This semester I am taking a government class named Deprivation of Liberty which is taught by a libertarian professor who along with the usual libertarian mantra (drugs, suicide) has included the interesting debate over mental illness and the load of you know what we call psychiatry. To tell you the truth i was intrigued because never have i heard such an argument made before. He assigned us Pharmacracy: Medicine and Politics in America by Thomas Szasz where some very compelling arguments are made despite my skeptical view.

Here are some excerpts:




The argument further goes into the semantics of a disease v. diagnosis and the power that psychiatrists are given in this country. This may be a rough basis for which to debate the issue but it is the best i can do without giving pages of information.

Questions for debate:
1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?
2) Does American society need to reasses its position on mental illness and psychiactric powers?
3) Do you consider a mental illness a real problem or a fabrication by the psychiactric field to justify certain behaviors?
4) What are the implications for the US health care system either way?

Before I answer these questions I pose a question to you: Are you sure this guy isn't a scientologist?

Doing a little digging I've found that he is (or is associated) with the Church of Scientology.

Thomas Szasz Entry

1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?

Ok, first off I'm assuming you're referring to the insanity defense when you say "defense against responsibility" and I'm not entirely sure what you mean by "as a coercive act to imprison a person who has committed no crime," but I think you mean "imprisoned" in a mental institution.

Firstly, it should be noted that the insanity defense is used in less than 1% of criminal cases, but more commonly called "Not Guilty by Reason of Insanity" (NGRI). If the jury and judge are convinced that the person had no ability to tell right from wrong then the person may be found NGRI if it can be proven that a mental illness has affected the persons reality so that the act committed was not intended. This of course relies on the basis that mental illness is a real thing. If the person is found NGRI then they will go to a mental institution for their sentance. It is a common misconception that people just walk out free. Not so. If you're tried and found NGRI you recieve a sentance which you would serve in a mental instituion, while being helped, and if you got to a level that the institution felt qualified for release then you would serve the rest of the sentance in prison.

Secondly, the part about coercive imprisonment. There are two ways to be put into a mental institution: voluntarily and involuntarily. If one is placed in an institution against their will it must be demonstrated that they are either suicidal or harmful to others. But this can only be done for 24 hours (if an officer does the appropriate paper work). This can be extended to a 72 hour if a judge and physician sign another piece of paper work, but again, only if the person is dangerous to themselves or others.

2) Does American society need to reassess its position on mental illness and psychiatric powers?

The short answer is no. Psychiatric power is not "out of control." The way mental illness is presented here is like this: Psychiatrists get bored and call a meeting, then then think of a behavior to make a new mental illness, a vote is taken and lunch is ordered. There is no mention of the research that is conducted to back up mental illnesses. Also, there is no mention of how the DSM is continually revised by not only creating new disorders (if there is a need) but also combining, narrowing, and removing other disorders.

Of course there are disorders which seem suspect, like ADD/ADHD. Perhaps it is a real disorder, but the definition is too broad and too often relied upon when other factors may be the cause. I think there are problems with psychiatry, mainly that medicine is prescribed too often, like democrats throwing money at a problem.

3) Do you consider a mental illness a real problem or a fabrication by the psychiatric field to justify certain behaviors?

It's a real problem that explain certain behaviors, not justify them. No where do psychiatrists say it's alright for people to act a certain way, they say people act a certain way because of an imbalance (usually in brain chemistry) to explain why a certain behavior is done.

4) What are the implications for the US health care system either way?

I think that the psychiatric field needs to be revised with less of an emphasis on medicine and more emphasis on other treatments while also doing more research into defining how and why a certain mental illness manifests itself.


Leder, if you're interested in this subject perhaps you should take an Abnormal Psychology class (at the very least it's quite interesting, or at least I thought so), and secondly get some more books not written by a scientologist.

1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?

My feeling is that it is pretty silly.

2) Does American society need to reasses its position on mental illness and psychiactric powers?

The reassessment is an ongoing process with experimentation, research, publication and review.

3) Do you consider a mental illness a real problem or a fabrication by the psychiactric field to justify certain behaviors?

Mental illness is a set of real problems having to do with brain functionality, such as bipolar and clinical depression syndromes. Self-delusions are sometimes part of this, sometimes not. Drugs can either bring on mental illness or alleviate the symptoms, so there you go. It's chemical.

4) What are the implications for the US health care system either way?

None whatsoever. The US health care system is sick, but this isn't why.

Like Devil's Advocate I was initially suspicious of this topic because it sound like a Scientology talking point, in much the same way that ID topics are stalking horses for Christian creationism debates.

However, your debate questions are well-fremed, so here goes...

1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?

I think that there are two types of "insanity" in regards to criminal defence (or, as has been pointed out, in criminal sentencing - people who plead not guilty on the grounds of insanity are arguably in a worse position that those who are found guilty, since they will be committed to the care of stae mental care facilities for unlimited periods, whereas even life sentences carry the possibility of parole).

The first type is "treatable" - for example most affective disorders (disorders of mood like manic or depressive illnesses), disorders of perception (e.g. schizoprhenia) some anxiety disorders, etc.

Such people's psychiatric problems can be cured or, at least, helped - though not always - and as such they need treatment in a secure part of the healthcare system if the justice system thinks this is the case, they are - by definition - a danger to themselves or others) , rather than formal imprisonment.

The second type is "untreatable" (most personality disorders - sociopathy, psychopathy, etc.). We haven't really found a way to deal with these people yet, and maybe we never will. The prison system is about the bast approximation that civilisation has yet come up with.

There is a third type - the "not really definable unless we can invent a drug treatment that seems to make a difference", which includes things like ADHD, socialisation disorders (or whatever the pharmaceutical euphemism for "shyness" is today). I'd say these things are both areas that don't pose the criminal justidce system any problems, and those that are most open to accusations of the medicalisation of normal human variability. (Only today, I read in The Guardian that some of the drugs used to treat Alzheimers could be used by normal people to improve intelligence and memory. Drugs companies are apprently thinking that there might be a potential market among students, etc. Personally, I think this is a step to far for the free market. What if you forget things that you learned while on Drug X when you stop taking it?)

2) Does American society need to reasses its position on mental illness and psychiactric powers?

I can only speak for Western society generally, but I think we should reassess our position to the extent where we don't see people with mental illnesses any differently than we see those with physical illnesses.

Some are transient (depression mentally, or 'flu or a kidney infection physically). Some are permanent (Down's syndrome or personality disorders mentally; CF or CP
physically)

In other words, some are permanent conditions we have to accomodate somehow (by inventing the mental equivalent of a wheelchair, which may in some cases be medical incarcaration), while some are temporary conditions we need to treat.

3) Do you consider a mental illness a real problem or a fabrication by the psychiactric field to justify certain behaviors?

Most serious mental illnesses are caused by real phiyiscal problems with brain function and/or chemistry. Alzheimer's disease shows up on brain scans AND cuase behavioural changes. Creutzfeld-Jacob disease (human BSE) causes serious behavioural and personality changes, but also causes great big physical holes to show
up in the brains of the unfortunate victims.

Simply put - we do not yet know enough about the functioning of the brain as a physical and biological structure to be able to convinncly say, one way or the other, whether a particular behaviour is caused by a particular physical state, or the other way around. Indeed, what little we do know is that the two are closely linked.

