Certainly, and analyses like these always ignore the fact that there are absolutely people (a majority?) who had horrifying childhoods and who don't end up mass murderers because of it. The truth is twofold: these people are absolutely responsible for their actions (as anyone should be, I personally think 18 is too high) but we can at the same time recognize that society's worst (and Breivik is undoubtedly in that category) do not necessarily choose to become the worst, and that the psychological conditions that make it seem like it's ok to kill people are not entirely within their control.
Incidents like these are a public health issue like any other: they point to broader deficits in societal attitudes towards medicine. Specifically in these cases it is the extreme stigmatization of mental illness in much of the Western world (for lack of a better term and not to say that it's nonexistent outside the West, just that I don't know) that makes it difficult for people to receive the care they want and need.
Reminds me of a case here in Sweden where a father was found guilty of attempted murder of his half year old child. Just hours before the attempt he had been at the hospital begging to be committed since he was hearing voices and he was scared that he might hurt someone, but the beds was full so he was sent home.
Healthcare for mental health is still very much underdeveloped, especially when the patient is male. It is just easier to blame the individual.
I see and feel your point. As a doctor who has worked with people with severe mental health issues I can imagine nothing worse than experiencing what they do. This must be especially agonising for someone so young, who will have to experience this her whole life.
That said, I'm not sure I could be part of euthanasia in a case like this. This one is very tricky with the mental state to consider. Also, what if a new treatment for some of her conditions arise within a few years? Unfortunately, progress in psychiatry is slower than probably all other medical fields.
There are behaviors which simply aren't acceptable, and it's important that the people who behave those ways are let to know that they're not. Threatening to kill people almost certainly falls on this list.
Not only that, but some people, such as people with schizophrenic disorders, need medicine (Specifically, pharmaceuticals.) to stay sane, literally. Part of the problem with disorders where you need to take pills are that some people don't want to take them, or the pills help them, and then they decide they're fine and stop medicating themselves. At which point they relapse into an episode.
I think we absolutely need better mental health care, and better mental health care research. We still don't know much about basic things like sleep. And yet we're being tasked with treating a growing number of people with psychiatric issues. Naturally, the result is something of a disaster.
"We" imprison people for decades ... because they got "diagnosed" with ADD, a psychological condition for which there is not even consensus that it exists, never mind how to correctly diagnose it.
Not that the lack of diagnosis procedure really matters : the diagnosis is usually carried out by completely unqualified personnel. (specifically preschool teachers make the diagnosis, and the odds that these children ever see a real psychologist is 50% at best)
(I mean any cursory study of the child services system in Norway will quickly yield the insight that the real problem is racism in child services itself, and not ADD/ADHD or any other mental disorders, but we're supposed to believe that the people involved are at least acting in good faith for some reason. Even if they're raging racists having children of immigrants abducted, apparently)
Mental health care ... has the same problem (whilst I'm sure the details are different in the US, please do remember: getting any kind of help at all, for any reason, from state health care, legally speaking is a totally unacceptable risk. You just cannot control what happens and you have no recourse. Stay away, and immediately respond VERY strongly on any whiff of attention to your kids). In Norway any competent lawyer should advise you that you can NEVER give your real name to any psychiatrist. It is a totally unacceptable risk.
(Decades ? Yes, decades: from 2-3-4 years old up to 25 years old. Imprison ? Yep, imprison)
It seems that, every time some mentally ill person does something like this, whether it's a big, splashy mass shooting or bombing or something smaller like this acid attack, you later find out that everybody around that person had known for a long time that they were uncontrollably and irrationally violent at times, but nobody could think of anything to do about it. Just like that article - the boy's own mother is pretty sure that he's going to do something horribly violent someday, but nobody has any idea what to do about him, besides getting him thrown in jail.
I suppose it's a hard problem, if you really think about it. Exactly what should the threshold be for having somebody involuntarily committed to some sort of mental hospital or something, and kept there against their will for their entire life, or until some doctor thinks they're safe again? As I understand it, it was fairly low back in the early 20th century, which led to lots of people being committed, some for various versions of being unpopular or eccentric, into mental hospitals that were real horror-shows. What we have now is the backlash against that, which might be too far in the other direction, where it's almost impossible to get someone committed like that until they commit a serious violent crime.
