersonal aggression as well as ten times more probable to be imprisoned of homicide compared to the public (Kesic et al., 2010.

Due to the momentous methodological problems encountered by scholars, the mode in which mental health problems at increased risk of violent offending remains unclear. For instance, the measurement of violence directly has remained hard. As a result, researchers have frequently depended on official certification or unconfirmed individual reports. The incidence of violence has been shown to vary considerably dependent on the source (Huw Williams et al., 2010). However, numerous models have failed to be linked to psychiatric disorders rather it has been associated to those who are at high risk of turning out to be dangerous, for instance, those individuals who are admitted or under arrest. The study design has eliminated not even one psychiatric person with previous violence history. On the same note, study designs have not excluded persons managed for co-morbid substance abuse, or evidently established the sequencing of incidents, thus deteriorating whichever causal disputes, which may be made (Fazel et al., 2012).

In The MacArthur Violence Risk Assessment Study done in U.S., it was found that the occurrence of violence among psychiatric persons without a history of substance abuse remained the same as those normal persons without the history of substance abuse. On the same note, it was noted that simultaneous substance abuse conditions increased the risk of violence by twofold. On the other hand, schizophrenic subjects were found to have the lowest violence occurrence (14.8 percent) in comparative to persons with a bipolar condition (22.0 percent) or 28.5 percent major depression. Similarly, there was no association of delusions with violence (Witt, Van Dorn & Fazel, 2013).

Basing on the incidence of criminal, Markowitz (2011) established that even though the total number of criminals admitted in jails remains considerably higher for psychic criminals, on separation from those with substance use conditions, psychiatric disorders alone is not linked to improved risk of recurrence (Markowitz, 2011). On the contrary, a substance use conditions are related to considerably superior corrections recidivism’s risk. However, it emerges that what leads to recurrence in criminal behaviors remains very similar, whether or not an individual is psychic or not: that is to say, definite personality conditions, different types of neurocognitive problems, typified mainly by impulsivity (basically, very similar neurocognitive impairments that are a linked to substance) and antisocial factors (Huw Williams et al., 2010).

Additionally, numerous research studies point out to the fact that psychiatric disorder, violence, and substance abuse take place more often in socially disorganized societies, as do stressful life occasions as well as impaired social help. Psychiatric individuals who are severely affected who live in these types of communities are taught to be violent in a merely very similar way as nonpsychic persons. Unfortunately, individuals who are set free or diverted from the criminal justice system are often brought back to these types of societies where they meet all of the very similar aspects and impacts that initiated them committing illegal events in the first place (Huw Williams et al., 2010).

A national survey conducted ten years ago in America found out that 60 percent of American citizens considered that schizophrenic individuals remained probable to act violently to another person, at the same time as 32 percent believed that individuals with major depression remained likely to do so. In fact, studied proposes that this discernment fails to reflect realism on the ground. Most psychics are friendly. Even though different psychic individuals are involved in assaults along with violent offenses, results have been incoherent concerning the extent in which psychiatric conditions add to this behavior as well as the extent in which substance abuse besides other aspects do (Whitaker, 2010).

Summary

It is clear if one is in the criminal justice system there is a high possibility that he or she is psychic. The term is baffling for the reason that the extensive term mental illness incorporates severe substance abuse and mental illnesses, neurocognitive impairments and personality disorders. Criminals may have numerous co-occurring conditions. However, in a highly small proportion of the criminal populace with severe psychological conditions, possibly 10 percent, there is an extremely clear and direct association between the psychiatric illness and the criminal actions. Violence and criminality remain closely linked to substance abuse, neurocognitive impairments, and personality disorders. Most of the criminals with severe psychological conditions have more risk aspects, which interact or mediate with the disease to lead to criminal acts, for the most part, antisocial personality disorder as well as living in disorganized or antisocial communities without social supports. Women in the judicial organization experience have superior rates of severe psychological condition compared to men, although they are frequently undiagnosed. The criminal justice system requires the address of both severe psychiatric illnesses along with the other risk factors. Numerous wide-ranging conclusions are held up by this summary. To start with, the above literature shows that psychiatric disorders remain unnecessary or adequate grounds for violence. However, the key determinants of violence persist on being socio-economic and socio-demographic aspects for instance male, young, as well as of lower socio-economic standing. Another point is that the general population unquestionably embellishes the strength of the connection between psychiatric disorders and violence and their individual risks from the severe psychiatric case. Ideally, it remains less unlikely that psychiatric individuals remain a casualty of violence. Also, the research has shown that substance abuse forms the primary determinant of violence irrespective of its occurrence in the situation of a concurrent psychiatric disorder or not. Similarly, individuals with substance disorder form the mains contributor to violence in the community, possibly this account for as much as a 30 percent of self-reported aggressive actions, as well as 70 percent of offenses of violence among psychiatric criminals. Most of the studies have focused on the psychiatric individuals but not the form of social interchange, which resulted in the violence. As a result, there is much less than what many would expect concerning the association between violence and psychiatric disorders and the related determinants of aggression, as well as much less than it is supposed to expect concerning primary prevention opportunities. Nonetheless, the present literature supports early diagnosis along with management of problems of substance abuse, and greater concentration on the management and diagnosis of concurrent disorders in substance abuse among severely psychiatric individuals as possible violence prevention approaches.

References

Baillargeon, J., Penn, J. V., Knight, K., Harzke, A. J., Baillargeon, G., & Becker, E. A. (2010). Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Administration and Policy in Mental Health and Mental Health Services Research, 37(4), 367-374.

Burke, T. (2010). Psychiatric disorder: understanding violence. Forensic mental health: Concepts, systems, and practice, 36-51.

Fazel, S., Singh, J. P., Doll, H., & Grann, M. (2012). Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis.

Huw Williams, W., Cordan, G., Mewse, A. J., Tonks, J., & Burgess, C. N. (2010). Self-reported traumatic brain injury in male young offenders: A risk factor for re-offending, poor mental health and violence? Neuropsychological rehabilitation, 20(6), 801-812.

Kesic, D., Thomas, S. D., & Ogloff, J. R. (2010). Mental illness among police fatalities in Victoria 1982–2007: case linkage study. Australian and New Zealand Journal of Psychiatry, 44(5), 463-468.

Large, M. M., & Nielssen, O. (2011). Violence in first-episode psychosis: a systematic review and meta-analysis. Schizophrenia research, 125(2), 209-220.

MacPhail, A., & Verdun-Jones, S. (2013, January). Mental illness and the criminal justice system. In Re-Inventing Criminal Justice: The Fifth National Symposium, Montreal, QC, Canada.

Markowitz, F. E. (2011). Mental illness, crime, and violence: Risk, context, and social control. Aggression and violent behavior, 16(1), 36-44.

Van Dorn, R., Volavka, J., & Johnson, N. (2012). Mental disorder and violence: is there a relationship beyond substance use? Social psychiatry and psychiatric epidemiology, 47(3), 487-503.

Whitaker, R. (2010). Mad in America: Bad science, bad medicine, and the enduring mistreatment of the mentally ill. Basic Books.

Witt, K., Van Dorn, R., & Fazel, S. (2013). Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PloS one, 8(2), e55942.

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