ABSTRACT
The fi rst chapters of this book examine the complicated relationship between mental disorder and crime. Teasing out the various strands makes considerable demands. By way of introduction it is important to bear in mind the broad range of the manifestations of mental disorder: personality disorder, learning disability, and psychotic disorders such as schizophrenia, have at one time or another all been deemed to be mental disorders. But equally, some of these manifestations have, at other times, been contested as properly falling within a defi nition of mental disorder. At present, the legal defi - nition of mental disorder under s 1 of the Mental Health Act 1983 (MHA 1983), as amended by the Mental Health Act 2007, is ‘any disorder or disability of the mind’; a defi nition seemingly so broad as to include the world at large. Indeed, it includes many who might consider themselves, and who might be considered by others, to be mentally healthy. For example, whilst learning disability needs to be associated with ‘abnormally aggressive or seriously irresponsible conduct’ in order to invoke a number of the Act’s other sections, it is not wholly excluded (see s 1(2A) and (2B) of the MHA 1983). Similarly, whilst ‘dependence on alcohol or drugs’ alone is not considered to be a mental disorder (s 1(3)), the Code of Practice 2008 under the MHA 1983 (Department of Health 2008: para 3.8-3.12) sets out the situations in which such dependence might bring one within the scope of the defi nition of mental disorder. The scope of offending behaviour is similarly wide, embracing property and commercial crimes, offences of personal violence (from the petty to the most heinous) and a host of other activities which do not immediately come to mind as offences, but which range from the terrifying and bizarre to the merely ridiculous. The likelihood therefore of there being any straightforward relationship between the constructs of mental disorder and crime is small. And whilst a number of texts (eg Stone, 2003; Littlechild and Fearns,
2005) have sought to describe the process whereby the criminal justice system in England and Wales deals with mentally disordered offenders, there is less available in an accessible form that refl ects on the fundamental nature of the relationship. Indeed, even those texts that engage admirably with the diffi culties (for example, Blumenthal and Lavender, 2000) tend to take mental disorder and violence as their focus, and then trail in its wake issues of risk prediction and management, without really grappling with crime per se. So what fundamental questions dog the fi eld? Does mental disorder cause or contribute to offending behaviour; does engagement with the criminal justice process through offending lead or contribute to mental disorder; does the occurrence of mental disorder make offending less likely; does engagement with the criminal justice process reduce the incidence of further offending and/or lead to the successful treatment of mental disorder; are crime and mental disorder generally unrelated, but the relevant populations of those with mental disorder and those who have offended overlap by reason of other factors (discrimination, exclusion, poverty etc)? Are offenders who have mental health problems coterminous with people who have mental health problems who offend (James et al, 2002)? Indeed, whatever the complex nature of the relationship between crime and mental disorder, that relationship has implications for the relevant procedures utilised in both the criminal justice and mental health systems. Do those procedures and systems deal fairly and equitably with either or both mentally disordered people who have offended, or offenders with mental disorders? Whilst the latter parts of this book focus on questions of how mentally disordered offenders are processed by the criminal justice and health systems, and whether those dealings are indeed fair and equitable, the fi rst chapters examine the fundamental nature of the relationship between mental disorder and crime, and the evidence relied upon to support the various assertions made. This is diffi cult terrain and it will be necessary to proceed slowly, charting a path through defi nitions of crime and mental disorder, and of concepts of causation. There will be a slow descent through levels of detail, both in respect of particular types of crime, and particular types of disorder. And paradoxically, as one digs into the detail, the evidence becomes more persuasive in respect of the logic of limited associations, but at the same time the empirical strength of those associations is undermined because of the progressively smaller number of people involved. Moreover, it simultaneously becomes evident that the associations are not between particular disorders and particular crimes, but between the specifi c symptoms people can experience at given times, the context in which they experience them and the likelihood of the occurrence of particular kinds of behaviour.
