Mental illness and Crime

Undergraduate Lecture 2016

1. Mental Illness & Crime Zahiruddin Othman

2. Lecture Outline Mental illness-Crime Relationships Crime in specific mental illnesses Criminal Responsibility Defenses for mental illness Insanity defense & diminished responsibility Malaysian’s Law Criminal Procedure Code (CPC)

3. Possible Relationship Between Crime And Mental Disorder

4. Prisoners in England and Wales (Gunn et al. 1991)

5. Study by Hafner & Boker, 1982 All homicides and attempted homicides in West Germany 1955-64 Mental disorder was associated with 5% of these The rate of mental disorder in the community was 3-5% Homicidal violence rate schizophrenia = 5/10,000 Schizophrenics were 100x more likely to commit suicide than homicide Homicidal violence rate affective = 6/100,000 Affective disorders were 1000x more likely to commit suicide than homicide

6. Violence And Psychiatric Disorder In The Community (Swanson et al. 1990) Active psychotic symptoms are associated with an increased risk of violence

7. Specific Mental Disorder & Crime Psychopathic disorder there is an increased likelihood of other psychiatric symptoms and disorders homicide risk is increased 10x in someone with an antisocial personality disorder Drug dependence Offences against property are associated with the need to pay for drugs Rates of drug abuse are increased among prisoners

8. Alcohol dependence Alcohol and crime are related in 3 important ways: Alcohol intoxication may lead to charges related to public drunkenness or to driving offences Intoxication reduces inhibitions and is strongly associated with crimes of violence, including murder The neuropsychiatric complications of alcoholism may also be linked with crime

9. Mental retardation Most offences committed by those in the borderline to mild ranges of learning disability The mentally retarded are more likely to be caught They may commit offences because they do not understand the implications of their behaviour, or they are susceptible to exploitation by others Association with indecent exposure and arson

10. Depression Severe illness may lead to homicide The depressed person is usually acting on delusions Family member is usually the victim in altruistic homicides The killer often commits suicide afterwards Sometimes associated with shoplifting

11. Bipolar Illness Offending is more common than in depression Manic patients may spend excessively, hire cars and fail to return them, or steal cars May be charged with fraud or false pretences Prone to irritability and aggression, though any resulting violence is seldom severe

12. Schizophrenia more likely to commit non-violent as well as violent crimes minor offences more likely than serious offences most criminal behaviour followed the onset of schizophrenia, although crime is frequently a result of personality difficulties and social incompetence risk of homicide is moderately increased in schizophrenia compared to the general population

13. violence in schizophrenics may be associated with any of: great fear and loss of self control associated with non-systematized delusions systematized paranoid delusions of persecution irresistible urges instructions from hallucinatory voices unaccountable frenzy risk of violence is greatest where delusions are accompanied by strong affect, and when the person has made efforts to try to confirm the truth of the delusions http://www.thestar.com.my/news/nation/2012/07/12/khalils-brother-fears-for-safety / http:// www.sinarharian.com.my/semasa/pengakuan-suami-isteri-saya-terjerat-dalam-fantasi-khalil-1.66517 http:// www.sinarharian.com.my/semasa/amuk-pengakuan-suami-muhdalina-bahagian-ii-1.66562 http:// www.sinarharian.com.my/semasa/muhdalena-percaya-lelaki-amuk-itu-imam-mahadi-1.250667

14. CRIMINAL RESPONSIBILITY

15. Events or state of the affairs of the crime State of the mind of the crime e.g. murder

16. Children below 10

17. McNaughten Determines whether the person understand the nature and quality of his actions, and if so, whether he knows that the action was wrong The strictest test, and the standard criterion in most jurisdiction American Law Institute (ALI) Model Penal Code Cognitive prong – determines whether the person appreciate the wrongfulness of his behavior Volitional prong – determines whether the person is able to conform his conduct to the requirements of the law After the Hinckley case, most jurisdiction that used this test dropped the volitional prong Durham Evaluates whether the person’s criminal behavior is the “product” of a mental illness The most lenient test, it has been abandoned in almost all jurisdictions Reference: High-yield psychiatry, pg:146

18. e.g., if he believed that man was attempting to kill him, and he kill that man, as he thought, in self defence, he would be exempt from punishment

19. Main Points of McNaughton’s Rules Every man is to be presumed to be sane and to possess a sufficient degree of reason to be responsible for his crimes, until the contrary be proved. An insane person is punishable "if he knows" at the time of crime. To establish a defense on insanity, the accused, by defect of reason or disease of mind, is not in a position to know the nature and consequences. The insane person must be considered in the same situation as to responsibility as if the facts with respect to which the delusion exists were real. It was the jury's role to decide whether the defendant was insane.

20. McNaughton's Rules

21. Diminished Responsibility Charge of murder  manslaughter Abnormality of mind as substantially impaired his mental responsibility for his action

22. AUTOMATISM If a person has no control over an act, he cannot be held responsible for it – the Concept is similar to being ‘briefly insane’ It is a legal term, and has no connection with epileptic automatisms Verdicts of not guilty have been returned when acts of violence were judged to have been committed as ‘sane automatisms’

23. Sane Automatism Leads to a full acquittal Seen to be due to an ‘ external cause ’ Includes: absent-mindednesss (in association with depression)

24. Insane Automatism Automatism thought to arise from a ‘disease of the mind’ – the appropriate defence is then insanity and the McNaghten rules apply Are due to an ‘internal cause’ because the conditions may reoccur Includes: epileptic automatism hypoglycaemia, hyperglycaemia sleep-walking arteriosclerosis

25. Fitness to Plead Understand the nature of charge Understand the difference between a plea of guilty and not guilty Instruct counsel Follow evidence in presented in court Challenge jurors

26. Treatment of Mentally Abnormal Offenders In prisons 1/3 of sentenced prisoners have a psychiatric disorder and 2% have a psychosis (Gunn et al 1991) In hospitals For indeterminate length of stay or under ruler’s pleasure In the community When a non-custodial sentence is passed

27. C riminal P rocedure C ode Detention of offenders in psychiatric hospital

28. Mental Institutions in Malaysia