A Cavendish Square Group publication 25 Mental illness and crime: addressing mental illness in offenders in the capital By Dr Ruchi Bhalla, Forensic Psychiatry Specialist Registrar and Dr Amlan Basu, Clinical Director of Broadmoor Hospital, West London Mental Health NHS Trust. Media coverage can make it seem like there is a link between mental illness and violence. But in reality most violent crimes have no connection to mental health problems at all. It was recently reported that at least one in three members of the general public perceive people with mental illness as likely to commit a violent crime. But the vast majority of violent crimes and homicides in England and Wales are committed by people who do not have mental health problems. In reality, individuals who suffer with a severe mental illness are more likely to be the victims of violent crime, rather than the perpetrators. So why is there a tendency for the public to exaggerate the link between mental illness and violence? The global reach of today’s media – whether it be the news, movies or television – plays an important role in endorsing this misrepresentation through its recurrent portrayal of individuals suffering with a mental illness as unpredictable and dangerous. Indeed, surveys have shown a significant increase in the public’s desire to maintain social distance from the mentally ill in the immediate aftermath of an extensively publicised violent crime. Offending in itself is not a characteristic symptom of any mental disorder and factors that are associated with an individual crime and incidence of violence are the same for everyone. These include gender, age, poverty and substance abuse. Latest figures reflect that people with severe mental illness are responsible for as little as one in twenty violent crimes. In only 7.5% of cases where a crime has been committed by someone with a serious mental illness is there an established link between the nature of the offence and symptoms of the individual’s underlying mental illness. It is true that the risk factors for offending overlap with those for mental illness – for example social exclusion, drug use, homelessness and unemployment. It is therefore unsurprising that rates of mental illness among offenders are high with four in ten offenders in the community suffering with mental health problems. The situation is even worse in prison, an environment that itself is conducive to an incubation of mental illness. The suicide rate in prisons is almost fifteen times higher than in the general population with 90% of prisoners estimated to suffer with a mental disorder. The health and criminal justice system have, in many ways, converged to address the needs of offenders with mental health problems. Great efforts have been made in the capital to promote collaborative working between public health and criminal justice particularly in areas where cultures and values vary. There are ten Trusts in London responsible for mental health, all of which offer specialist input to the assessment, treatment and rehabilitation of offenders with mental illnesses. This care is coordinated by forensic mental health teams who work in partnership with many external organisations including the police, probation services, the courts, the Crown Prosecution Service and prisons in supporting patients by addressing their treatment needs. Although tailored to the individual and their family, treatment often involves helping offenders to understand their illness, address problems of substance misuse and to identify the impact of their actions on others. Tackling mental health in offenders, both in the community and in prison, benefits not only the individual and their families but also the wider community. Successful rehabilitation and reintegration of offenders with mental health problems would certainly offer the public an alternative to the perception that those who suffer with a severe mental illness are destined to commit violent crimes.
London Mental Health Fact Bbook
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