In my view, to categorically rule out one extreme, or another, is not only a premature decision, but is every bit as blindly judegmental as to take a categorical view on any other subjective matter. It's no coincidence that the most forthright opinions on this, one way or the other, revolve around subscription to, or rejection of, Scientology (it took me a lot of effort to resist typing "the cult of..." before that).

4) What are the implications for the US health care system either way?

None.

There might be cost implications for the US penal system, but that's not the question. Given the general aversion to taxation that's prevalent in the USA, I'd be vaguely surprised if, over the next decade or so, lots of Scientiologists got voted or appointed into prominent positions of influence in these matters.

This is actually two questions.

The validity of mental illness as a defense against responsibility depends on the mental illness. Some illness renders its victims unable to determine basic right from wrong, and such illness actually exists, although there are times that defense attorneys use this to defend clients who know the difference very well.

As to the second part of the first question, I could very easily see a repressive regime using "mental illness" as an excuse to imprison and therefore silence political dissidents, especially if they adhere to a religion whose tenets are in direct opposition to the goals of that regime. It's not so far-fetched.

I would like to know just what psychiatric "powers" you are referring to before I address that. But I do think that American society does need to recognize that there are illnesses that are not as obvious as headcolds and broken legs, and that they are every bit as valid as the aforementioned.

Having worked as a nurse, I have seen compulsive handwashers whose hands are red and chapped with cuts on them and who must wash them anyway in spite of the pain. I have also seen those who are immobilized by a depression so profound that it seems that they have forgotten that there is anyone else in the world.

There is such a thing as malingering, but make no mistake: mental illness is real. Of course there will be those who want to use some psychiatric disorder to excuse bad behavior, just as there are those who burn their own businesses down to collect on the insurance money.

But for some unfortunate victims of mental illness, the sky really does seem to be falling. And if it is due to a chemical imbalance, the person can't very well be accused of having a character flaw.

Invest in the pharmaceutical companies--antidepressants seem to be a real winner. I can foresee half the population being on some sort of antidepressant as the economy continues to chip away at the middle class and jobs continue to be shipped overseas, while the administration continues to claim that we've never had it so good.

Edited: spelling

1. There's a general consensus here that mental illness is real. This does not mean, of course, that every diagnosis of mental illness is accurate. Serious abuses are quite possible. The one that worries me most is the possibility of throwing people into mental hospitals against their will without very strong proof that they are a danger to themselves or others. It's no secret that this went on in the Soviet Union as a way to silence dissidents.

Link



And this same article suggests that some people who are being held against their will in mental hospitals in free nations are also having their human rights violated.

It's possible to go to the other extreme, and allow people who are severely mentally ill to wander the streets. Some will be a danger to others, but the vast majority will be victims of their illness.

Link



I'm less worried about false pleas of mental illness being used as an excuse for criminal behavior, although it is a possibility.

2. In general, mental illness should be recognized as a very real problem, and a very difficult one. Proceed with caution.

3. As I said, it is very real. That's doesn't mean that we have to believe that everything requires treatment. For example, I pretty much fit the description of someone with a mild case of "Avoidant Personality Disorder." I have always been extremely shy and withdrawn, and I always will be. However, I am able to function, so I don't think it's a good idea for me seek treatment.

4. The big challenge is to make sure that resources are directed in the right direction; towards those individuals who are genuinely in need of treatment.

Thank you so much for posting a topic I have been involved with for the last 17 years LOL - I have worked in the state mental facility, the only one in our state, for nearly my entire adult life. Most of that time, approx. 11 years, has been on the criminal unit, were we do "E&Os"- evaluation and observation- on suspects CHARGED with a crime, but NOT (usually) CONVICTED of a crime- there is alot of legalese involved in certain aspects- culpability, competency, dispositions of sentencing etc.

I have just returned to work after 4 months off for "workmans comp" - due to repetitive stress injury to my back from the constant assaults against my person. It is possibly the most violent place outside of a war zone you will ever work. The prison sends us folks they can't even handle- and the cops are scared to even come on the unit.

I have had knee and shoulder surgery in my years here as well.

We don't get weapons, we don't get tear gas, we are not allowed to kick anyones butt if they "go off".

But, that being said- it can also be an incredibly easy job sometimes, with me just sitting on the computer, talking about the latest political crud on "americasdebate" LOL

1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?

Okay- this varies so much state to state it is almost a useless statement. Some states have very lax mental health standards regarding culpability in a violent crime- I believe New York is one of those states- whereas Alaska has a 'guilty but mentally ill" and Florida has NO law for "diminished capacity" - either you are guilty or you are not- mental illness is not allowed to play out in the defense;

Myth #1 "They use the defense to get out of jail time"- most of the time, a second degree murder charge gets about 7 years on average of actual jail time- whereas a NGRI (which doesn't even exist in our state and about 7 others now I understand) - averages you about 20 years in a mental facility- you see, once you get that label- THE ACCUSED has the burden of proof to the judge to show he/she is a competent person to return to society.

Myth #2
In my state, as far as "imprisoning poeple with no crime"- PURE HOGWASH- the mental facilities in this country are 1000% overburdened and understaffed- all are running at 110% capacity most of the time- unless a person is gravely disabled, a harm to self or others- we don't even try to keep them here- even when they are whacked out of thier head (in laymans terms LOL) - you can be as crazy as you want to be in our society- as long as you can take care of yourself and don't hurt anyone.




2) Does American society need to reasses its position on mental illness and psychiactric powers?

I do think we need to reevaluate why we are medicating so many children- I have worked on the childrens unit about 5 or 6 of my years here, and it is definately WAY over diagnosed. ADD and ADHD need to have much stricter guidelines for medicating, without a doubt.


3) Do you consider a mental illness a real problem or a fabrication by the psychiactric field to justify certain behaviors?

He doesn't believe in mental illness? 15 minutes on my ward and I have some folks that will make him believe REAL quick- you can see with your own eyes them dealing with "internal stimuli" and how gravely disabled they truly are.

There is, however, one class of mental disorders that are NOT a form of mental illness, but rather, a type of behavior mechanism that IS highly abused by many entities- the personality disorder- borderline is the worst, around 95% female, and it is a nasty person that has them- believe me, if you have run into one you will know it! They are a horrible drain on our system, staff, and everyone that comes into contact with them. We definately need to have some laws passed to allow these folks to kill themselves however they like outside the hospital - because the liability issue as it stands with the Drs right now- we have to admit them- which is the worst thing you can do for a personality disorder- give them a captive audience!


4) What are the implications for the US health care system either way?

Well, since we are horribly overburdened, wouldn't hurt us a bit to allow about 75% more of our patients out on the street- course- they will be in fine upstanding citizens nieghborhoods like your professor there at all hours of the night fighting thier demons- so he may be the first one to be giving the police a call to "deal with this lunatic in the street" .

Ignorance of my proffession is totally understandable- there is almost no way a sane person can explain an insane person without having interacted with them for some time- but to make broad pronouncements about the field without really experiancing it IS unexcusable- ESPECIALLY from someone teaching others about our field.

I just cant understand WHAT is being said here, I think it does pertain to the topic enough to question:



How do you qualify yourself? A doctor or a psychologist, a therapist or an attendant? CR, Reading this I feel like I am reading Freud in his worst sexist moment.

