The relationship between mental health and crime
The relationship between mental health and crime has been debated for hundreds of years in the academic fields of criminology, psychology, and sociology.
Many researchers, scientists, doctors, and psychologists tried in the course of history to explain or to link crime in connection to mental health as if the latter was the root of all evil.
Poor journalism and misleading media portrayals depicted a distorted image of the relationship between the two, leading the general population to believe that individuals with mental health issues are more prone to violence by nature, dangerous individuals, and evil human beings.
This work will explore the history of crime in relation to mental health in order to try to give an answer to the questions that have been asked for hundreds of years, and try to reduce the unjustified and unfair stigma that is attributed to people with mental health issues.
The work will start with an historical analysis of the public perception of crime and mental illness to understand how this has changed in the course of the last two hundred years.
Subsequently, the work will present statistics of recent times and discuss the current situation, discussing mental health, incarceration rates, prevention, and stigma.
Historically the mentally ill have been disregarded, neglected, and despised by society, even though some research by the French philosopher Michael Foucault suggests that in ancient times they were simply seen as different or alienated from society, without any dangerous label being attached to them as a consequence of their “disorders” (Foucault, 2006); interestingly enough, nowadays thanks to the contribution of evolutionary psychiatry we are starting to wonder if mental health problems constitute problems at all, and we are wondering if the sole idea of defining mental illnesses and trying to explain them and cure them does in some way create a stigma toward the patients (Nesse, 2020).
Interestingly, in 2012, a group of renowned psychiatrists from Harvard School of Medicine redacted a paper studying religious figures from a psychiatric point of view analyzing their behavior and actions as reported in scriptures, and came to the conclusion that figures like Jesus, St. Paul, Abraham, and Moses in today`s medical standards would have been diagnosed with mental illnesses ranging from schizophrenia to mood-disorders (Murray et al,. 2012); but at the time, they became examples, loved and revered to this day by millions of people, showing how our understanding and perceptions of mental illness have shifted in the course of history, and how much we should instead embrace and appreciate the diversity of our species and do our best to live in harmony with all our individual differences.
A change occurred at the beginning of the 19th century, inspired by the Enlightenment and the humanity that was instilled in this period in England the Country Asylum Act of 1808 was passed, guaranteeing that institutions and structures were built to host, support, and eventually cure the “mad” and “lunatics”; this allowed the construction of sixteen asylums in England by 1842; is important to note that as noble and respectable this was at the time, the conditions of the patients were inhumane and remained so for more than a century (Rosen, 2015).
The birth of the asylum conferred some dignity to the patients, even though they were often abandoned by their families or secluded for problems like today`s depression, stress, insomnia, or abnormal behavior (Ruggeri, 2016).
The first criminologist who carried out extensive research on the relationship between mental health and crime was the Italian psychiatrist Cesare Lombroso (1835–1909).
Lombroso started studying all sorts of criminals and was able to collect large samples of prisoners to study them individually; he was convinced that criminals were a completely different species, a sort of drawback to primitive and instinctive behaviour typical of our ancestors and therefore were to be recognized easily through physical and mental characteristics (Newburn, 2017) (Lombroso, 2014).
In his most famous work “Criminal Man” published in 1876 he presented a myriad of photographs of convicted criminals and tried to utilize phrenology in order to prove his point; some of his most infamous theories include defining criminals by judging only their race, nose or skull shapes, mental state, marital status or profession (Lombroso, 2014).
In regards to mental health, he declared that “every kind of mental abnormality contributes in some way to crime… and that can determine the type of crime that is been committed” (Lombroso, 2014, Criminal Man, pp. 84).
Despite most of his theories have now been discredited as simplistic, narrow-minded and racist, Lombroso`s idea that crime could have a biological basis to it and that some individuals might be born with a natural proclivity towards anti-social behavior has found many supporters in current academical fields of criminology, sociology, psychology, and biology (Raine, 2013).
Many theorists in the following decades developed theories that directly or indirectly tried to explain the nature of the relationship between mental health and crime; Freud at first, was not overly interested in crime, but some of his theories were later adopted by criminologists pertaining to the group of Psychological Positivism to explain in some way criminal behavior (Newburn, 2017). His psychodynamic theory of personality was utilized to explain how some people resorted to criminal activities, which at the time was still considered a kind of primitive or animalistic instinct prevailing over logic and reasoning, the famous id, as referred to in the abovementioned theory was prevailing over the ego (Newburn, 2017).
