Mental Illness and Murder

Contrary to popular belief, homicide due to mental illness is declining, at least in England and Wales:

The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise.

Paper and press release.

Remember this the next time you read a newspaper article about how scared everyone is because some patients escaped from a mental institution:

We are convinced by the media that people with serious mental illnesses make a significant contribution to murders, and we formulate our approach as a society to tens of thousands of people on the basis of the actions of about 20. Once again, the decisions we make, the attitudes we have, and the prejudices we express are all entirely rational, when analysed in terms of the flawed information we are fed, only half chewed, from the mouths of morons.

Posted on August 19, 2008 at 3:23 PM • 23 Comments

Comments

Doug NapoleoneAugust 19, 2008 4:19 PM

But how does this correlate with the density of mental patience in institutions who are prone to physical violence? Mental institutions have steadily been closing after the 70's with only those who are perceived as a being a 'significant danger to society or themselves' being institutionalized. My mother-in-law works at a juvenile institution and all the patients are those who have been convicted of violent crimes (and over half of those sexual crimes). When she started working there in 1971, only 15% of the patents were considered violent (convicted of crimes or otherwise).

The number of 'guests' has risen, and the number of staff has dropped.

While the number of mentally ill people who are committing violent crimes is quite small.
http://www.stopstigma.samhsa.gov/topic/facts.aspx

The risk associated with any one 'escaping' from a mental institution is a measure of that specific persons risk to society, not mental illness as a whole (obviously). The trend to de-institutionalize mental illness treatment in the past 40 years, means that there is a much greater probability that if a person is institutionalized for mental illness that they are violent.

I have yet to see any studies on the particular statistics you imply: Of people to escape from mental institutions, how many had a prior history of violence and of those how many committed an act of violence to themselves or others while not under supervision.

I have looked for those statistics and can not seem to find them. My suspicion is that the act of escaping from an institution is so rare as to make any such calculations meaningless anyway (as pointed out by your link), but that is an assumption based on a lack of evidence, not evidence its self.


andyinsdcaAugust 19, 2008 4:32 PM

There's lots of homocide in San Francisco (sorry, it's too easy of a gag).

That being said, mentally ill people on the street put people at risk for bodily injury or just intimidation, nevermind murder.

Also, the designation for innocent by reason of mental defect/illness is a jury's determination (at least here in the US), which means it has everything to do with who has the better lawyers and "expert" witnesses and not whether or not the guy in the defendant's chair is actually nuts.

HunterAugust 19, 2008 4:36 PM

Last sentence of the conclusion:

"Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder."

Is any sort of "tough on crime" trend responsible for covering up homocides by the mentally ill by just throwing them in jail with all the rest?

cmosAugust 19, 2008 4:50 PM

Its likely due to a change in the cultural definition of Mentally Ill. Just look at the last 30 years or presidency- mentally ill or world leaders?

mehAugust 19, 2008 4:59 PM

Re: andyinsdca
"Also, the designation for innocent by reason of mental defect/illness is a jury's determination (at least here in the US), which means it has everything to do with who has the better lawyers and "expert" witnesses and not whether or not the guy in the defendant's chair is actually nuts."

Concerning the lawyer part of your statement.. How much of this opinion is also based on a few rare cases or misinformation from media? (or maybe exposure to fictional scenarios from TV or movies)

Are you sure it's really true that in a majority of cases a Jury will ignore evidence about condition of the defendant and rule solely based on the words of the highest paid lawyer and professional witnesses?

Based on the second half of Bruce's summary I thought the point of all of this is that we may be acting on bias views based on a limited or incorrect amount of information, making it even more surprising when we come across information that contradicts our popular beliefs.

I just thought it would be ironic if your cynical statement about U.S. courts was based on the same type of misinformation. Forgive me if you actually are an experienced lawyer.

sooth_sayerAugust 19, 2008 5:12 PM

As Charles Manson famously said "at one time it meant something to be crazy; now everyone is crazy"

John JenkinsAugust 19, 2008 5:31 PM

The finding is generally "Not guilty by reason of insanity," (and is not a finding of innocence). It also usually results in a commitment order for the defendant. That has nothing to do with whether someone is mentally ill (which is a different issue altogether). I am a lawyer, and findings of not guilty by reason of insanity are few and far between.

More common is a competency hearing where a judge (or jury, either side has a right to one) determines whether a defendant is competent to stand trial (the standard for which is whether the defendant is able to assist the defendant's lawyer in preparing the defense). It is a super rare case where you have dueling (expensive) experts over a competency issue.

I don't know about England and Wales, but in the United States, you can see a inverse correlation if you look at graphs of mental institution populations and prison populations because since the 1970s people who might then have been treated as mentally ill are today simply tried and imprisoned because of the patients' rights movement. The same sort of thing may cause the relationship these researchers noted.

clive RobinsonAugust 19, 2008 5:57 PM

@ Bruce,

The problem with what you say is where do the figures come from?

