Insanity
From Wikipedia, the free encyclopedia
Traditionally, insanity or madness is the behaviour whereby a person flouts societal norms and becomes a danger to himself and others. Greek tragedies and Shakespeare often refer to madness in this sense. Psychologically, it is a general popular and legal term defining behaviour influenced by mental instability. It is defined by the Merriam-Webster dictionary as a deranged state of the mind or lack of understanding. Today, it is most commonly encountered as an informal term or in the narrow legal context of the insanity defense, and in the medical profession the term is now avoided in favour of specific diagnoses of mental illness as schizophrenia and other psychotic disorders.[1] When discussing mental illness in general terms, "psychopathology" is also considered a preferred descriptor.[2]
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Linguistic roots
In English, the word "sane" derives from the Latin adjective sanus meaning healthy. The phrase "mens sana in corpore sano" is often translated to mean a "healthy mind in a healthy body". From this perspective, insanity can be considered as poor health of the mind, not necessarily of the brain as an organ (although that can affect mental health), but rather refers to defective function of mental processes such as reasoning. A Latin phrase for "sane" is "compos mentis" (lit. "of composed mind"), and a euphemistic term for insanity is "non compos mentis". In law, mens rea means having had criminal intent, or a guilty mind, when the act (actus reus) was committed.
In medicine
Insanity is no longer considered a medical diagnosis but is a legal term in the United States, stemming from its original use in common law.[3] The disorders formerly encompassed by the term covered a wide range of mental disorders now diagnosed as organic brain syndromes, schizophrenia, bipolar disorder and other psychotic disorders.[1]
Historical treatment
During the 18th century, the French and English introduced humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as speech impediments and epilepsy.
Europe's oldest asylum is The Bethlem Royal Hospital of London, also known as Bedlam, which began admitting the mentally ill in 1403. The first American asylum was built in Williamsburg, Virginia, circa 1773. Before the 19th century these hospitals were used to isolate the mentally ill or the socially ostracized from society rather than cure them or maintain their health. Pictures from this era portrayed patients bound with rope or chains, often to beds or walls, or restrained in straitjackets.
Legal use of the term
In United States criminal law, insanity may serve as an affirmative defense to criminal acts and thus does not need to negate an element of the prosecution's case such as general or specific intent.[4] The states differ somewhat in their definition of insanity but most follow the guidelines of the Model Penal Code. All jurisdictions require a sanity evaluation to address the question first of whether or not the defendant has a mental illness. Most courts accept a major mental illness such as psychosis but will not accept the diagnosis of a personality disorder for the purposes of an insanity defense. The second question is whether the mental illness interfered with the defendant's ability to distinguish right from wrong. That is, did the defendant know that the alleged behavior was against the law at the time the offense was committed. Additionally, some jurisdictions add the question of whether or not the defendant was in control of his behavior at the time of the offense. For example, if the defendant compelled by some aspect of his mental illness to commit the illegal act, the defendant could be evaluated as not in control of his behavior at the time of the offense. The forensic mental health specialists submit their evaluations to the court. Since the question of sanity or insanity is a legal question and not a medical one, the judge and or jury will make the final decision regarding the defendant's status regarding an insanity defense.[5][6]
In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to a psychiatric institution for at least 60 days for further evaluation, and then reevaluated at least yearly after that.
Feigned insanity
Feigned insanity is the simulation of mental illness in order to avoid or lessen the consequences of a confrontation or conviction for an alleged crime. A number of treatises on medical jurisprudence were written during the nineteenth century, the most famous of which was Isaac Ray in 1838 (fifth edition 1871); others include Benjamin Rush (1827), Ryan (1832), Taylor (1845), Wharton and Stille (1855), Ordronaux (1869), Meymott (1882). The typical techniques as outlined in these works are the background for Dr. Neil S. Kaye's widely recognized guidelines that indicate an attempt to feign insanity.[7]
Today feigned insanity is considered malingering. In a 2005 court case, United States v. Binion, the defendant was prosecuted and convicted for obstruction of justice (adding to his original sentence) because he feigned insanity in a Competency to Stand Trial evaluation.
References
- ^ a b L M Tierney, S J McPhee, M A Papadakis (2002). Current medical Diagnosis & Treatment. International edition. New York: Lange Medical Books/McGraw-Hill, 1078-1086. ISBN 0-07-137688-7.
- ^ An interview with Dr. Joseph Merlino, David Shankbone, Wikinews, October 5, 2007.
- ^ "What’s in a Name?": A Brief Foray into the History of Insanity in England and the United States. Journal of the Academy of American Psychiatry and the Law (2005). Retrieved on 2007-10-20.
- ^ Criminal Responsibility and Intent -- Poortinga and Guyer 35 (1): 124 -- Journal of the American Academy of Psychiatry and the Law Online. www.jaapl.org. Retrieved on 2008-02-22.
- ^ Shapiro, David L. (1991). Forensic Psychological Assessment: An Integrative Approach. Needham Heights, MA: Simon & Schuster, 70–72. ISBN 0-205-12521-2.
- ^ Gary, Melton (1997). Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers, 2nd, New York: The Guilford Press, 186–248. ISBN 1-57230-236-4.
- ^ Neil S. Kaye M.D.. Feigned Insanity in Nineteenth Century America Legal Cases.
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