Psychosis and the perception of a “threat to society” create a compelling

Participatory Concepts in Mental Health Care: Will they be a driving force behind a reform movement supported by unified advocacy? PART III

Psychosis and the perception of a  “threat to society” create a compelling

The accused Tucson shooter, Jared Lee Loughner, is described by experts as suffering from a psychotic disorder.

Julie Schenecker, the Tampa, Florida mother who admitted to fatally shooting her two children and Deyan Deyanov, a man who publicly decapitated a British tourist visiting the Canary Islands earlier this year, are also described by experts as suffering from psychotic disorders. The intersection of
psychotic disorders and violent criminal behavior becomes widely publicized in high-profile murder cases such as these.

Unlike most other medical conditions, a psychotic disturbance can result in violent criminal behavior against others.  The relationship between severe mental illness and violence has a significant effect on mental health policy, clinical practice, and public opinion about the perceived dangerousness of people with psychiatric disorders.[10]  Violence towards others by a minority of individuals under psychotic distress is a significant public health concern which involves conflicting opinions concerning the right of the patient to treatment, and punishment for the crimes they commit. [11][12]

Based on personal experience and supporting research, it is the opinion of this author that various medical conditions and substances known to induce psychoses can be overlooked and considered symptoms of bipolar disorder or schizophrenia.  Recognizing etiological factors of a psychosis can substantially impact the outcome of a criminal court case and it is imperative they be considered. [13][14]

The expert opinions regarding the diagnosis of Jared Loughner are of particular importance considering such a high profile case may influence public policy in mental health care, as in the case of Kendra’s Law.  Named after Kendra Webdale, the New York State law allows forced treatment for certain individuals.  Although the law restricts a patient’s freedom and right to refuse treatment, the state’s compelling interest outweighs these restrictions. Webdale died in 1999 after being pushed in front of an oncoming train by a young man suffering from symptoms of schizophrenia
and a history of noncompliance.

Public discussion to prevent tragedies like the Tucson shooting commonly examines early warning signs of severe mental illness, mental health intervention and the ethics of compulsory treatment in psychiatry.[15]  The main consideration regarding preventative measures involves family, friends, educators and mental health professionals initiating treatment intervention when obvious psychotic behavior is observed in others.

Unlike a jail sentence, forced psychiatric treatment deprives individuals of much more than just the
right to liberty, it also deprives patients the right to refuse unwanted, and potentially harmful treatment.


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