This Article is written by Akanksha Ghorpade (Semester 1 (ILS, Pune))Intern at Legal Vidhiya
Keywords: Mental health, crime, substance abuse, antisocial personality disorder, schizophrenia, India, USA, Canada, Japan, South Africa, juveniles, prisons, recidivism, healthcare access
Abstract:
Mental health issues have existed for long. However, the subject was stigmatized and taken rather lightly. However, with changing times, mental health began to be prioritized in several countries. Studies have time and again, proven that mental health is just as important as one’s physical health. Mental health and crime are complex issues that intertwine in societies across the globe. This paper aims to discuss mental health and its link with crime. With the aid of various national and international statistics and research, this paper aims to throw light on the topic. Looking through the situation in various places across the globe will help us comprehend the subject better.
Introduction:
The World Health Organization defines mental health as a “state of mental well-being that enables people to cope with the state of life, realize their abilities, learn well and work well, and contribute to their community.” While multiple researches have stated that the proclivity of a mentally ill person to commit a violent crime is greater, there also exist studies that state that mentally ill people are more likely to be victims than perpetrators of crime. Further, certain studies say they may be prone to more violence if they’re not given appropriate treatment. Usually, psychiatric illnesses that cause hallucinations, substance abuse, and homelessness, among others are factors are cause violent behaviours. This paper will follow through the situations and data of some countries.
Additionally, this paper shall discuss juveniles and their mental health. Suicide prevention and mental health in prisons will also be included. Global conventions and agreements pertaining to mental health, and additional suggestions shall also be provided through the means of this research paper. Most importantly, the link between mental health and crime shall be covered well.
Mental Health: Types & Link with Violence
There are over 200 types of mental disorders. In 2019, there were 970 million people in the world living with mental illness. Anxiety disorder, Depression, Bipolar disorder, Post Traumatic Stress Disorder (PTSD), Schizophrenia, and eating disorders like Anorexia are just to name a few.
Now, it is imperative to take note that mental health is a sensitive issue and that mental illness doesn’t independently imply violent or criminal behavior. That being said, there are certain mental disorders with elevated risk of violence, such as:
Substance Abuse-
Substance abuse is a global issue that is detrimental to the society as well as the individuals involved. Substance abuse, essentially, is the excessive use of psychoactive drugs, such as alcohol, pain medications or illegal drugs. It can lead to physical, social or emotional harm. Substance abuse leads to several problems, apart from legal issues. Societal and domestic peace is disrupted when substance abuse is involved. Several crimes are committed under the influence of such harmful substances. Not only is buying and dealing with illegal drugs a crime, the abuse of these drugs leads to further crimes. Areas like South Asia hold a large network of illegal drug trafficking systems. A study in United States of America in 2010, held that 70% of the male prisoners were drug abusers. Another study revealed that 21.4% of aggressive crimes were perpetrated by drug abusers. A study proved a direct relationship between level of drug abuse and committed crimes. As levels of drug abuse were found to be elevated, the crimes also increased. Another important point to note is that most addicts were forces to commit crimes by acquiring drugs, implying that they did not get paid to do the task. Therefore, left with no other source of income, they were coerced to resort to illegal activities. It can be drawn that this entire process is a vicious cycle involving poverty, addiction, and crimes.
Antisocial Personality Disorder-
If you’re into psychological thriller books and films, you’ve probably heard of this illness before. Antisocial Personality Disorder is a mental illness, characterized by a disregard for other people and their emotions. Usually, symptoms may appear since childhood however, it is onerous to diagnose it until the person reaches adolescence or becomes an adult. Some symptoms include:
- Ignoring right and wrong
- Feeling no remorse about hurting and harming others
- Being aggressive and violent to other people
- Manipulating people
A survey conducted at the Psychiatric Hospitals and the Mental Health Centre revealed that people with antisocial personality disorder were more likely to be violent at times. There are multiple complications and consequences that arise, such as:
- Domestic abuse
- Problems with drug abuse
- Social problems
- Financial issues
- Criminal and legal issues
Firstly, it can be implied that antisocial personality disorder may sometimes lead to substance abuse and financial issues, which as discussed earlier, lead to criminal activities. Second point to be taken here is the direct correlation of the illness with violence. A major symptom of this mental illness is violence and aggression. It can be said that people with antisocial personality disorder are likely to commit crimes, especially violent ones. For instance, a study done in 2008 by Swanson et al., which investigated the correlation between antisocial activities in childhood and violence in adulthood, revealed that aggression was more common among the people with this disorder as well as substance abuse.
