Tag: mental illness

Mentally Ill Judge Cynthia Brim Removed From the Bench

By Charlton (Chuck) Stanley, Weekend Contributor

CT  MET-AJ-JUDGE-BRIM-1102The sad case of Cook County (Illinois) Judge Cynthia Brim has been discussed on this blog previously here and here. To sum up, she had a mental breakdown while holding traffic court on March 8, 2012.

She went on a paranoid rant, accusing police of targeting minorities for traffic tickets. For the next 45 minutes, she rambled on about her childhood as well as describing at least five prior hospitalizations for mental illness. During her rambling outburst, she told her audience she was once removed from the courtroom by paramedics after a previous breakdown.

Witnesses reported she said, “Not only men have balls, but women can have balls too. You just have to grow them.”

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From DSM-I to DSM-5 in the Legal System: Mental Illness Issues in the Courtroom

Submitted by Charlton Stanley (Otteray Scribe), guest blogger

Dr. Isaac Ray
Dr. Isaac Ray

The relationship between mental health and the legal system is a turbulent one at best. One major problem is they speak two different languages. For example, insanity is a legal term found nowhere in any psychiatric or psychological diagnostic manual.

There are several key words used commonly by both professions, but which have quite different meanings. The words “validity” and “reliability” are part of the vocabulary of science. To a scientist, the word validity means that a test measures what it claims to measure. When a test is intended to measure depression or anxiety, the user can assume it measures depression and anxiety.

Reliability refers to the repeatability of a test or measurement. If we give the same test to the same subject several times, all the scores will fall within the standard error of measurement 95% of the time.

When an attorney uses the word validity, it means, Binding; possessing legal force or strength; legally sufficient.

The legal interpretation of the word reliability suggests the subject matter is trustworthy, and that one can rely on it. However, when a scientist says something is reliable, it means whatever is being tested will get the same results with every retest, within the Standard Error of Measurement.

An examination of the literature of both professions reminds us of the quip attributed to George Bernard Shaw, “[We] are two peoples divided by a common language.”

When I was in graduate school, a well-known attorney gave an invited lecture to the student body. The speaker made several sweeping generalizations about the mentally ill; all of them displaying a stunning ignorance of facts. Then he turned his venom on those in the mental health professions, referring to mental health professionals scornfully as, “Soul doctors.” I would like to say people like him are rare, but they are not. I have known judges who, quite literally, did not believe in mental illness. We had one of those in our area who, mercifully, retired a few years ago.  People like that remind me of those misogynistic knuckle-draggers who don’t believe there is such a thing as rape.

Now, back to the stormy relationship between the legal system and mental illness.

Continue reading “From DSM-I to DSM-5 in the Legal System: Mental Illness Issues in the Courtroom”

Criminalizing Mental Illness: Jails, Hospitals, or On the Street?

Submitted by Charlton Stanley (Otteray Scribe) guest blogger

NIMH sealBoP sealWhat is wrong with this picture?  According to figures obtained from the Department of Justice, the National Alliance for the Mentally Ill (NAMI) reports that back in 1999, sixteen percent of the prisoners in State and Federal jails and prisons had a diagnosable major mental illness. These diagnoses include schizophrenia, bipolar disorder, major depressive disorder, or some other mental illness that can be classified as “severe.” Based on the number of known prisoners, this means there were roughly 283,000 persons with severe mental illnesses locked up in Federal and State correctional facilities, and that was 13 years ago. It has gotten worse since then. At the end of 2011, 2,266,800 adults and approximately 71,000 juveniles were incarcerated in Federal and State prisons, and jails.  That is 2,337,800 incarcerated inmates. If the sixteen percent figure holds, and there is no reason to believe it hasn’t, there are now about 374,000 mentally ill inmates in correctional facilities. “Correctional facility” is an oxymoron when it comes to providing treatment.  According to both law enforcement and mental health groups, the percentage of mentally ill being locked up is growing, not decreasing.

By way of contrast, public psychiatric hospitals have a patient population of 70,000 with similar severe mental illnesses. Want to know something else scary? Thirty percent of those patients are classified as forensic patients. They are awaiting trial, or so in need of treatment the prison system cannot cope with them. This was something I saw when I worked at the Mississippi State Hospital on the forensic unit. We would get prisoners from the State Department of Corrections that could not be managed adequately on the psychiatric unit at the penitentiary. Almost all State and Federal correctional facilities now have special units for the mentally ill, or with mental or physical handicaps. County jails nationwide do not usually provide mental health care at anything more than the most superficial level.

Furthermore, law enforcement officers are increasingly becoming first responders to people with severe mental illnesses in crisis. That is not working out very well for the police or the public, as we have seen in numerous stories reported on this blog. I talk to many sheriffs who are both angry and frustrated their jails are filling up with the mentally ill. They do not have the trained staff or the facilities needed to care for the mentally ill. At the same time, access to mental hospitals is becoming increasingly difficult.

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What is mental illness? Where is the bright line drawn?

Submitted by Charlton Stanley, guest blogger
(Otteray Scribe)

Image What is mental illness?  It’s a hot topic in the news recently, because of proposed gun control legislation. I saw a photo yesterday of people holding up a huge sign saying, “Keep guns out of the hands of mentally ill.”

There is far more to the demonization of the mentally ill than just the firearms issue. It spills over into the Federal Aviation Administration and the Department of Transportation. It is not just guns; it is airplanes and trucks as well. This brings us to the core question of, “What is mental illness?”  The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is the current handbook for classifying mental disorders.  DSM-V is in the final stages of development and will be published in May 2013. That is only next month.

Continue reading “What is mental illness? Where is the bright line drawn?”