Association between Offending Behavior and Mental Illness
Psychiatry focuses on diagnosis, treatment, understanding, and prevention of mental disorders in addition to emotional, and behavioral illness. The diseases may involve perceptions, behavior, emotions, and cognition. Psychiatry also includes treatment and diagnosis of substance use disorder. The role of psychiatry entails performing a broad range of medical and psychological tests also talks with the patient to offer the patients mental and physical state. Psychiatry provides the diagnosis by understanding the intricate relationship that exists between mental illness and the emotional state and the relationship between genetics and family health history. Mental illness affects the normal feeling, thinking, and mood of an individual which often affect the regular daily interactions. The primary role of psychiatry is to identify, investigate, diagnose, and offer treatment to patients with such disorders.
According to the medical model of psychiatry, abnormal behaviors often points to physical, medical complications, for example, injury to the brain may result in abnormal cognitive behavior. Proponents of the medical model argue that if specific symptoms of a physical illness are put together, the cause of a mental or behavioral disorder can be identified and treated. For instance, behavioral tendencies such as hallucinations point to phobias or fears that may group together to cause illness. The biological approach to psychiatry shows that mental or behavioral disorder is linked to the structural arrangement of the brain (Adjorlolo et al, 2014). It covers and looks into a patient’s medical record, psychometric tests, keen observation, such as mood conditions, and clinical interviews.
Forensic Psychiatry specializes in the treatment, diagnosis, and understanding of mental illnesses in the community, prisons, and secure health facilities. The treatment and handling of forensic psychiatrist balances between the welfare of the patient/offender, and that of the society as they offer treatment in secure locations whereby patients are under legal restrictions. In addition to providing treatment to patients, forensic psychiatry has also played a significant role in providing reports and advice to the courts or prison services on psychiatric cases concerning criminals showing high-risk tendencies (Wetterborg et al., 2015).
As a medical branch concerning with criminal behaviors, forensic psychiatry offers an assessment of practices that may be considered dangerous both to the society or the courts. It provides legal advice and opinion on practices that have a high potential to cause injuries, disruption, inconvenience, and the nuisance to the courts or the risk of such behavior within the society. Offending behaviors in most cases tend to be linked to criminalities and criminal actions, for example, a history of child cruelty may contribute to offending behavior a situation in which forensic psychiatry, may help diagnose, understand, and treat subsequent psychological, social, and behavioral challenges that may become apparent later in adult life. Snowden et al., (2014) argue that by linking a history of child mistreatment to an existing adult psychiatric disorder, forensic psychiatrist transforms a traditional component of a child’s life to a current disorder in which a therapeutic treatment can be applied.
According to Wetterborg et al., (2015) mental illness refers to a medical complication that results to mild to severe instability in behavior and thought that results in the inability to handle the normal day to day life demands and routines. The most common types of mental disorders include dementia, schizophrenia, anxiety disorders, bipolar, depression, and bipolar. The most common symptoms attributed to mental health problems include frequent mood changes, personality, social withdrawal, and strange personal habits. Just as in conventional medical complications such as diabetes, heart disease, or cancer, mental illness often results from psychological, physical, and emotional difficulties (Simpson et al, 2015). These include genetic factors, environmental stresses, biochemical imbalances or a blend of all these elements (Snowden et al., 2014). Some of the warning symptoms and signs of mental illness in adolescents and adults include:
- Social Withdrawal,
- Strange thoughts
- Confused and erratic thinking
- Unknown fears, apprehension, and uncertainties
- Suicidal thoughts
- Substance use and
- Unexplained frequent physical diseases
In younger children, the signs and symptoms include;
- Poor performance in school
- Constant rage and tantrums
- Disobedience and aggression
- Poor eating and sleeping patterns
Psychotic and Non-Psychotic Illnesses
While psychotic illnesses point to high symptoms of psychosis, non-psychotic disorders are less severe and include symptoms such as panic attacks, depressive disorders, and anxiety (Adjorlolo et al, 2014). Psychotic disorders include illnesses, such as bipolar disorder and schizophrenia. Non-psychotic disorders are caused by factors such as losing a loved one, imprisonment and moving to a new neighborhood (Snowden et al., 2014). Insight plays a significant role in the distinction between psychotic and non-psychotic disorders as it helps in determining the best kind of treatment, investigation, diagnosis, and treatment to administer. The non-psychotic disorder tends to manifest most in offenders than psychotic disorders. For instance, hallucinations, depression disorder, and anxiety. The figure below shows the occurrence of mental illness among prisoners. As can be observed, the number of inmates showing signs and symptoms of non-psychotic disorders such as substance abuse, alcohol dependency, episodes of depression is high as compared to inmates showing signs of psychotic disorder such as obsessive compulsive disorder (Fazel et al., 2013).