This is important as in the U.K. since Maggie Thatcher introduced "care in the community" most official figures tend to show improvments in mental health issues.

However frontline healthcare practitioners in hospital A&E and GP's practicies are seeing record levels of attacks on them from patients. And although some can be written off as "under the influence" most cannot.

Further ofther facts such as the number of ex armed forces personel living rough on the streets of London has increased. Most of these people appear to be suffering from one form of mental imparement or another.

Also mental health has made great progress in the past thirty years. For instance a number of mental health issues are nolonger seen as illness but disorders. For instance Post Trauamatic Stress Disorder is now recognised and treated radicaly differently to the 1970s and 80s.

Further a lot of cases of what was once considered clinical depression are not actually mental illness at all but are now recognised as being due to such things as poor medication control on longterm drugs used for chronic illness such as back pain / thirod / latent heart problems etc..

All of the above tend to suggest that the figures might well need to be looked at as the goal posts have been moved.

Josh OAugust 19, 2008 8:44 PM

Did they account for detection bias? We are constantly redefining mental illness. If there are less murders due to mental illness, couldn't that just mean that we are doing a better job of preventing them from committing murder? I don't see how it necessarily means that mentally ill are less homicidal than before. If that's the case, then those statistics don't mean anything when it comes to fear over escaped lunatics.

noneAugust 19, 2008 9:15 PM

http://abcnews.go.com/print?id=5613502


TSA Snafu Damages Nine Planes at O'Hare Field
Pilots Furious with Misstep
By JOSEPH RHEE, BRIAN ROSS, and ERIC LONGABARDI

August 19, 2008—

Nine American Eagle airplanes were grounded Tuesday after a TSA inspector, conducting an overnight security check, used sensitive instrument probes to climb onto the parked aircraft at Chicago's O'Hare Airport, aviation sources tell ABCNews.com.

A TSA official confirmed the incident.

At least forty regional commuter flights were delayed throughout the day, according to American Airlines. "We think it's an unfortunate situation," American airlines spokesperson Mary Frances told ABCNews.com.

The TSA agent, as part of spot inspection of aircraft security, climbed onto the parked aircraft using control sensors mounted on the fuselage as handholds, according to a TSA official in Chicago, Elio Montenegro.

"Our inspector was following routine procedure for securing the aircraft that were on the tarmac," Montenegro told ABCNews.com.

The TSA agent was attempting to determine if someone could break into a parked aircraft, according to Montenegro.

Pilots were furious at the TSA misstep.

"The brilliant employees used an instrument located just below the cockpit window that is critical to the operation of the onboard computers," one pilot wrote on an American Eagle internet forum. "They decided this instrument, the TAT probe, would be adequate to use as a ladder," the pilot wrote.

Another pilot wrote the TSA agents, "are now doing things to our aircraft that may put our lives, and the lives of our passengers at risk."

The TSA has been conducting such overnight spot checks at airports around the country.

Another airline, Mesa Air Group, told its employees earlier this month that "48 percent of all TSA investigations involving Mesa Air Group involve a failure to maintain area/aircraft security."

Mesa said it was imposing a "zero-tolerance" policy for such violations, threatening employees with dismissal.

Eric Longabardi is a freelance journalist who is a frequent contributor to the ABCNews.com investigative page.

Click Here for the Investigative Homepage.

Copyright © 2008 ABC News Internet Ventures

SejanusAugust 20, 2008 3:00 AM

Mental illness is a made up term anyway. One who commits homocide because God orders him to do so is definitely mentally ill by all definitions. But one who doesn't eat meat on fridays because God orders him to do so, is not considered to be mentally ill. The difference? One harms others and the other doesn't. Well, pretty damn goo definition. Then just about everybody who commits homocide is mentally ill.

SejanusAugust 20, 2008 3:02 AM

Correction: I do not mean that mental illness does not exist or is impossible to tell. Yeah there are people who e.g. see hallucinations because of brain disfunctions etc. But what I want to say is that mental illness nowdays is like terorism: we label "mentally ill" every person whos behavior doesn't fit "society's standards".

billAugust 20, 2008 3:32 AM

Does this correspond with a reduction in diagnosis?

I think Social Services are obliged to care for the mentally ill, rather than the mentally fit.

The hypothesis of 'shifting goal posts for budget purposes' is testable, just not by me.

AnonymousAugust 20, 2008 4:28 AM

Re: Andyinsdca

"being said, mentally ill people on the street put people at risk for bodily injury or just intimidation, nevermind murder."

I presume you mean those individuals who have a violent mental disorder, rather than all people suffering from a mental illness. There are thousands of people walking the streets right now suffering from mild/moderate depression who are absolutely no danger to the people around them.

John CampbellAugust 20, 2008 6:40 AM

Homicidal loons?

That's the undiagnosed psychos, like many fundamentalists (of almost ALL religions) who seem to specialize in mass murder.