Where's the happy medium? Or is there one? I don't know... but it's something we all ought to think about.
You are completely correct. I'd also add that even if we assume everyone IS dangerous, would you really want to lock them away for 5, 10, 15 years without any thought as to what sort of human they'd be after that? My personal opinion is that we should treat these people humanely and with sympathy, but if GP is taking an extreme self-centered approach then why not consider the possibility that the system is creating people who are more dangerous to them in the long run?
Sadly, I can see the counter argument. "It's not kidnapping, because someone with mental health issues can't be trusted to make their own decisions." {Cue jury ignoring logic errors and nodding}
Maybe it's currently reading Larsson's books, but mental health issues seem to raise incredibly challenging ethical questions (under economically feasible settings).
"
A colleague of mine explained his options, such as they were. But that’s the bit that stayed with me. "Do I have to beg you? [he had asked]"
It’s why I struggled to keep my hands from shaking as he was eventually held down on his bed and I administered the injection. He didn’t put up a fight. We weren’t preventing and managing violence and aggression. From Amit’s perspective, I don’t doubt we were perpetrating it. In that moment, however good my intentions, I was knowingly participating in his suffering.
"
Read the story. I feel that it's likely they were doing the right thing, even against the patient's will. If that were me I'd probably agree, though not at the time (thank god that's not my life, I count myself so lucky).
But taking your question in a different direction, what would you prefer, that the government does not get involved in such cases? That we leave it to, say, private (profit-driven) companies?
And how about people without real psychological problems who ruin their lives?
Psychiatry has a rolling history where everything that was done 30 years ago is so barbarous that the treatments are criminalize, and it has been that way for a century. At what point are we going to realize that there is no baby in the bathwater?
I never said anything about prioritizing the aggressors over the victims. Certainly not. But I think we really need to start thinking, as a society, about how and why people end up in these dark places and how we can change that.
Maybe - maybe - if it were entirely voluntary, it could be okay. But I think you’ll find that convincing someone who doesn’t trust you very much they should take medication to change their minds is also going to be a very hard sell. People generally think they’re right, after all, otherwise they would have different beliefs.
Well, I would interpret that as "With something so horrible, people want to make sure it never, ever happens again and they don't really believe that someone who would do something like that can ever be trusted."
Compassion is one thing. Giving people a second shot at doing something heinous is another.
We don't really know how to cure more prosaic mental health issues, like depression or social anxiety. If they are wrong about him having been successfully treated, we will likely find that out the hard way: When we discover he has done it again. Only, possibly, multiple times and covered it up successfully for some time, what with being older and savvier.
First of all, NO. I DO NOT understand. Nothing justifies treating people like this, and certainly not what was used at this facility. Week-long solitary confinement for nail biting ...
And let's not pretend this facility is a huge negative exception. It's not. It just got caught recording client-lawyer confidential conversations because they boasted about it in court. Yes, they actually boasted in court that they did this and used it in the case. That's how they got caught. Then the inspection report fell into the hands of the press and this patient treatment stuff leaked. In other words, this is a random sample.
And what does the government do about this ? They ask the management to come up with ideas by year-end. Clearly nobody cares or wants to see improvements.
So the problem that this is exactly what is being proposed here as the solution to mental health problems ... I feel like it would be more humane to just round up all mentally ill patients and shoot them.
Let's please not pretend that torturing them for a decade or two before they accidentally die in such a "fixation" is more humane, because it's not, it's far, far worse. Solitary confinement for weeks is torture, constantly living under that thread is also torture.
Needless to say, when you check your find the same ("internment") is done to their kids, even if the only thing against them is that one of their parents has some mental health problems. Doesn't matter if the parent recovers. Doesn't matter if they are 16 or even 18 years old (mental health "care" lasts until 25). There was a story of a 21 year old student ripped out of independent living (well, a student dorm she paid for herself) and studying at university because her mother got interned.