The reason I ask in such a way, allow me.. In our 'mental health care system' of recent past, womens mental and physical health issues were greatly influenced by mens attitudes toward their behavior. Male doctors designed to 'rip out' the female uterus based on womens percieved mental health issues, provocativity, promiscuity and free thinking 'illnesses' or lock them up for varied 'strange-ness'.

I would like you to reread your post above, and take it out of context, lets say put it in the early 1900's. It reads unbelievably like a 1901 diary of a doctor that considers women to be strange and alien and unworthy of treatment, and wants to have them kill themselves to rid society and doctors of a useless part of mental illness that is NOT an illness, yet takes up time and funds. Womens illnesses are anything but serious, nothing an extracted uterus or suicide wont fix.
You know, weve heard this before.
Heard it too many times.

Do you even realize what you are saying here?

I dont believe what you said and you show yourself to be judgementally flawed.
First of all, you say that a borderline personality disorder is 'the worst', ( hardly) You say it is a 'nasty person' who has it, a horrible drain on our system and if we ever are in contact with them 'we'd know it'. Yet, you claim its not a mental illness but a behavior mechanism. Well, if we are all to be horrified by a person we meet with this 'behavior mechanism', enough for them to be justified in 'Killing themselves', then perhaps they should be at least 'seen' by a doctor, or perhaps you should, for exageration.

You make no sense and Im glad you are not my psyche ward attendant. It just goes to show the jading involved. I imagine dealing with crazies sucks.
My partner and Ioften question our sanity, but we have made a pact, that we will NEVER admit each other into a psych ward NO MATTER how bad it gets.
Freedom is only free as long as you do not get institutionalized.

Well, hmm, I see how one would read this as "anti-woman" I suppose- of course, because I didn't include the fact that far greater in number would be the diagnosis of "sociopath"- which about 98% are men- in fact, if you wanted to get technical, and I suppose you do, any repeat offender or career criminal meets the DSMR 4 criteria of "sociopath"- another created mental illness.

But, for not going on in my already long post, I apologize, -

the "borderline personality disorder" is primarily diagnosed in females- that DOES NOT mean it is EXCLUSIVE to females- but females have different ways of coping (or, if they are regularly hospitalized, not coping) with life's curve balls.

Okay, how many poeple on this board have had to deal with lot's of stress in thier life? Probably 100% of various degrees, probably 50% or higher with EXTREME stress- violence, sexual physical abuse etc- so how many of us does it totally ruin our lives? Probably about 10%- the rest of us, to some degree, learn to deal with it in a "succesful" manner- i,e,- not frequently suicidal, or homicidal or any number of behaviors that will get you removed from society- this doesn't mean we don't have all kinds of neurosis or problems in our relationships later- it just means we stay below the radar of the police and mental health community, social workers etc.

Now- almost any person that works in any psychiatric hospital in the world will tell you that there are really two groups we, as health workers, put poeple in- our own "defense mechanism" if you will- because, you have to survive in this career, and interact with these folks in a professional manner, day in and day out, no matter your personal feelings- and a small digression here- after the birth of my first child, I found it very difficult to remain professional with the baby killing women and the baby raping men, harder than usual- but I held it together and was therapuetic as I had to be.

So we group folks into two basic categories that help us deal with outrageous behaviors-
1) Chronically and or acutely mentally ill treatable with behavior modification and/or medicine-

2) Personality disorders.

We don't get as many men with personality disorders- because men are typically OVERTLY violent- which means they end up in jail usually- though not always.

Women are not TYPICALLY as overtly violent- instead, they have some incredibly nasty behaviors that will drive anyone around them to distraction as well. - so, instead of going to jail, which is a real debate among health care psychiatric providers today- most believe they should go to jail for assualt just like the men- but our state doesn't do that to the women, only the men- so they end up here, and we have to deal with those behaviors, and, because of the nature of the illness, it is actually not helpful to thier "illness" - because it is attention seeking behaviors- and the only way to extiguish these behavior is to NOT pay attention to them- but, because of liability- we have to stop them when they start cutting on themselves or we have to sit with them when they say they feel "suicidal"- when that is exactly the opposite treatment recomended.

Artemise- I did not mean to offend or demean women one bit- there are some mental illnesses in our society that don't even exist on others- take Anorexia for instance- not found in some cultures- right? Primarily women, right?

So please take my most profound apology if it sounded that way- didn't mean to!

But here is one way of explaining it-

You take a schizzoaffective or schizophrenic or bi-polar and stick them, un-medicated on a desert island with no other poeple around- and you will see no change in the behavior they are presenting at the door of the emergency services clinin. They probably won't survive at all- they will forget to eat, or try to poke out thier eyes or cut off thier genitalia and stuff like that, just like in the hospital.

You take that personality disorder person, man or woman, and stick them alone on a desert island- well, you won't see one bit of difference between them and a "normal/sane" person- they NEED human contact to be "crazy".

The difference between men and women personality disorders, is that men usually end up in jail, women usually end up in mental institutions, for good or bad- that is the way it is.

Artemise- one universal among ALL psych workers is this: we will take 20 male patients if we had to choose before we would take 1 female- female patients are about 10 times harder to deal with, regardless of the sex of the provider, than male patients- don't ask me why- I don't know why- but that is the way it is.

If you don't believe me- see if you can get a job here at my work- you know where it is- I am not fibbing here- and believe me, we welcome all female psych aides with open arms, God knows we need all we can get- most of the time, this place scares off most, and the good ones get better jobs because of the horrible(mis) management of this place!

All that being said- I have quite a few patients I consider myself , well, if not friends with, at least I have pretty good rapport with about 90% of them, and that is part of the job too- knowing who your very presence will "set off".

You can't be proud here, well not of anything but your ability to do your job, because mental patients have an uncanny way of delving into YOUR psyche and KNOWING what YOU hate about yourself, and exposing it loudly and often.

It is a high stress job with a high turnover, well, now it has a high turnover, it didn't used to be that way- but it is high stress, and you have to learn how to deal with extremely difficult behavior, and we can NEVER pre-judge a patient we have never seen before based on sex, diagnosis or behaviors others have claimed they performed. We have to judge our reactions based on what we see presented before us- and when we go inside a secure, quiet area away from patients to vent- we are not very politicaly correct either!

You know Artemise- if you ever feel suicidal, or your partner does- here is one stat for you- we have around a 98% satisfaction rate among the community that has had to "visit" us- they had no idea what the place was like, and most had your feelings towards our "wards"- but in some ways- we are too gentle- some folks feel a little TOO safe here, and keep coming back despite not needing to really be here!

Here is a couple facts about my workplace:

1) Average stay is less than 3 days
2) 95% of everyone admitted is here one time ony and never returns.

And when asked "why"- that 95% says "because I saw REAL reasons to be in a place like that when I was there, and I just felt that my problems weren't so bad".

I stick by my statements about borderline personality disorders- you really don't know how horrible these poeple are, and the same with a true sociopath.

I challenge you to find one experianced psych worker on the planet that will tell you otherwise.

It is just that the male version of that isn't usually diagnosed the same way- or treated in the same manner by society- if anything, society is far gentler and kinder to the female version- both have about the same life expectancy- most are dead before 40 anyway.

You may have known one or two in your life, or even more- but chances are, you liked them at first, but hated them later!


Oh- and BTW Artemise- there IS a component of "real" mental illness- I mean the kind that I mentioned whose behavior does not change when placed on that imaginary desert island- of hormones. I say this, because even though about 95% of freud's stuff has been discounted- and, like you say, there is a very troubling history dealing with womens mental health- but we do know for a fact that there is a hormonal component- in both men and women, and we do see a decrease in some behavior when there is a hysterectomy or castration of the males.

