sue bilstein

While murder rates in NZ have tripled since 1970, the number of murders by
the mentally ill has stayed constant. So the percentage of murders by
mentally ill has fallen from c. 20% in 1970 to c. 6% now.

The article then puzzles over whether this represents a success for
de-institutionalisation. IMHO it seems more likely that social factors
since 1970 have caused more normies to kill - drugs, unemployment, the
brainwashing effect of violent entertainments, the usual suspects. But that
the factors leading to killings by mentally ill people are related to brain
chemistry and genetics, which have not changed over this period.

NB the article is clear, honest, non-alarmist & full of data. For example,
of the murders by mentally ill people, about half were committed by people
in psychosis - this equates to 2 or 3 people per year. They make the point
that at any given time about 12,000 people in NZ are psychotic (about a
third of one percent of the 4 million population).

<http://www.nzherald.co.nz/storydispl...esection=news&
thesubsection=general>

I'll quote it here at some length, since the Herald doesn't keep stories
online for long.

Murder and the mentally ill

17.08.2003
By GEOFF CUMMING
Everyone knows society is more dangerous these days: there's violence on the
streets and it's beamed into our living rooms. And it's no coincidence that
the closure of Carrington, Tokanui, Lake Alice and other mental institutions
led to this surge in murders, right?

Psychiatrist Sandy Simpson tests the theory on his masters students and the
community groups he addresses: do they think the proportion of murders
committed by the mentally ill has risen or fallen in the past 30 years?

"They all think it's getting worse."

But a study released today quashes myths about the risk posed by the
mentally ill. It finds no basis to claims that care of psychiatric patients
in the community has contributed to the increase in murders. It even
suggests that the likelihood of violence by people with mental illnesses has
fallen since "deinstitutionalisation".

"Community care hasn't failed," says Jim Burdett, who represents people in
contact with mental health services. "People aren't being killed by lunatics
in huge numbers."

The study, Myth and reality: the relationship between mental illness and
homicide in New Zealand, examined the files of 1501 murderers between 1970
and 2000. It found 133, or 8.9 per cent, were judged not fit to stand trial
or not guilty by reason of insanity, in line with rates for low homicide
countries internationally.

But an interesting trend emerged. Although the number of murders has
tripled, from fewer than 20 a year in the early seventies to between 50 and
70 in recent years, the number of killings by the mentally ill has remained
steady - and is usually less than six a year.

The result: murders by the mentally ill have fallen as a proportion of total
homicides from nearly 20 per cent in the early seventies to around 6 per
cent today.

The study is one of only four in the world to look at time trends in
homicides, and is touted to be the most comprehensive. Researchers satisfied
ethical and privacy concerns to cross-match data from the police, coroners'
office, Ministry of Health, Justice Department, Parole Board and New Zealand
Herald archives.

Simpson, who led the research team, says it is significant that the study
period coincides not only with deinstitutionalisation but an era of
increasing social fragmentation.

Rising unemployment, poverty, marriage breakdowns, drug and alcohol abuse
and increased exposure to violence are factors which could lead us to expect
an increase in mental illness. But the 18 killers judged to be mentally ill
in the past five years of the study period compares favourably with the 20
identified in the first five years.

"It almost makes me proud that, in a less hospitable world, people with
mental illness haven't succumbed to these pressures in the same way that
people without mental illnesses have by murdering more often," says Burdett,
who himself has a mental illness.

The study for the Mental Health Research and Development Strategy addresses
another myth: that community care raises the risk of being killed by a
stranger who knocks on the door or "loses it" in the street.

Of 84 murders by strangers between 1988 and 2000, only two offenders were
mentally ill. The flipsides: mentally "normal" perpetrators are more likely
to kill strangers and the mentally ill are more likely to target loved ones
and family.

Tony O'Brien, senior lecturer in mental health nursing at Auckland
University, says the research confirms there's more reason to fear a drink
or drug-affected single young male than someone with a mental illness.

"The fact that homicides by the mentally ill have stayed constant over this
long period of deinstitutionalisation suggests mental health services are
doing a pretty good job of managing the risk."

In the cauldron of emotion, science and politics that is mental health,
there is reluctance to make too much of the findings, a mere stepping stone
in research to improve the delivery of mental health services. The
researchers admit the data has limitations and expect robust scrutiny from
both the pro-institution lobby and mental health service consumers.

"I don't think you can say it gives community care a free bill of health,"
says Simpson, clinical director of the Mason Clinic in Auckland. "We're not
saying dreadful things haven't occurred because of deinstitutionalisation.

"Nor are we saying there's not a case for more acute beds and some long-term
beds."

When he started at Porirua Hospital in the mid-1980s, there were 1200 beds.
Now there are no more than 800 nationwide. But Simpson says it's important
not to romanticise the past.

"We would have two or three nurses in a villa with 35 people in it and one
doctor in charge. The quality of care we could provide to people in terms of
frequency of review and planning of rehabilitation was very limited indeed.

"Then when we shifted into the community the resources were never adequate
to provide thorough care."