Research and studies show that mental illnesses are common in detention centers than in the society in general. According to studies, out of 10 inmates, 7-9 demonstrate mental illness with some of the most common symptoms include sleeping problems, poor eating habits, and anxieties. Research further shows that over 60 percent of young offenders stand a high chance of mental health illness. Studies further show that youths in juvenile delinquents have a high chance of developing mental illness as compared to children within the society (Snowden et al., 2014). Additionally, the reports indicate that girls have a higher chance of developing mental health complication while in the detention centers than boys. While offenders within the age group of young adults and children fail to comprehend and account for their conducts fully, adult offenders have the full knowledge of what they engage in at any given time (Skeem 2014). In juvenile delinquents, the confusion that exists in reasoning, social and emotional competencies often result in anxiety behaviors, depression, hallucinations, and poorly coordinated habits that may point to a psychiatric case. According to Simpson (2015), adult offenders, on the other hand, often face tough mental choices while in detention, a situation that often sees the onset of depression, anxiety, substance abuse, and sleeping disorders. The development and implications of mental illness in both adults and young offenders often point to emotional and psychological pressures, in addition to accepting their fate as criminals (Wetterborg et al., 2015). Taking the change may have severe mental implications for offenders who may not have the strength to face their fate behind bars.
While psychotic disorders involve the loss of sensation or reality, neurotic illness often involves distress and may show signs and symptoms such as mental confusion, low self-esteem, sadness, anxiety, disturbing thought patterns, obsession, cynicism, and socially-uncultured behaviors. It may also entail the poor ability to adapt to a given environment, or the inability to adjust to a given lifestyle or develop a more recommended personality. According to Jung’s theory, the disorder often affects inmates who face a long-term period in jail and is often manifested during the initial period following sentencing. Inmates always face the troubling questions of how long, why, when, and a host of disturbing mind scenario (Prins 2015). According to forensic psychiatric, the prevalent thoughts dominating the offender’s accounts often drive them to a point to disillusion, in which they start showing signs of obsessive personality disorder, hysteria, and anxiety. Failure to recognize these signs in their early stages, the offender may gradually slip to the extreme mental state of obsession.
Jung’s theory maintains that people develop neurotic behaviors as a result of failing to get the right answers to life’s questions (Snowden et al., 2014). Different kinds of personality disorder are therefore manifested in the offender as a result of mentally failing to comprehend the challenges of life in the face of confronted with a long prison sentence. In many cases, the patients do not have insight into their mental state or problem. The situation may also be made difficult due to lack of medication or attendance. Personality disorders such as Schizotypal, paranoid, schizoid, and anti-social personality disorder. In offenders, the above disorders have a tendency to blend each other with a patient with a cluster A personality disorder blurring with signs and symptoms of another personality disorder (Light et al., 2013).
Mental health in offenders tends to point to the reaction of the offender to the general environment. While an offender may be brought to the detention facility while healthy with no history of a personality disorder, the developing behavior later, while in custody is often a pointer to an attempt by the offender to adapt to the environment. However, due to the unfavorable circumstances within the prison or detention facility, the offender tends to develop habits that portray denial or aggression towards the standard environment. According to forensic psychiatry, the attempt to balance between the different thought patterns result to depressed feelings, anxiety, discomfort, rejection, a sense of insecurity, violence, and hidden fears (Lundberg et al., 2014). Forensic psychiatrists argue that failure to get immediate medical attention may result in potentially explosive behaviors such as outbursts and tantrums, emotional instability, impulsive behavior, deadly threats, and poor patterns of thought (Wetterborg et al., 2015).
In most cases, offenders develop a sense of carelessness towards responsibility and duty to others which may result in a repeat of the offense or engaged in a criminal act. For example, forensic psychiatric maintain that borderline personality disorder in males leads to erratic and impulsive behavior in addition to unstable relationships and suicidal threats often result in antisocial behavior which in many cases, lead the offender to engage further in antisocial behaviors such as assault, murder, or violent robbery. Additionally, studies and research show that antisocial behaviors such as aggression and hostility are often the number one cause of the development of a serial killer (Peterson et al., 2014). For example, patients with Schizophrenia tend to exhibit violent tendencies in addition to fear and delusions. The fear and delusions arise from anxiety developed by the patient over a long period.