WE don't do these procedures- they do it to themselves. It is not unusual to see someone mutilate thier own genitalia in my hospital- so, we track thier behavior when they are succesful in damaging these organs or removing them, as case studies.

Also- in male schizophrenics, especially those that had violent incidents, criminal or otherwise, that live to be over 50 years of age, when thier testosterone levels plunge, so does some of the acute nature of thier mental well-ness.



This is a hugely long post trying to describe a profession that is really lost on the gneral public, or horribly misunderstood when we make realistic statements about mental illness- but, at some point, every society has to make thier own determination of what 'mental illness" is- and in the US, I would say we have classified TOO MANY things as a form of "mental illness"- and I am not sure if that is healthy for the patients either!

I think at the reala heart of this debate is whether or not we as a society have a right to incarcerate people against their will when they have done absolutely nothing wrong. Just because someone is deemed by a psychiatrist to be dangerous to themself and others...does that automatically give them the right to send them to a mental hospital? There are plenty of dangerous criminals out there who go in and out of prison but for them to be incarcerated it is necessary for them to have been convicted of a crime and have their due process. People deemed with a mental illness are afforded no such rights.

People are then coerced into taking drugs to help their "illness" against their will. If they deny taking it, than psychiatrists will brush it off as a stubbornness as a result of their illness instead of a competent chocie to refuse medical treatment. I even learned that people who fake a mental illness in order to be cleared of responsibility (such as a crime or receive some benefits) are considered to have a mental illness!

It's amazing that so much information is withheld from the public about the issue. We are both depriving innocent people of liberty as well as clearing people of responsibility for supposed behavior problems. As i quoted in my earlier post, mental illnesses are invented. If your kid acts out in class...he has ADHD...if you like things to be nice and neat, you have OCD.

Usually when people are sent to a mental institute it is because they have displayed violent behaviors towards themselves or other. It does not take a psychiatrist to determine if wielding a knife at person A because person B has delusions about the person A (i.e. that person A is actually trying to kill them, or person B is in some sort of conspiracy, ect). As I said before, although I'm not sure if you read my post, was that officers usually fill out the paper work for a 24 hour period to withhold them. Later on (depending on state) a judge and doctor can determine if the person needs help.




People are sometimes forced to take drugs to fight their illness because the drugs may have side effects that aren't wanted. Obviously new and better drugs are being developed all the time which have lesser side effects and combat the problem more. I'm not sure why illness is in quotations here, have you done any research or reading as to what exactly is constitute as a mental illness besides reading the Szasz book, which is obviously pushed from a Scientologists perspective?

Did you know that for people with hallucinations (i.e. the ones that say they're hearing voice in their heads) the auditory complex that decodes speech (Wernicke's Area) is activated when they says the voices are talking to them? So in essence they are hearing voices because one part of their brain is tell another part that it is decoding speech while the other area finds the meaning. Malfunctioning of the brain doesn't seem very made up, in fact, it seems very objective.



This is true only because most people, like the public, have no idea what they're talking about. I'll agree that ADHD is over diagnosed and may not even be a real mental illness, but people who like to be neat and call themselves OCD are just displaying their ignorance. If a psychiatrist diagnoses someone with OCD because they arrange their CD's and books in alphabetical order then that doctor is a quack and should be stripped of their M.D. You have to remember, psychiatrists are medical doctors and thus trained as such, with a heavy emphasis on objective data. Now of course not all data in the world of psychology is objective, but there is still much work being done to quantify mental illness because it is different than having cancer or a broken bone.

1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?
I believe that anyone who commits a serious crime has a mental disorder. I cannot think of any examples of someone being unwillingly imprisoned in this country without first demonstrating intent to cause harm.

2) Does American society need to reasses its position on mental illness and psychiactric powers?
I do not see a problem with the limited powers that our psychiatrists already have. However, I do feel that our society is hooked on drugs. It seems like we are too willing to get doped up to reflect some kind of norm rather than considering alternatives.

3) Do you consider a mental illness a real problem or a fabrication by the psychiactric field to justify certain behaviors?
First of all, I do not consider it an illness, but a disorder, and only when it is pronounced enough to interfere with daily activities. Otherwise, it is merely a syndrome, and we all have some kind of syndrome. People who are normal have neurotypical syndrome.

As an example, some people satisfy criteria for ADHD, but it does not have a significant negative effect on their lives. Therefore, they may simply have a manageable attention deficiency, just as someone might have a manageable level of shyness.

Consequently, there are overdiagnoses. Everyone is different, and we too readily accept this as a problem. We see commercials describing normal human mental conditions, like sadness, as something requiring medication. Psychiatrists will rarely argue because that would mean rejecting a customer.

4) What are the implications for the US health care system either way?
The health care system focuses mostly on artificial medications. This is where the money is, but I do not believe that this is always the best route. For example, some mental disorders could be explained by an omega-3 deficiency, or a lack of excersize, or some other effect of habit. You cannot patent omega-3, because it is natural, so research into this area is not very profitable and is therefore generally avoided by pharmaceutical companies.

But even though we have a huge bias toward artificial solutions to natural inconsistences in human mental function, I still believe people should be able to choose their treatment, or lack thereof. Only in the case of someone intending to cause or actually causing harm should there be any intervention. I do not see any conflict with this and criminal behavior.

You see what you are posting? You are saying that it is ok to imprison people involuntarily because they have displayed a violent behavior. There are plenty of criminals or ex-criminals out there who display violent behaviors but are not imprisoned without a trial and due process. The fact is that we are deeming people mentally ill because of behaviors that in our society they should be free to make. Our system of justice is highly reactionary and not based on what we "think" someone will do. I can't predict whether or not a person out of jail will commit another crime so i cannot imprison them indefinately.



First of all, labeling something as being from a scientoligist perspective is meaningless to this debate and i would prefer if it was discussed on the argument's own merits. The question that I ask to you is having hallucinations warrant for involuntarily imprisonment in a mental hospital. And furthermore even if one hears voices and then kills someone, is that person responsible for their actions? Does one not have a right to hallucinate if they do not harm anyone?

People talk about how mental illness is brought upon by such things as a brain disease (which makes it a disease not a mental illness) or a chemical imbalance. But why is it that we only attribute negative effects on a chemical imbalance instead of positive ones? If a person commits a murder...it is due to a chemical imbalance. But if a person creates a symphony, it is based on their own talent.



So just because someone shows an intent to cause harm, they should be imprisoned? I thought our justice system was based on the notion of innocent until proven guilty of a crime. You can't lock someone up if they have not committed any crime but thats exactly what goes on. Furthermore, people that are malingering can get out of responsibilities of every day life or even for a crime based on their mental illness or the drugs that they were forced to take.

With intent, I mean something parallel to attempted murder. We cannot let someone off just because they have poor aim or butter fingers. Mental disorders do not themselves show intent. A kleptomaniac should be held to the same standards as a regular thief, in both criminal justice and medical attention. If a crime has neither been committed, nor been in the process of being committed, then there is no grounds for imprisonment. Likewise, a criminal should not have to make an insanity plea to get the same psychiatric attention.