In today`s society the opinion of the general population on the relationship between mental health and crime is incredibly and dangerously distorted; decades of wrongful media depictions, movies, novels, and unfounded news articles helped to shape the idea that the mentally ill are intrinsically violent by nature and therefore pose a risk to society, forcing the population to further distance themselves from them (Angermeyer, 1995); despite nothing could be further from the truth. The fact that individuals with severe mental illness are institutionalized could be another factor that contributes to this baseless stereotype, by preventing the socialization of the general population with the latter individuals, the lack of interactions between the two is another barrier that creates an unfortunate stigma towards mentally ill patients (opinion of the author).
Diving into the intricate evidence and extensive research that is been carried out on the topic in the last forty years we notice that the evidence indeed suggests that individuals with mental illness are more likely to commit acts of violence compared to the general population, particularly individuals suffering from severe mental illness (which includes schizophrenia, bipolar disorder, major depressive disorder and schizoaffective disorder) (DeAngelis, 2021) (Ghiasi et al,. 2021); but in order to understand the data we must analyse more closer the statistics and research presented; indeed multiple sources indicates that individuals with mental illness are more likely to commit acts of violence compared to the general population (DeAngelis 2021) (Ghiasi et al., 2020), but what is also true is that the majority of individuals with mental illness that were arrested following acts of violence were found under the influence of drugs and/or alcohol (DeAngelis, 2021) (Stuart, 2003) (Ghiasi et al., 2020) (Fazel, 2009) and a recent study found that more than 50% of individuals with schizophrenia or bipolar disorder had a substance misuse dependence (Varshney, 2015); therefore attributing the behaviour solely to mental illness would be very narrow and simplistic.
Is imperative to report that the large majority of people with mental illness will not commit crimes in their life; a Canadian study analyzed 1151 newly detained prisoners and estimated that only 3% of them were affected by serious mental illness (Stuart, 2003).
People suffering from mental illnesses are more likely to have been victims of violence or sexual abuse and live in poverty, therefore what we must consider in the equation is not the condition of the patient but their socio-economic background, as they are more likely to be victims than perpetrators of crime (Ghiasi et al., 2020); is also important to notice that when the latter are incarcerated very often they do not receive appropriate treatment, and this is another factor that could contribute to future violence (Ghiasi et al., 2020) (DeAngelis, 2021).
Incarceration is one of the biggest issues that people with mental health conditions will have to face in their lifetime; statistics in the United States show that individuals with mental health problems are at least 9 times more likely to be incarcerated rather than hospitalized, which considered what has been stated above about the care offered in the prison service could create serious problems and incredible costs (Zezima, 2020); as a proof of this, the data suggests that individual with mental illness on average remain in prison four to eight times longer than individuals without a mental condition for the exact same crime (Zezima, 2020).
Research suggests that roughly 40% of individuals with serious mental illness will come into contact with the criminal justice system at least once in their lifetime, this is concerning for the number of people affected by SMI in the United States which is 5% of the general population, despite this the percentage of individuals with SMI in prison at any given time is 25% (Zezima, 2020) (NIMH, 2022) (Collier, 2021).
Having analysed decades of research, gathering statistics from multiple sources and different academic fields we realised that despite all the data available, this is still a very debated topic in academia among experts in the field of psychology, criminology, and sociology.
The relationship between mental health and crime is still difficult to define, comprehend and explain; what emerges is a distorted picture, even though facts exist that are undeniably in favor of individuals with mental health, demonstrating that they are being failed by the system, by institutions, governments, psychiatric hospitals, and health care systems all around the world, but still thwarted by a wrongly formulated public opinion that neglects the facts with a proclivity to see evil in people suffering from mental health conditions.
Not enough is being done, it never was, to support and help these individuals, and despite having at hand the tools and data to understand the problem and provide prevention, which turns out to be the single most effective solution to reduce crime among individuals with mental illness or serious mental illness (NAS, 2018) we are still failing people and instead of helping them we continuously fuel a stigma towards them.
The radical change has to start from the general population, they must be informed, they have to appeal to governments, push for changes in legislation, defend and represent those individuals, ask for better structures and institutions, prevention programs in schools, universities and colleges, better conditions in psychiatric wards, better laws to decrease the detention of people with mental illness, more working and academic opportunities, more equality and diversity.
We also need more research on the relationship between mental health and crime, to demonstrate continuously that the two are not necessarily and inevitably intertwined.
Thank you for reading this article.
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Giovanni Foglia
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