Schizophrenia-
Schizophrenia is a disorder that affects a person’s ability to think, feel and behave clearly. This illness is characterized by “thoughts that usually seem out of touch with reality, disorganized speech or behaviour and decreased participation in daily activities.” A symptom of this illness is psychosis, which is basically “a typical episode of hallucination and delusions triggered by stressful situations.” However, it is quite important to take into account that though schizophrenic people may experience psychosis, it is not imperative that every person with schizophrenia does so. Now, coming to the link between the illness and crime, it was revealed that in Western countries, about 6% of perpetrators of homicides were schizophrenic. It is also seen that a person with schizophrenia has a 4-6 times greater proclivity to commit violent crimes as compared to a healthy person. A study was conducted in Zanjan province of Iran involving 358 patients of schizophrenia, between 2004- 2006. According to it, 59.2% of these patients, i.e., 149 were offenders of crimes. Most of these crimes were violent in nature- child abuse, homicide, assault and rape. However, other crimes like theft, and damage to property were also observed.
Another intriguing research in 2002 by Maghsoodloo et al. revealed that most schizophrenic criminal patients also had antisocial disorder, discussed above.
It is interesting to observe that these 3 mental illnesses are quite closely linked, and form a cycle. Patients with these illnesses have larger propensity to perpetrate crimes, both violent and non-violent. In the next part of this research paper, we shall discuss mental health in various countries across the globe.
Mental Health: India
About 1.7% of people in India have been found to have antisocial personality disorder. About 0.7% have schizophrenia. As for drug abuse, 2.1% of the Indian population uses opium, heroin and 2.8% consumed Ganja, bhang and charas.
Mental illnesses have received acceptance to a certain extent in India, however, there is still a lot of progress to be made in the area. People are often labelled ‘crazy’ for having mental illnesses and seeking help, which further worsens the situation.
When having a discourse on criminality in India, it is imperative to note that a crime in India has 2 major components- mens rea (malicious intent) and actus reus (an act in furtherance of that ill intent). So, essentially, if a person is incapable of knowing that the nature of the act that they are committing is erroneous, the act shall not be labelled as an offence. So, unsoundness of mind at the time of commission of the crime is a defence.
Further, in 2019, a bench led by former CJI, Justice NV Ramana held that capital punishment shall be disallowed for extremely mentally unsound criminals.
Mental Health: USA
About 3.2 million people in USA have schizophrenia, 3.6 to 6% have antisocial personality disorder. Additionally, drug abuse among the youth of the country is an issue that needs to be resolved. A concerning percentage of people, 19.4% are involved with substance abuse in USA.
According to a study by Standford Institute for Economic Policy Research (SIEPR), “Within two years of losing access to health care, those with a history of mental illness are more likely to be incarcerated.” The study essentially implies that proper access to healthcare shall diminish the setback to a great extent.
Now, an intriguing factor to take into account is that several researches suggest that people with mental illnesses are more likely to be victims of violence than perpetrators. The entire subject comes under great scrutiny and debate, especially in light of the veritable rise in the number of mass shootings that occur in USA.
Mental Health: Japan
Though the former traditional system admitted offenders with mental disorders within general psychiatry, the Medical Treatment and Supervision Act of 2005 changed this to a great extent. Under the new act, these offenders are also provided with psychiatric treatment while undergoing prosecution for the crimes that they committed. However, it is also pertinent to note that there is still not enough legal guarding against violation of patient’s rights in penal institutions.
When compared with USA, in terms of drug abuse, Japan is better off. This is because drug users are shunned from society as it is highly taboo there. It can be said that Japan has zero tolerance towards drug crimes.
Although that doesn’t imply that Japan doesn’t have its own set of obstacles when it comes to substance abuse. Metamphetamine has been a root of apprehension in Japan for quite a while now. Abuse of drugs like MDMA (ecstasy) and cannbis is also rising in the nation.
Mental Health: Canada
Drug addiction and mental disorders are major matters of health concern for offenders in Canada.
As of 2014-15, it was recorded that 27.6% of the criminals in Canada required mental health attention and treatment. It was reported that the most common mental illnesses in males were substance abuse and antisocial personality disorder.
Risk factors are seen as important points to be taken into consideration to determine future criminality of a person with mental illnesses. It was also observed that people with ADHD had a risk of developing future criminality, albeit, there also exist studies to disprove this theory as well.
Mental Health: South Africa
The capability of a person with mental disorder to stand in a trial has not been explored much in South Africa. The courts, usually after assessment of such persons discern whether or not they are fit to stand trial.