Very quickly. I have read Szasz work and I think that the answer to your question is that some mental illnesses are an illusion and some are very real. Szasz has made a good point that some mental illnesses are simply a way to marginalize people who act different than the dominant values. Hence, African-American people have historically been labelled as more mentally ill and less intelligent. The prbolem has been the racism that occurs in science. Furthermore, some mental illnesses have come and done -- homosexuality was once considered a mental disorder. However, there is a very realness to other mental illnesses, such as schizophrenia and clinical depression. I would suggest reading Dr. David Healy's book "Let them eat prozac" -- as a hisotrical psychatist her highlights how the pharmaceutical industry creates mental illnesses so that they can make money. Hence, some mental illnesses are an illusion and some are very real.

I would for the most part agree with your assessment but someone needs to play devils advocate and i think i will assume the role. I've looked at evidence for both sides and are very skeptical of even schizophrenia or clinical depression as mental illnesses. The reason is again that these diagnoses are based on symptoms which are subjective observations of behavior. This differs from a diagnosis of a real illness in that they are based on signs through objective testing (i.e. blood test). The whole point is that we as a society have begun to equate good/bad with healthy/sick. Things that are considered good are considered normal, healthy behavior. If someone acts outside of the mainstream, then they are deemed ill. Thus, we deem what is good and bad in our society through what we perceive one's behavior to be.

Okay, as I sit at my desk on the night shift at 0310 in the am, in the state's only mental health facility- I see this assumption through many posts that the Hospital GOES OUT LOOKING FOR CUSTOMERS- this is the first wrong assumption- we screen OUT more poeple than we let in- because they simply don't meet the criteria for admission-
Gravely disabled, iminent harm to SELF or to OTHERS is the fast definition of what we are allowed to place, involuntarily, into the hospital.

And there is due process- first- let's discuss the "how" of being involuntarily placed in a mental institution-
1) Most usual of the first paperwork filed to have someone commited - the POA= police officer admission. The officer starts this at the scene, were he has been called because of some strange behavior, usually a suicide attempt, such as jumping in front of moving vehicles, which seems to be popular here in Anchorage this week
This order has an expiration date of 24 hours, weekends and holidays included

2) then Ex-parte- The doctor files this and it goes in front of the magistrate for a hearing- which has to be done withn 3 WORKING days from the date of filing

So the longest they can hold you is about 5 days if you are unlucky enough to be hauled in about 4pm on a friday before a 3 day holiday weekend.

by the time that five days are up- you get your due procces in the

3) Petition for involuntary commitment hearing- first one is for 30 days, then 60, then 90, then every 120 days, no matter how long you have been enjoying your stay here!
This involves a magistrate, usually a very experianced one, that has had some major background in clinical psyche- in my hospital, we have court three times a week, and have our own courtroom.
You get a public defender if you can't afford a lawyer- and if you can- why the heck are you at a public facility- you need to go somewhere and pay for your treatement (j/k- just hospital humour)
But at this point- you have had due proccess

Now- at the same time, if the Dr deems it neccesary- at the same time of commitment- you have hearing on involuntary medications- yet even more due process here.

There is enormous set of checks and balances here- I can honestly say I have never seen someone commited that has not been an IMMEDIATE danger to self or others- the criteria for admission, and an ethicaly sound one IMHO.

We are contantly over crowded, and love to discharge poeple and not admit anyone for a while- but business is just too good!

Another observation was about creativity and such- Schizophrenics and Schizzoaffective patience typically are MORE creative when they are mentally stabilized- you won't see a full blown Schizophrenic creating anything to nice, until they are on thier medications, and then they start making real art.

In 18 years I have never hear a Schizo-diagnosis patient say "but I am so much more creative when I don't take my meds" - it is the opposite, big time.

Those mental illnes, if severe enought to warrant hospitialization- and we have had our fair show of artists and performers- simply CAN'T do good work while in full blown symptoms are observed- they simply are too confused stay on task. We actually have 2-4 "creativity groups"- pottery and such that helps them focus- and you can see thier mental state get better right in front of your eyes through thier art!

Thier is a very will witchhunt nation wide right now against the clinical mental facility like mine- because, most of the time, we can't even legally respond to allegations! WE can't even say 'Oh yeah, prove it"- because it may break patient confidentiality!- so when an organization like NAMI makes an allegation- we can't even set the record straight- very frustrating, believe me.

Mental illness is no illusion- and if you think so- go volunteer in a place Like I have worked for 17 years- you will be converted, believe me!

CruisingRam, do you understand the paradox of both due process and 'involuntary' treatment in the same line of thought? I contend that despite any effort at this supposed due process, that if it has to do with the involuntary treatment of a person that their rights are inherently being violated.



What is immediate danger to self or others? Is that not subjective? And who are doctors to predict the future? How can anyone say what someone will do? Our justice system is based on a reactionary principle. You are charged and convicted only after you have committed a crime. This set of due process that you talk about is in response to what someone potentially might do some time in the future. Is there not something wrong? These are important questions that need to be asked more and more.



I really do not see what that has to do with involuntary treatment. Just because someone is subjectively more creative when on medication is NOT justification to forcefully medicate them no matter how you slice it.

Okay- you want an example of immediate harm to self or others? Running in front of cars in traffic, running down the street naked in 40 below weather, ripping thier genitals apart with various instruments, wielding a knife and threatening to hurt themselves and others. And so on. We simply don't have the resources to go after anything less than that.

There is no ambiguity in "iminent harm to self or others". None whatsoever. NO, it is not subjective- it is empirical- you can document it, observe it, and any logical person can see it.

We simply do not have the resources to "lock up" those that are merely gravely disabled but NOT an iminent harm ot self or others.

Guardianship, however, is a whole 'nother ball of wax when dealing with this issue- and that can get pretty murky!

Aren't some of the things you listed as harm to self or others considered criminal? And is it possible that someone wants to harm themself but is in an ok state of mind?

"Imminent harm to self or others" is indeed subjective because it has to do with acceptable/unacceptable behavior which are social constructions that should not be regulated by government but rather by social controls.

You see the thing is that people who are considered mentally ill are considered to have "bad brains" meaning they have a disease or that there is a chemical imbalance. But how about people that do good things? Do they have "good brains"? If its all about good/bad brains then there is nothing left of the person. There is no free will and we are all just souless machines.

In all honesty- I don't know if you are debating this just to be contrary or actually have had 0 contact with clinical mental facilities- and I am going to hazard a guess that it is the latter?

1) There is empirical evidence of clinical mental illness and recovery from this illness.

2) Mental illness results in diminished capacity for a person to make an informed consent (just as relevent as a coma)


I am all for informed consent suicide- but there has to be informed consent!

The basic part of mental illness that appears, to me from my POV- to be prefacing your argument that somehow the have the ability to have informed consent of thier actions despite mental illness. Can you boil it down for me if that is not the crux of your argument?

Before I post my answers, as this is my first post on this forum, I'll supply a little bit of background.

I am the father of a 5 year old boy who was diagnosed with Autism Spectrum Disorder with Pervasive Developmental Delay (aka PDD) in January 2003. Thus began our foray into the gray area between neurological and psychiatric disorders.



1) What are your feelings on the debate over the validity of mental illness as both a defense against responsibility and as a coercive act to imprison a person who has commit no crime?

Before I answer this, I detect another issue behind it. Which is more important: law enforcement or crime prevention? One seeks to prevent elements of society from harming each other, the other cleans up the mess post facto.