Leaving them to rot on the streets, again, is a far more humane approach than mental health care.
We cannot seriously suggest this as a solution until massive improvements are made to the system, starting with a minimum complement of actual mental health professionals. The system doesn't have that, nor are there any plans to change it, so ... it is not humane or reasonable to suggest mental health services as a replacement to letting them live on the streets.
The problem was that if the court declares Breivik insane, Norway couldn't (legally) put him in a high-security criminal prison.
That's wrong - they can do that without Lex Breivik. The issue is when he's declared healthy, what would then happen? It's legal to detain him if it can be proved that he constitutes a danger to society. However, if he is not considered a danger to the society, he will be able to walk freely. With Lex Breivik, they will be allowed to detain him as long the society is a danger to the person.
Think about that for a moment. With Lex Breivik, you can be isolated even if you've not done anything illegal (or have finished serving your imprisonment) or is considered healthy, because some people in the society want to do you harm.
My friend was stabbed by a schizophrenic who lived in the flat opposite and believed that my friend was stalking him. Ten years later and my friend still has virtually no feeling in his hand as the nerves did not grow back correctly and he had to give up being a professional musician.
I know the guy didn't choose to be the way he was and I'm sure what was going through his mind was hell. But that doesn't mean that the rest of us should just live with the consequences of harmful actions.
Of all the human rights stuff happening around psychosis an early diagnosis doesn't seem too bad. It's a bit of a worry, but it's not as bad as being shot and killed[1]; transported to hospital by police against your will; being medicated (sometimes by force) against your will (with meds that will shorten your life); being deprived of your liberty (in more ways than just being held in a hospital); etc etc.
> Incarceration that is designed for rehabilitation is characterized by not having a set finite length. They keep the person until they are fixed, not release them after a predetermined amount of time despite no evidence of being cured. This is done in some cases, at mental health facilities in the US, and in other the criminal systems of other countries.
In England a person who goes to trial but who is found to be insane will be diverted by the court to a forensic mental health unit. Prisoners who develop a severe mental illness during their sentence will be sent to a forensic unit. While there they are patients, not prisoners. When their illness is stabilised they get sent back to prison, unless they are too ill. So, someone operating under a psychosis will probably get stabilised and sent to prison; a person with a personality dosorder will probably stay in hospital. (This is just broad brush stroke generalisations). I have spoken to patients at two different medium secure units in the south-west of England. Most people said they would prefer to be in prison. One reason they gave was that in prison they had a sentence to serve, whereas in hospital it was treatment. (Other reasons given were better food in prison (something that shocked me, and that I raised with commissioners) and better activity programmes). (English people tend not to know that these important NHS facilities are often provided by private companies).
It's probably important to note the difference between people who commit violent crime because of their mental illness, and people who commit violent crime who happen to have a mental illness which played no part in their violence. Breivik appears to be the latter -- he had various diagnoses but was found not to be operating under a psychosis when he committed his murders.
It's an important difference. People with a mental illness, even a severe mental illness, are overwhelmingly not violent. But the constant linking of mental health words -- "crazed killer" -- and acts of violence act as a strongly stigmatising force. A person with a mental illness is far more likely to be the victim, not perpetrator of violent crime; a person with a mental illness is far more likely to hurt themselves than anyone else; mental illness is at best a weak predictor of violence.
And your implication that a "loving community" can wave a magic wand and make this sick adult better is equally incorrect.
I would suggest in fact that some of the signs this troubled individual would behave in this manner were probably already apparent to his parents, but they chose to dismiss it because no parent really believes their own child can be capable of such horrible behaviour.
This is a person that needs professional help - from an objective third party. The authorities, while certainly imperfect, can provide this.
For all you know, when this adult was confronted and "broke down" it could have all been an act. He could truly be a psychopath (and his actions certainly suggest that)
Incidents like these are a public health issue like any other: they point to broader deficits in societal attitudes towards medicine. Specifically in these cases it is the extreme stigmatization of mental illness in much of the Western world (for lack of a better term and not to say that it's nonexistent outside the West, just that I don't know) that makes it difficult for people to receive the care they want and need.
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