Offenders who have grown to accept their fate as hardened criminals often develop narcissistic personality disorder and tend to develop a controlling, destructive habits that push them to selfishness, revenge, destruction, and insensitivity towards others (Prins 2015). These offenders often find themselves on the wrong side of the law, and as argued by forensic psychiatrists, Narcissistic PD may easily lead one to a repeat of offenses such as violent robbery, rape, kidnap, and substance abuse. The secure feeling of importance and heroism often lead them to think that they are above the society regarding their responsibility towards others and the community. On the other hand, Schizophrenia often sees an increased incidence of violence and aggression, majorly caused by personal frustrations and fear (Light et al., 2013). While out of detention, offenders with this type of disorder tend to be frustrated with getting back to the society as a healthy individual without the tag of the criminal act. Due to this mixed feeling of fear and disillusionment, the offender may find himself or herself in a repeated criminal serve as a justification of their usual self. Forensic psychiatrists argue that these offenders develop the criminal tendencies soon after their release from detention as a way of getting back to the justice system or going against the norms of the society (Peterson et al., 2014). In most cases, the offenders engage in the criminal act as a way of getting some relevance in the community as a result of their perceived fears.
Criticism of Psychiatry
Anti-psychiatry believe that the treatment of mental illness is detrimental and unhelpful in the end. According to their views, psychiatry is a challenging and subjective method of handling mental cases in patients. Some of the thorny issues raised by anti-psychiatry include coercion versus freedom, social justice versus racial justice, personal freedom, social shame, and the side effects of the drugs used. The use of psychiatric drugs for children has often raised objection amongst anti-psychiatry, with their primary concern arising from the dangerous effects the drugs have on the children. Much of the challenge to the branch of medicine dealing with mental illness derived from the approach of medical facilities and countries that used the commonly “madhouses” to restrain the perceived mentally challenged patients. Over the years, protests against the use of restraints have led many to believe that psychiatry has no place in the modern society. Currently, anti-psychiatry believes that many countries apply methods used in the treatment of mental illness to subdue and detain political opponents. Light et al., (2013) maintains that the method is therefore used to bypass the necessary legal requirements for instituting a guilty or not the guilty case. They further believe that it is a branch of medicine that is highly abused to the advantage of both medical practitioners and caretakers of a patient. The majority of anti-psychiatrists believe that the so-called mental institutions or restraint methods are similar to concentration camps, monasteries, and military organizations that serve at the whim of powerful individuals in the society. Many in the society believe that the crusades for the support of psychiatric treatment and diagnosis are as a result of bureaucracy and political reasons.The political and bureaucratic reasons tend to be invented rather than real. Proponents of anti-psychiatric believe that the underlying problem that exists between medicine and mental illness is a product of the challenge medical practitioners face in distinguishing the different kinds of diseases they are presented with. They further believe that instruments such as the DSM categories are unreal and are only invented to cloud the reality behind the challenge of identifying the truth behind mental illness.
In many cases, the various categories presented by psychiatrists point to a man-made construct rather than an accurate reflection of a medical fact. They, therefore, serve the interest of the medical practitioners rather than the patient. Additionally, the decisions on mental illness tend to serve a clique of leaders who may stand to benefit with the detention or restraint of the offender or patient. Going by the argument of anti-psychiatrists, patients face a difficult task in receiving help, getting treatment, and healing. In covering up the real medical condition of the patient, the patient stands a high chance of not healing from the current predicament in addition to the risk of death. Lundberg et al., (2014) argues that this further poses a significant threat to women’s experience in psychiatric situations. Study and research show that women have a high chance and degree of susceptibility to mental illness which is a direct threat to their ability to nurse and bring forth psychologically balanced children (Peterson et al., 2014). On the other hand, BME groups face the greatest challenges that may be compounded to their children, offsprings, and lead to their concentration in the child care organizations. Research and studies show that BME parent stands the highest chance of poverty, crime related incidences, homelessness, and unemployment.
Relevance of Psychiatry
Despite the anti-psychiatric movements and ideologies, psychiatry plays an imperative role in the medical field. Besides offering theories behind human behavior, psychiatry opens up opportunities for understanding some of the most challenging concepts of human behavior in addition to coming to terms with different personality disorders in various contexts and different environments.
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