While I will not answer the question I've just posed, it does lie at the heart of the this first question. If a person is mentally ill and they do, in fact, pose a threat to society, or themselves for that matter, should society inter this person now or just throw them into prison after they've killed/raped/mutilated someone?

There is also another issue as well: profiling. In order to successfully prevent a mentally ill person from harming the population at large (or, again themselves), behavioral profiling must be used to successfully identify these people.

Is there a difference between people who prey on society by choice and people who do so without their full faculties? If the answer to this question is no, then we should get rid of NGRI verdicts and toss the criminally insane into prisons or just let them kill themselves. If the answer is yes, then these people should be treated.

So, how/when should these people be treated? Before they've committed a heinous crime or after? If a society is willing to make the distinction between criminals and the "disturbed", should they also be willing to help cure or control them before they've committed a crime?

I seem to asked more questions than I've answered. Suffice it to say that I believe that each event listed in the question is a valid societal tactic, but probably not in every case in which it's used today.

By the way, I find the term "defense against responsibility" to be somewhat biased. It predetermines intent when the truly mentally ill harbor no such intentions.


2) Does American society need to reassess its position on mental illness and psychiatric powers?

Yes. However, this reassessment is an ongoing process.

Before the early 1990s, autism was described as a purely psychiatric condition, the result of maternal rejection of the child. There were all manner of books and papers written on the subject. Research now indicates that it is a physical issue, related to either a neurological birth defect, genetics or mercury poisoning from vaccines. As a result, the diagnoses of children with autism spectrum are getting better and the therapies are improving.


3) Do you consider a mental illness a real problem or a fabrication by the psychiatric field to justify certain behaviors?

Mental illness exists. I do think that the psychiatric field likes to think of itself as the final word on such things and plays too large a role in shaping our viewpoints, however.


4) What are the implications for the US health care system either way?

Unknown.

L,

Looks like oversimplification to me. Are we to deny that drugs affect the brain and other bodily functions, that we are not chemical beings? Are we to swallow the premise that we are manifestations of the will, a property which cannot be measured? Actually, I am a big will fan, but it is a matter of faith. On the other hand, I do know that many drugs, which are chemicals that can be measured, do impact the brain for good or bad.

Aye, good and bad--these are also unmeasurable properties. So let's put it like this: If a person believes that harming others or self is good, that's bad. It is especially bad when I am one of the targets of harm. It really flies into the face of my will.

As far as why people do good in the world, I go toward the social aspects of humans. Other species are not concerned due to the lack of social structures in their brains. Many fish eat their young. Spiders eat their mates. This is natural for them, not for us.

We don't understand how the brain works, or how other parts of our rather complex bodies impact the whole. As a result, we oversimplify why we do what we do. It's like a mirror image. We only know ourselves as mirror images, pale reflections of the reality. Actually, the reflections can be brilliant illusions, thus fooling us into thinking we actually know something about ourselves. Eh, this is heading into deep water, so let's do another kind of oversimplification:

The brain is a chemical computer. It needs oxygen or it dies. It needs food or it dies. It needs water and a body that makes various chemicals for its use. A good brain keeps the whole alive and thriving. A bad brain does not.

Why does a bad brain try to destroy the whole?

Arg, therein lies the question. We don't know. So should we not try to fix the bad brain? At least keep it from getting up in my face, defying my will?

My vote is no. Keep on trying. Maybe we'll get it someday.

And if it's a good brain with a bad will, then what? Oh yeah, we have laws about that, dating back to something like 5,000 years ago. Hitler was a pretty sharp cookie after all. So we can conclude:

Fully functional brains can still come up with really bad decisions. Being stupid has always been part of the human condition, and probably always will be. We are masters at it.

Meanwhile, people get sick. We, as social beings in chemical bodies, need to try to figure this out. It's not okay to axe your mudder. It's not okay to slaughter your kiddies. Shooting wifey or hubby, not okay. Castrating self--okay? Think not. Piercings and tatoos are grey areas, along with drinking and smoking. Let's throw pot in there and maybe things like going to wars of aggression voluntarily. Buying a Hummer? Aw, what the hey.

From oversimplification comes the vast complexity of human existence, if one choses to look deeply into the mirror, that is. This heads into deep water. Better learn to swim or build a boat. Taking drugs might help, or not. We don't know.

I am not necessarily saying that i share the beliefs that I am arguing but rather trying to pose an honest question about our current state of medicine in this country.

My basic argument has been enumerated earlier in the thread, but it basically boils down to this: actual diseases are discovered through objective testing such as blood tests whole mental diseases are invented through subjective observations of behavior deemed hazardous. You cant take a blood test of 100 random people and tell who has depression and who doesn't. But you can tell who has cancer and who doesnt. We have a reached a state where what is healthy/ill is determined by our own perceptions of what is acceptable/unacceptable behavior. The basis for mental illness is behavior so if someone acts in a way outside the mainstream, then their behavior is deemed hazardous and thus must have some sort of disease. The argument many theorize is that this is not the fault or intent of the people because they are infected if you will. But i argue that if there are certain people who have "bad" brains and that THAT is what causes behavior than is there such a thing as a "good" brain that allows people to have acceptable behavior? What happens when someone with a "good" brain does something bad?

Finally the crux of the argument is that if a person is not charged with a crime is it constitutional to deprive that person of liberty to forcibly treat them in a mental facility without consent? If a person has cancer, they can refuse treatment as it is their legal right to do so...but this right is not extended to those deemed mentally ill because they could at some point in the near future might possibly hurt themselves or others. Psychologists cannot predict the future and cannot predict the actions of an individual. Our justice system is reactionary...innocent until proven guilty.



To answer the first part of your post, isnt the basis of our justice system innocent until proven guilty? Doesn't someone have to commit a crime before they are charged and/or convicted? What you are theorizing is that we lock people up on what they MIGHT do which is a blatant violation of the constitution. Do you not agree?

If a person breaks the law, then they are a criminal and should go through our justice system as every other person. Just because you may have a mental illness does not mean you are a criminal. People who talk about schizophrenia and how they can't control themselves or whatever...i find that argument illogical because not everyone with schizophrenia commits crimes so we can logically deduce that some people can control themselves while others cannot.



Of course drugs affect the brain and other bodily functions but that is introducing a harmful substance into the body that is usually not there. I am arguing that people have free will to do what they so choose. Just because you suffer depression doesnt mean that you had no control over your actions when you killed your boss because others with depression do not go around killing people. In my mind this person is no different than any other person who is tried and is assumed to have full control over their bodies. What about people who are being involuntary treated but dont want to continue because they do not like how they feel on the medication...should they not have the right to refuse?



Should we incarcerate people on what they "think" or what they actually do? Good and bad are social constructions and i am saying good/bad has been combined with healthy/ill.



You're right when you say all those things are wrong which is why a person should go to jail if they commit those crimes. They shouldnt be forcibly treated if they thought about it but never actually acted upon those urges. That is the basis of our justice system.

Doesn't anyone else find it disturbing that in this day and age that if alive today people like Jesus or Muhammed would be deemed mentally ill and probably forced to take drugs because their thoughts were a little wacky?

An enormous facet of the justice system, especially when it comes to crimes gainst the person, is intent. Intent can make the same act in two cases entirely different crimes. Every first year law student in the first week of classes learns the critical importance of actus rea and mens rea, as exemplified by the most used latin phrase in the history of law:

Actus non facit reum nisi mens sit rea, or "the action will not make a person guilty unless the mind is also guilty".