Mental health aid is available in South African Federation for Mental Health, which runs a toll-free service for mental health issues.
Another pertinent subject to set a discourse on is recidivism. It has been observed that people with untreated and undiagnosed mental disorders are more likely to re-commit crimes. Substance abuse, aggression & violence as well as recidivism are closely linked to one another.
Suicide, Incarceration & Mental health
About 1.7% of prison inmates were suffering from mental health issues across India as of December 2021 as per ‘Prison Statistics India’ report of NCRB.
It is essential to adopt reformative forms of punishment to a certain extent for criminals. It aims to rehabilitate them and transform them into law-abiding members of society. Mental health check-ups and counselling should also be a part of prisons.
Improper conditions in prisons may drive the offenders to suicide, which is undesirable. Suicide, prevention is a global priority and is also a part of Sustainable Development Goals. As observed in Mohd. Hanif Quareshi vs. State of Bihar (1958), reformative theory of punishment, is based on the belief that human nature is capable of reform and that the object of punishment is not to inflict retribution but to reform the offender. This theory is well reflected in the Juvenile Justice Act.
Juvenile Justice Act
Juvenile Justice (Care and Protection of Children) Act, 2015 delas with the reformation and rehabilitation of juvenile delinquents through educational & vocational training and counselling. The act aims to provide utmost importance to the mental health of juveniles and counselling to prevent recidivism and transform them into law abiding citizens. Further there have also been instances of minors from the LGBTQ+ community being involved with juvenile justice systems. Bullying is a factor that increases the proclivity of children to commit crimes.
Mental health issues like depression, anxiety, ADHD are often linked to substance abuse among the youth. Peer pressure plays a major role in drug addiction and abuse. Socioeconomic conditions also determine delinquency to a certain extent.
Conclusion
WHO Member States agreed to implement the “Comprehensive mental health action plan 2013–2030″, which aims to improve mental health globally. The Convention sets out clear guidelines for nations to improve mental health. Such global conventions hope to better the current situation. Mental health illnesses are complex and are a spectrum. It is extremely essential to deal with this subject sensitively and carefully. There exist multiple predicaments when determining the criminality of mentally ill person. Can we hold them completely accountable? Or should they be set free without any consequences? Or is there another measure that can be figure out by global organizations and countries? The quandary continues to exist. However, that does not imply that there is nothing that can be done on a smaller scale.
The following are some suggestions to improvise the current situation:
1. Throughout our lives, multiple individual, social and structural determinants may combine to protect or undermine our mental health and shift our position on the mental health continuum. A healthy growing environment must be provided.
2. Harsh parenting and physical punishment is known to undermine child health and bullying is a leading risk factor for mental health conditions. So, such measures should be avoided and better parenting styles must be applied.
3. The determinants of mental health often requires action beyond the health sector. Therefore, prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors as well.
4. Promoting child and adolescent mental health and spreading awareness and developing acceptance for the same
5. School-based social and emotional learning programmes must be introduced by government and private schools.
Though loopholes and drawbacks may arise in the process of dealing with this complex issue with multiple dynamics, efforts should be made to strengthen the justice system and societal situation.
Citations:
Nakatani Y. [Treatment of offenders with mental disorders: focusing on prison psychiatry]. Seishin Shinkeigaku Zasshi. 2011;113(5):458-67. Japanese. PMID: 21706853-https://pubmed.ncbi.nlm.nih.gov/21706853/#:~:text=In%20the%20traditional%20Japanese%20system,this%20situation%20has%20radically%20changed.
Yamamoto J. Recent trends of drug abuse in Japan. Ann N Y Acad Sci. 2004 Oct;1025:430-8. doi: 10.1196/annals.1316.053. PMID: 15542746-https://pubmed.ncbi.nlm.nih.gov/15542746/#:~:text=Abstract,rising%20at%20an%20alarming%20pace.
Ghiasi N, Azhar Y, Singh J. Psychiatric Illness and Criminality. [Updated 2023 Mar 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537064/
Shishane K, John-Langba J, Onifade E (2023) Mental health disorders and recidivism among incarcerated adult offenders in a correctional facility in South Africa: A cluster analysis. PLoS ONE 18(1): e0278194. https://doi.org/10.1371/journal.pone.0278194
Juvenile Justice (Care and Protection of Children) Act, 2015- https://cara.wcd.gov.in/PDF/JJ%20act%202015.pdf
https://www.ncbi.nlm.nih.gov/books/NBK537064/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705679/
https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
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