The Devil You Know
Encounters in Forensic Psychiatry
Gwen Adshead & Eileen Horne
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4 quotes
Introduction
- The work we do requires people to take responsibility for their life story, which can be a difficult and lengthy process. This is done in the context of shifting political agendas which shape mental health resources and outcomes. I well remember how, not long after I started out in my forensic career in the early 1990s, our then prime minister in the UK, John Major, famously said, “Society needs to condemn a little more and understand a little less.” Mandatory minimum sentences and the wave of mass incarceration that followed, coupled with drastic cuts to mental health care services, have had far-reaching and dire social consequences both in the UK and around the world. Much has been written and said about this elsewhere by people far more expert than me; I will just say that we imprison far too many people, essentially to feed the public appetite for punishment, when only a small percentage of them are too cruel or risky to rehabilitate in the community.May 10 2024 1:46PM
- Little has been written about the field of forensic psychiatry for the public; usually, mental illness and the treatment of violence are mythologized and misrepresented, often in fictional form or in true crime depictions which tend to ignore our common humanity.May 10 2024 1:48PM
- Each chapter covers different ground, but an important theme here and in all forensic work is the common risk factors for violence. A colleague of mine helpfully describes the enacting of violence as a bicycle lock. A combination of stressors aligns: the first two “numbers” are likely to be sociopolitical, reflecting attitudes to masculinity, vulnerability, or poverty; bluntly, most violence in the world is committed by young, poor males. The next two may be specific to the perpetrator, such as substance abuse or varying kinds of childhood adversity. The final “number,” the one that causes the lock to spring open and release an act of harmful cruelty, is the most intriguing. It tends to be idiosyncratic, something in the action of the victim which has meaning only to the perpetrator: this might be a simple gesture, a familiar phrase, even a smile.May 10 2024 1:49PM
Chapter 1
- Having visited a number of different countries to observe firsthand how things work, I’ve been struck by the fact that it is those that have known military occupation within the last century, like Norway and Holland, that have among the most humane, progressive attitudes to the mental health treatment of violent offenders. Some studies suggest that experience makes it easier for them to understand these fellow human beings as rule-breakers who are ill rather than “bad people.”May 10 2024 1:51PM