If I kill a person because I don't like them, or if a person jumps in front of my car and I kill them, how can the crime be different, in both cases a person has been slain. The difference lies in intent.


Mental illness is not a get out of jail free card. My uncle is Chief forensic psychiatrist at one of Canada's largest institutions for the criminally insane, so an 'expert' does not even begin to describe him. The fact that someone is clinically insane, that is they have a psychiatric illness, does not excuse them from a crime. A person who thinks the sky is alive and talking to him, then kills his neighbour because he caught him in bed with his wife will go on trial for murder. The only time mental illness becomes a factor is if the mental illness alters the intent of the person, usually by altering their perception of reality.


Take as a case study: If somebody in a dark alley pulls a gun on you for no reason, the law of the United States says you can use deadly force to protect yourself because you are in imminent danger. However, if somebody in a dark alley pulls a realistic looking TOY gun on you, and you use deadly force, then you are still considered to have acted in self defence, even though there was NO THREAT to your life. Why? because you had reason to believe there was threat to your life. Reality here becomes secondary to perception.


Someone with a reality disconnect, whose mental illness prevents them from interacting with the normal world, or who lives in a dissociative state, hallucinates or whatever, may genuinely perceive themselves tobe in mortal danger. Allmost ALL cases of violence among schizophenics result from what they deem as self defence. They were under attack from something or someone, or felt threatened. The law clearly states that this IS a valid defence if it can be established.


If someone is unable to tell the difference between right and wrong, or cannot understand the causality of their actions, then there is cause for the justice system to treat them differently. The fact that the situation that frees them is in their mind is irrelevant according to the law.

Lastly, faking mental illness is essentially impossible in front of a trained forensic psychiatrist. About once a month my uncle gets a faker trying to escape responsibility for his crimes: not only is he inevitably discovered, but usually withing less than 5 minutes. Thats because since most of these disorders are well known and the chemical imbalance which causes them, while not understood, is at least generally known, there are destinct patterns of behaviour which cannot be mimicked.

There is no hokus-pokus or which doctory about mental illness, we know a lot more about these diseases than some people here seem to think we do...





There is an argument to be made that if somebody HAD given those two some antipsychotic drugs and some serious therapy, the history of the last few thousand years might be a lot less bloody...

Leder- thank you very much for clarifying your position- I appreciate it-

okay- I see your point- and it is a very, very valid one, and that is testing for non-testable mental illness? For instance- some forms of mental illness and dementia can be very, very specific and objective- like bi-polar disorders, classic schizophrenic illness, and some others.

The real issue comes into play in personality disorders- and they are awful to really nail down those with a consistant diagnosis.

Vermillion- thank you so much for your post- very realistic and true on the observations of your uncle- it is virtually impossible to fake mental illness to even a relativity experianced line floor staff like myself.

In fact, the Dr quizzes me on my guess to diagnosis after he makes it, and we bet a cup of coffee if we are the same or not.

I have NEVER missed a malingerer in 16 years. I have got schizzoaffective and some manic disorders mixed around- but psych tests reveal the difference.

I have to disagree with AM a bit on crime and punishment and the mental illness. It is a very, very rare case that true diminished capacity makes it's way into a crime.

Lot's of criminals have a mental illnes, one of them the near terminal and sometimes fatal lack of good choice making.

I have over 10 years of experiance in forensic psyche alone now. And a great deal of those poeple seeking NGRI prior to our own legal change of those definitions could, under our old laws, find it quite easy to 'get away with murder"- except for the fact, that once commited under this term- they found it very difficult to get out!

You see- there are two things in play here:
1) Legal definition of diminshed capacity, culpability, competency, and overall mental illness issues surrounded by these definitions when responsibility for thier actions come into play

2) Treatment for mental illness against the clients wishes.

Those categories, are really seperate and distinct- one if for the commision of a crime, the other, an innocent person.

The libertarian in me doesn't like the idea of scooping poeple up against thier will as long as they are not harming anyone, but only harming themselves. But in that same libertarian streak- I also have recognized that all members of a free society have to have free will and informed consent to be in this ideal free libertarian society.

And, with my work with the really, really chronically ill (I don't really deal with someone that is not pretty seriously mentally ill, so the grey areas don't really come into play at my work place) - so I do know there are poeple that are not capable of an informed adult, consent- the same reason we don't let children make decisions for themselves.

The difference is that i do not see supposed mental illness to be a valid defense for someone's illegal activity. The reasonable argument that a toy gun was thought to be a real gun is not on par with the claim that the sky was talking to you and "made" you kill someone.



Unable to tell the difference between right and wrong? I think you mean the difference between what society finds acceptable and what they don't. And since when does not understanding the causality of one's actions freed someone from responsibility? Ignorance of the law is not a defense.

Secondly, did you know that faking a mental illness is actually CONSIDERED a mental illness? I mean no disrespect to your uncle, but how could he truly tell if one person is malingering and another person isn't? Having a mental illness depends on your behavior. If i said that a tree told me to hurt someone...how is it possible for someone to disprove that?



Again, how could you possible know that? You perceive one's behavior and if it conflicts with societal norms than it is deemed hazardous and some sort of disease. All behavior is voluntary.



Here is where you and I differ in our libertarian views. I believe that the only three instances one can be treated against their will are : 1) literally a child 2) literally unconscious 3) literally contagious. What you are saying is that its ok when a person is 1) metaphorically a child 2) metaphorically unconscious 3) metaphorically contagious. The person isn't really a child, they are metaphorically one in your eyes never stopping to think that maybe they have the right to act that way free of government interference.

Why not?

In both cases, the life of the threatened person was in NO DANGER WHATSOEVER, however their legitimate perception of the situation caused them to reasonably feel they were in danger. The mistake was through no fault of their own.

Why is it different? If a person has a serious psychotic disorder, then they are as convinced of the threat as you are that you are currently siting at a computer. It forms the basis of their reality. It is not just voices in the head or a bad headache, it is an entirely different perception of the world around you. More importantly, it is a different perception based on no fault of their own. Why should they be held to a DIFFERENT tandard as everbody else? The rest of the population, if they can prove that according to their reasonable perception they were in danger, can get away with murder so to speak.

You need to explain why we need to alter the justice system to create another standard for the mentally ill...




Sinnce when? Well, how about when children commit a crime? Why do we not execute the 9 year old for shooting his father because his father would not let him have a bike? Because the child had 'dininished capacity', that is no full understanding of the consequences of their actions.

Again, the precident is there in the legal system.

Now here you need to be aware of certain terminology. There is a difference between somebody who does not understand the consequences of their actions, like someone with a serious psychotic disorder, and somebody who does not CARE about the consequences of their actions, like a psychopath (which despite the similar names, is NOT the same thing at all). As I said, mental illness is NOT a get out of jail free card, and a psychopath will be processed by the justice system no problems. There needs to be evidence, as testified to by a forensic psychiatrist, that the person's perceptions of the events gave them diminished capacity.

'Law and Order' and such TV and film also give a terribly skewed perception of mental illness. Almost NEVER do you get conflicting psychiatrists testemony on defence and prosecution. Modern psychiatry is as much as science as surgury is.