<snip details re NZ mental health services>

Government financing did improve - and Simpson says the homicide study is
one indicator that service levels are approaching what is needed.

"Have we still got gaps out there - yes, we have. Are we closing them at a
rate in which the service can actually grow and improve - I think we
probably are. Everyone would say there are quality gains to be made, but we
have also come a long, long way."

The report offers hope that services are getting it right - most of the
time.

"It may be that the improved quality of services that people have striven
for in the past decade are preventing more tragedies than we may have
expected," he says. "That's the other way of looking at the numbers - we
don't know about all the homicides we have saved."

While citing the advent of community support, recovery-based policies,
forensic services and better medicines, the study offers pointers for the
future. Just over half the mentally ill killers suffered psychotic illnesses
such as schizophrenia, conditions associated with delusions and
hallucinations that can lead to violence. Half had been admitted to
psychiatric hospitals or acute facilities, 10 per cent within the previous
month and 20 per cent within the previous year.

But most had been admitted only once or twice in the previous five years and
nearly a third had no previous contact with mental health services.

<snip details re NZ mental health services>

Does this mean society has nothing to fear from mental illness? Not quite,
says Simpson. The mentally ill whose illnesses are not well managed do have
a greater tendency to violence than the rest of the population.

The second most common diagnosis for mentally ill killers in the New Zealand
study was major depression, a common cause of infanticide - which helps to
explain the higher proportion of mentally ill women who murder than in
"mentally-well" homicides.

"If we can decrease the number of people with active psychotic illnesses or
provide better care for postnatal depression - these interventions may lead
us to reduce homicides even further."

<snip details re NZ mental health services>

Simpson says the statistics also highlight the hairline judgments which must
be made on psychiatric risk.

It is estimated that 12,000 people have a psychotic illness at any one time.
The research found these responsible for half the murders by the mentally
ill, maybe two or three each year. "So we are trying to predict a very rare
event, a very shocking and horrible event, but nonetheless very rare."
rate is on a par with Britain and Australia and a third that of the United
States.

"If you have a fairly stable home environment and you stay at arm's length
from illicit drugs and alcohol your chances of dying violently by another's
hands are almost zero."

Chaplow says more than 30,000 people are in contact with mental health
services over the course of a month and perhaps a dozen will come before the
courts. "Should we lock up the 30,000? The study also shows that at least 30
per cent [of mentally ill killers] have never come in contact with mental
health services.

"It's really a matter of who we target, and we have a better idea now:
people with psychotic illnesses and a past history of risk to themselves or
others.

"But that 30 per cent figure means we also need to say to the community, 'If
you have a loved one who's acting strangely, who has funny ideas and is
frightening you, then get help real quick'."

hhhaller

Never been to New Zealand.The mentally ill have a history of
committing fewer crimes than the normals.don't they?Anyway,is a person
"mentally ill" if they have been treated,but not mentally ill
otherwise?I got nothin' against New Zealanders,but the general
population sounds a bit in need of treatment.Might lower the crime
rate.R

hhhaller

Never been to New Zealand.The mentally ill have a history of
committing fewer crimes than the normals.don't they?Anyway,is a person
"mentally ill" if they have been treated,but not mentally ill
otherwise?I got nothin' against New Zealanders,but the general
population sounds a bit in need of treatment.Might lower the crime
rate.R

sue bilstein

I hate the term "mentally ill" when it's misused, as it often is, to mean
people like us - people with a psychiatric diagnosis. In this report, it's
used quite precisely to refer to people who are not sane when they commit
murder - according to the judgment of the police investigating the case.
The main finding of the report is that the rate of murders by people who are
mad has not increased in 30 years, whereas the murder rate over-all has
tripled - in other words, murders by normies have gone through the roof.
(Up to the level in the UK, by the way, but still well below the US rate).

hhhaller

in the many times i been in a facility,some of my family would get
nervous about bringing cigarettes or something.they didn't know that
the unit was one of the safest places they could be.patients
overmedicated,physically fit young men on guard.whereever you go,there
you are.(who said that?)Richard

hhhaller

in the many times i been in a facility,some of my family would get
nervous about bringing cigarettes or something.they didn't know that
the unit was one of the safest places they could be.patients
overmedicated,physically fit young men on guard.whereever you go,there
you are.(who said that?)Richard

sue bilstein

The 2 times I was in Carrington in Auckland, I didn't feel that safe. The
staff spent most of their time in the staff room, and there were lots of
tough-looking male patients around. I was worried about getting raped or
beaten up, but on the other hand I was also worried that Ronald Reagan was
trying to find me to drop an H-bomb on me.

Maybe Carrington was a bit of a snake-pit compared to the places you
describe.

colleen

I've never felt unsafe in a psych ward. Finding a decent shrink was nigh on
impossible though!

Maybe I was just too f'd up to know danger when I saw it.

--
c

website http://www.plazaearth.com/philo

hhhaller

anyway,i asked often (like Olivier in "Marathon Man"),"is it safe?"R