Tag Archives: Crime

K – #AtoZChallenge on Mental Health

Welcome to the letter K post in the #AtoZChallenge on mental health. I have only one word for you that is truly related to long-termmental health care and a few that are only perceived to be related. Here goes.

Keys

There is a joke that the differences between the patients and staff on a mental unit are, among others, that the patients get better and leave and that the staff have the keys. There are of course the locked units, where the staff have the keys to open the door of the ward. Even on open units, some rooms and cupboards are locked. This goes of course for the medicine room and cupboard, but also on some units the kitchen cupboards are locked so that patients can’t get food outside of meal times. My side of the unit is the only one where kitchen cupboards are open during the day. I was very surprised to find out that, not only are the cupboards locked on the other side of our unit, but on other units, the entire kitchen gets locked sometimes. This means people can’t even have tea when they want to.

Killers

Like I said before, some people get to the mental hospital on a forensic section. I don’t honestly know of most patients with a forensic status what crime they were convicted of. As such, it is totally prejudiced to assume some are killers – except that some people within the general population are killers too. People with psychotic disorders, which are the most common type of disorders in long-term mental health, don’t tend to kill random people even if they are violent. For clarity’s sake: most people with mental illness are not violent and the evidence is mixed on whether people with mental illnesses are more likely to become killers than those who don’t have a diagnosis. Some mental disorders do predispose people to criminal behavior, such as psychopathy or its milder variant antisocial personality disorder. Other disorders do not.

Kleptomania

It is a common belief that theft is particularly common in institutions, both mental and otherwise. I don’t know whether this is true. I for one have *knock on wood* not had anything stolen from me.

Kleptomania though is a compulsion to steal. It is not the same as someone stealing believing (delusionally) that an item is theirs or wanting the money to buy drugs or anything. Kleptomania is about stealing for stealth’s sake. Kleptomaniacs may even steal worthless items. Kleptomania does not usually lead peope to become institution patients. After all, theft is not serious enough a crime to get someone on a forensic section. Kleptomania is an impulse control disorder. Other such disorders, such as pyromania and intermittent explosive disorder, do potentially lead to serious enough crimes.

Mass Murder and Autism: I’m Not Impressed

Today, I came across a post on why the new DSM-5 definition of autism may actually be good. In it, the author talked about an apparent mass murder and the associated speculation of the killer having Asperger’s Syndrome. I googled, hoping to find out which mass murder she was writing about, but instead came across a Washington Post article which claimed a “significant” link beteeen mass murder and autism. I read the original study (Allely et al., 2014) on which this article was based, and I’m not impressed.

First, the actual question the authors aim to answer, is inverted. They research whether a significant number of mass or serial killers have autism and/or head injury. They found that this is so: roughly ten percent of the mass or serial killers the researchers read about, had suspected or diagnosed ASD, and a similar percentage had a possible or definite head injury. This may be significantly more than the prevalence of autism or head injury in the general population, but so what? The really important question is whether autistics or those who sustained head trauma are more likely to become serial killers. One thing I learned from Ton Dekrsen, author of Lucia de B., a book on the Dutch nurse falsely accused of serial murder on her patients, is that a statistical link that runs in one direction, doesn’t necessarily run in the other as well. Since serial or mass murders are rare, this is especially important.

Also please note that Allely et al. state that, of none of the six murderers (out of 239 total!) with “definite” autism, diagnostic data was available. “Probable” ASD also included a psychiatrist or psychologist having said the murderer had ASD. This raises suspicion, as psychologists and psychiatrists are not immune to media hyping wanting to label every murderer with the mental illness du jour. Dutch readers might remember psychiatrist Menno Oosterhoff accusing Volkert van der Graaf, who murdered politician Pim Fortuyn, of having Asperger’s in 2003. With no diagnostic data on any of the murderers with suspected or “definite” ASD, it is really speculative to even say that there is a one-directional link between mass murder and ASD. And don’t get me talking on the “possible” ASD people, who were simply described as “odd” or “loners” by their family members.

Allely et al. do say in their discussion that speculation about a link between autism and mass murder may lead to negative steretoypes. This of course is not a reason not to document it. If autistics are in fact more likely to be serial or mass murderers, there’s no reason not to write that into a research paper. The thing is, due to the rarity of serial and mass murders, this is unlikely to ever become truly apparent. And even if a definite link could be found, so what? I recently read in another book that, while there is a link between schizophrenia and violence, locking away all schizophrenics in England and Wales for the rest of their lives would save the lives of four potential murder victims each year.

Reference

Allely CS, Minnis H, Thompson L, Wilson P, and Gillberg C (2014), Neurodevelopmental and Psychosocial Risk Factors in Serial Killers and Mass Murderers. Aggression and Violent Behavior, 19(3)288-301. DOI: 10.1016/j.avb.2014.04.004.