No, this is plain wrong. All behaviour is not voluntary, motive and perception is at the very BASIS of the criminal system. Thats why self defence and murder have different statutes even though the result is the same. Thats why there is a crime on the books for attempted murder, though no 'de facto' crime hs ben committed. This has nothing to do with 'societal norms', it has to do with chemical imbalances in the brain, misfiring wiring, allmost all of which is now correctable, and which in the next 10 years, with the recent innovation indesigned impact drugs, will be even more easily treatable.

FAR too many people seem to draw their opinions of psychiatry from bad 19th century movies of people in straightjackets howling at the moon. That simply could not be further from the truth.



Firstly, faking a mental illness is not considered a mental illness. I dont know where you got that from.

Secondly, as has been repeated here, simply HAVING some form of mental disorder does not get you out of prison. EVEN IF you were right with your above point, its irrelevant. You need to have a situationally exact mental disorder that substantively alters your perceptions of spoecific events, and it has to have direct bearing on the case. My uncle often gets criminals who have some kind of mental ailment, but who are completely fit to stand trial because their ailment has no impact on their perception or intent to commit the crime.

Thirdly, (and I men no insult here whatsoever) your question can only come from a certain common ignorance of how mental illness works. If you go to my uncle, or any trained forensic psychiatrist and tell him a tree told you to kill somebody, I bet you my life savings he will kick you out of there inside of 4 minutes, no matter how 'insane' you pretend to be.

How can you tell leg is broken? You cannot see the bone, you cannot examine the bone itself with the naked eye, yet a doctor can tell a broken leg even without X-rays. Thats because that specific ailment has specific symptoms, a variety of them. The patient may only know of three or so: can't walk, won't support weight, exceedingly painful, but in fact there are a lot of symptoms: the effect it has on the nervous sytem, curculation, inflamation, immune system, and so on. A good doctor can diagnose a broken leg without ever seeing the leg.

Mentail ilnesses are not just 'the guy's wacky'. They are one of many possible specific types of disorders affecting specific chemicals in the brain, the parts of the brain that affect emotion, behaviour, perception.

You seem to think when a guy calls himself loony, the doctor sits him down and has a chat with him, and determines his loonyness. But in fact the first thing the prospective 'loony' goes through is a series of blood tests, lab tests, reflex and acuity tests, pathology, CT scans, and so on. By the time the doctor has an inteview, they already know a lot about your condition, because it is a MEDICAL condition, not just some claptrap about 'differing societal values'.

In the room, the doctor will ask you simple standardised questions, and not about your crime. They will for example ask you to draw a clock, and draw quarter to two, on the clock. Different disorders will give VERY SPECIFIC results to these questions. Some guy who sits down and draws a cow will be kicked out as faking. They are looking for very specific answers to very specific, scientific questions.

Not only are fakers always caught, they are always caught inside of 5 minutes, unless they happen to be psychiatrists themselves. But EVEN THEN, once treatment has begun it is again EASY to make out even the most expert faker.

An example: a disorder is caused by having too litle of chemical X in your brain. Lack of chemical X has Y and Z PHYSICAL symptoms as well as menal ones.

So you give the patient doses of Chemical X. However EXCESS amounts of Chemical X is ALSO bad, and has a series of PHYSICAL symptoms as well as mental ones. There is no way to 'fake' the myriad of physical symptoms on either end of the scale, aven if you knew what you were being given.


Psychiatry is a science, not a buch of shamans dancing around a fire. If a forensic psychiatrist says a person has a specific disorder which caused them to be acting in self defence of a genuinely perceived threat, they are not guessing based on a quick chat, they know what they are talking about. Why do you think in ANY modern medical school Psychaitry is the LONGEST of all the medical resdencies?

I am not saying they should be held to a different standard than everyone else, i am saying that they should be held to the SAME standard as every other person who is responsible for their own actions. The fault i find in your argument is that not everyone who has a supposed mental disorder commits crimes just as some people who supposedly dont have a mental disorder do commit crimes. For some people, a mental disorder is an explanation for why someone commits a certain action or acts in a certain way. I find that explanation to be fallacious.



There is a stark difference between the psyche of a child and a fully developed adult. You are doing what CruisingRam did and saying that someone who is literally a child is metaphorically a child and thus does not deserve the same rights and privileges that we all share. And i don't really care what the legal system has set because i think there is serious flaws in their arguments. The fact is that the concept of mental illness has been so politicized that it is tough to reverse the damage it has done. Do you not remember when homosexuality was considered a bonafide mental disease? That was conveniently taken out of the DSM recently. Why ist that? Because they didnt understand homosexuality? Would a pathologist make such a mistake? Real diseases are discovered through objective testing. Mental illness is created through social construction. Once it was no longer the construction to consider homosexuality an illness, it was conveniently taken out.



Again with chemical imbalances in the brain. What does that even mean? You are suggesting that there is a biological foundation for mental illness when there is none. When there is a lesion of the brain...that is a brain disease, something that can be tested objectively. The major problem in here are semantics with word usage. A sign is an objective display of a disease such as having blood appear when you urinate. You can have signs but not symptoms. A symptom is something you complain about such as "my throat hurts." A doctor can make a diagnosis based on symptoms but that diagnosis does not show the appearance of disease. For instance, if someone complains that their throat hurts and that they have flem...those symptoms told to a doctor can indicate any number of things and the doctor may theorize that you have strep throat. But he can't make that diagnosis off symptoms. Once he takes a culture of the back of your throat can he know for sure if you have strep throat since that culture is an objective test of real disease. Mental illness if based on symptoms...not signs. You can have any number of symptoms but not be ill just as you can have no symptoms but be sick.

Chemical imbalances is a fallacy of an argument because it goes back to my earlier point that there is such a thing as a bad brain and a good brain. We blame bad things such as crime and deviant behavior on bad brains, yet we never blame good behavior on "good" brains. "I got an A on my paper because i studied hard and knew the material." "I committed the crime because my brain is not working correctly and i thought the person was a space alien."



In 1924, Eugen Blueler, the inventor of schizophrenia declared: "Those who simulate insanity with some cleverness are nearly all psychopaths and some are actually insane. Demonstration of simulation, therefore, does not at all prove that the patient is mentally sound and responsible for his actions." The source on that is E. Bleuler's book A Textbook of Psychiatry. During World War II, there were obviously a lot of malingerers to get out of combat. Kurt Eissler, world famous psychoanalyst and psychiatrist said: "It can be rightly claimed that malingering is always the sign of a disease...which to daignose requires particularly keen diagnostic acumen...It is a great mistake to make the patient suffering from the disease liable to prosecution."

From Szasz's book i mentioned in the opening post, "DSM-IV defines malingering, coded V65.2, as "the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives." This is a pretentious circumlocution for feigning illness. Factitious disorders- coded 300.16 or 300.19 depending on whether "psychological or physical signs and symptoms" predominate- are defined as "characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role." That seems pretty clear to me.



Believe it or not, i think that i am seeing the situation in the exact opposite of ignorance. I think it is ignorant to blindly accept that mental illness exists when the evidence is hardly definitive. Again I ask how your uncle could possible know if he caught every malingerer that he encountered. How could anyone know that? A pathologist can know every time a person with cancer comes into their office through a blood test. A psychiatrist uses subjective observations to reach a conclusion.



Again, symptoms = subjective while signs = objective. You may have the symptoms of a broken leg, but that may not mean you have a broken leg. Only an x-ray will let you know for sure. You can have no symptoms of a broken le