I'd refer to Aral's comments in "Shards of Honor" but don't have a copy handy.

bobAugust 20, 2008 7:07 AM

@clive Robinson: "Further ofther facts such as the number of ex armed forces personel living rough on the streets of London has increased. Most of these people appear to be suffering from one form of mental imparement or another."

You lot should do what we've done over here - we have a whole monolithic branch of the government, the "Veteran's Administration" (notice nothing is said about HELPING or BENEFITTING veterans, just administering them) which is dedicated to making sure that former military members who risked their lives for the country shuffle off their mortal coil as quickly as possible and therefore don't tie up precious resources or lie around mentally ill. Admittedly, they (the VA) do provide some nice cemeteries.

AnonymousAugust 20, 2008 9:52 AM

@ bob,

"which is dedicated to making sure that former military members who risked their lives for the country shuffle off their mortal coil as quickly as possible and therefore don't tie up precious resources or lie around mentally ill. Admittedly, they (the VA) do provide some nice cemeteries."

Sounds like the U.K.'s Ministry of Defense (MOD), apart from the cemeteries, these are run by the "war graves commision" (WGC).

The WGC employ war vets on a small stipend to look after the cemeteries, and for what they get they do an amazing job.

However the WGC get their funding from the MOD, and guess what the MOD has been cutting back, so there is nolonger the money to look after all the cemeteries.

Oh and the MOD has a cute little policy, the partners and children of soldiers, sailors and airmen who live in (the fairly disgusting) housing that the MOD provide, have an eviction notice served on them if their "Brave Hero" happens to get killed. This usually happens about the time of the funeral...

Also the service personel earn a pitance which is why so many of them have their loved ones in MOD housing as they cannot possibly afford to rent a room, let alone a three bed house.

And the MOD say they do not know why they cannot recruit enough service personnel to meet the needs of the country...

JasonAugust 20, 2008 10:21 AM

In Memphis, in the 80s, there was a slate of mental hospital and institution closings.

As a result, many people were suddenly declared perfectly sane and turned out on the streets. Cue a large increase in the homeless population.

The definition of who was mentally ill changed because the budget to care for the mentally ill changed.

bobAugust 20, 2008 2:11 PM

@Anonymous: Back in the late '80s we had a huge bunch of layoffs in the military (30-50% depending on who you ask); accordingly in the early '90s we closed a bunch of bases.

I (evidently among a bunch of others) suggested we use the gigantic number of homes freed up by these closures to help house the homeless.

BUT - that was not legal; the housing that military families were provided was not up to the standards required to house someone hitherto living in a cardboard box under an overpass. They were only good enough for the children of people risking their lives for the country.

MaryAugust 20, 2008 5:18 PM

I have no doubt that in England and Wales, where there is universal health care and mentally ill individuals are able to take their medication because it is affordable or free, homicides committed by MI people have declined.

I've been a psychiatric social worker for 15 years, and I can tell you EXACTLY why other industrialized countries have lower rates of murder by severely mentally ill people - universal healthcare with parity between "physical" and "mental" illnesses. (Since all "mental" illness is actually physical, there should be no distinction made.)

Even US statistics show that mentally ill people are LESS violent than the general population when treated with medication. But effective antipsychotics tend to cost $800-2000 per month. Even the "wealthiest" people on SSI Or SSDI (disability) have entire incomes under $1200/month. Those $1200/month folks made six figures when working, BTW. The typical disabled MI person gets $200-500/ month for rent, food, medicine, utilities, transportation, and physical care necessities such as soap and shampoo and toilet paper. Even the lowest income medicaid recipient usually has a a monthly "spend down" (like a deductible) often EXCEEDING their actual monthly income. Living expenses are not considered when figuring spend down either. And medicare folks don't fare much better, their medicine is paid for (with a copay) for several months, then they hit a "donut hole" where medicare doesn't pay another cent until they have spent $2000-10,000 of their own income on the medication before medicare kicks back in. Again, living expenses are not considered and the demanded contribution often exceeds the person's actual income. You do the math.

Most mentally ill people, especially those who have hurt others when off medications, desperately want treatment. Virtually every murder by a mentally ill person is caused by all of us neglecting them and refusing them necessary healthcare. We can court order violent people for mandatory treatment all we want, but if they can't afford the medicine they aren't GETTING effective treatment. Even the most violently criminally insane person effectively has NO access to the treatment that would control their symptoms and prevent tragedies. Until we change that, innocents will suffer and die. And we will all be culpable.

leftystratAugust 22, 2008 12:02 AM

It can be argued (and has) that you have to be insane to commit murder in the first place.

As for people escaping from the Happy Place, times have changed. Due to (mis)managed behavioral healthcare, most people spend their time trying to break *into* these facilities.

Seriously - if you want to get in, you had better be able to *prove* you want to kill yourself. Then you'll have to explain exactly how you're going to do it, when, and why. Only then will your insurance begin to consider pre-authorizing your stay (* which is still no guarantee they'll pay for it).

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