Crime and the Mentally Ill

Crime and Mental Illness

Mental illnesses have been around since the beginning of time. The only things that have changed are the diagnosis and attitudes about the diseases. The history of mental illness has been a process of trial and error, through medical theory and public attitude.

In prehistoric times, people thought that mental illnesses stemed from magical beings or spirits that interfered with the mind. They used rituals similar to exorcisms to try to coax the evil spirit out. They even went as far as drilling holes into people's skulls in order to give the spirit somewhere to escape from.

In ancient egypt mental illness was regarded as magical or religious in nature. They also had the first known mental hospital. It was a temple, meant to treat the mentally ill. Methods used to cure mental illness included: using opium to induce visions, saying prayers to specific gods, performing rituals, and sleep therapy. Egyptian society was the first society to make mental healthcare a priority.

Ancient Judaism also viewed mental illness as religious in nature, but some of their ideas differed fromk past ideas. They believed in a single god, unlike the previous societies, so they thought that mental illness was not caused by the interference of multiple gods, but was caused problems in the relationship between the individual and god. They thought that if someone was not following god's path, then they would have self-conflict and repressed guilt. The Hebrews believed that righteousness was the key to mental health.

In ancient Islam they also stressed a need to understand their mental situation. They thought that mental illness was caused by being possessed by supernatural spirits, that can be either good or bad. They thought that mental illness was a supernatural intervention, unlike the jewish conception that thought it was caused by sin. They used song, dance and narcotics to bring people closer to god. It was the ancient islam beliefs that paved the way for scientific examination into mental illness. "The Arab physician Rhazes wrote the landmark texts El-Mansuri and Al-Hawi in the tenth century, two which presented definitions, symptoms, and treatments for illnesses, including mental illnesses, and also ran the psychiatric ward of the Baghdad hospital." In the middle ages mental illness was treated quote differently. It was most often diagnosed as witchcraft. People who acted strange of had hallucinations were thought to be possesed. They were not treated, because they were usually tortured and killed. "Recent psychologists have read case studies of proposed witchcraft and have suggested explanations like ergot poisoning. From the early decades of the fifteenth until the middle of the seventeenth century, between 200,000 and 500,000 witches were executed in europe."

During the renaissance the thought on mental illness changed. People were no longer accused of witchcraft, instead they were thrown into insane asylums. The most well known of these was St. Mary of Bethlehem, which is more commonly known as Bedlam. People in asylums were treated very poorly, most times they were even worse than prisons.

Around the nineteenth century, activists and psychologists began a movement to treat the mentally ill humanely. There were many notable people that pushed for this reform. One was Phillippe Pinel, who is regarded as the father of modern psychiatry. Another was William Tuke, who is responsible for The Retreat at York, which was a mental institution that treated patients humanely, and did not use excessive force or restraints. It is still open today. Another important person involved in the movement was Dorothea Dix. She was an activist that pushed for changes in the way that the mentally ill were treated. She was also very instrumental in the founding of the first public mental hospital in Pennsylvania. This is the Harrisburg state hospital, and she also later established its library and reading room. "These individuals are credited with the development of clinical psychology."

At the twentieth century, psychologists used different methods in treating mentally ill patients. Early treatments included spinning and bloodletting. A few years later treatments included electro convulsive therapy and lobotomies. In the 1940's Walter Freeman wrote that, "lobotomies would make good American citizens of society's misfits, schizophrenics, homosexuals, and radicals." In the middle of the twentieth century psychoactive drugs began being used. Chlorpromazine was widely used to treat schizophrenia, while in the 1960's lithium began being used for manic depression. Since the start of using medical drugs, the need for asylums has decreased. "In 1955 there were 560,000 mental patients in the United States. In 1984 there were less than 150,000."

Although the insanity plea gets a lot of attention, it is used in less than 1% of all the United States criminal cases. Of that 1% only a quarter of those cases were successful, and out of that quarter of 1% about 70% of insanity acquittals were the result of out of court agreements between the prosecution and defense. In order for a person to be criminally insane they must not be able to distinguish between right and wrong.

Before the 1970's the public was fine with a person being found "not guilty by reason of insanity" ("NGRI"). They felt this way because usually these people spent many years, even the rest of their lives locked in mental institutions. More recently, however, NGRI's are released more rapidly from institutions. This early release of NGRI's is due mainly to two factors:

1. Court rulings that insanity acquitees are entitled to the same

constitutional due process and equal protection rights of civil

patients; this makes it more difficult to keep an individual in a

hospital after recovering from mental illness.

2. Advances in psychiatric treatment

This makes the public less accepting of the insanity plea, because they know that the person can be released in a short period of time.

The insanity plea has its roots in 1843, when Daniel M'Naghten attempted to assassinate the British prime minister. He plead insanity at trial. Even though the prosecution tried to prove sanity by showing how his actions were planned, it was not successful. Several physicians testified on the defendants behalf, even though