Mental Illness and Violence

Last week we went over to Stanford to hear a discussion on mental illness and crime co-sponsored by the law school and the medical school.

Our society faces increasing pressure from a growing number of mentally ill people, many manifesting a lethal blend of mental disorder and addiction and either living on the streets or filling up our jails.

For me, the discussion at Stanford raised more questions than it answered.

In the same way that our educators are learning that every kid has “special needs” associated with his unique way of learning, is it possible that most human beings have unique mental issues, some of which are at odds with societal expectations?

Is it possible that most criminal acts (not just the typical over-the-top acts of violence) reflect a breakdown of mental process, whether it’s impulse control, ability to link action to outcome, fear, anger, anxiety or delusion?

How does the legal system distinguish between the insanity defense for a crime (inability to understand the consequences, right from wrong, etc.) from terrorism (an erroneous belief that an act will be rewarded in heaven)?

Of course, at the end of the day, the extent to which the legal system accommodates to psychiatrically-defined mental illness depends on how a legislature views the goals of criminal punishment:

            Getting a dangerous person off the streets?

            Making a role model out of him so someone else won’t do the same thing?

            Rehabilitating him so that he can become a useful citizen?

            Making him pay for what he did?

I don’t have any answers, but I think there is a problem.  Most mentally ill people do not commit crimes.  Our society has decided we should not institutionalize people against their will if they are not an immediate threat.  But leaving people to live on the streets is not a great solution.