Question: Would you say that the offenders you work with commit crimes due to their mental disorders, or could you argue that the life and nurture of offenders needs to be considered when assessing their reason for crime?

Stephen Baillargeon answered on 15 Jun 2018:

This gets into some tricky concepts and people who look at and define mental illness differently will disagree about the conclusions. Basically, I would say that a mental disorder is a pattern of behavior and thoughts that causes problems. People who study aggressive behavior for example have noticed that some aggressive people repeatedly compare themselves to others, care little about the suffering of others, feel entitled to more than they think other people are entitled to, and thrive on attention. So this pattern comes up so often that they just call in Narcissistic Personality Disorder (NPD), just so they can talk about it more easily. And there are several disorders that are a bit associated with crime, and it is very helpful to have those labels when discussing treatments. For example, if somebody came up with a treatment that tended to reduce aggression significantly among people with NPD (which many researchers are working on), than it would be easy to direct those people to get the treatment they need to stop doing crimes.

There are different treatments that have been invented to treat different patterns, and the patterns are also associated with different causes. So even though all of this varies a lot from one person to another, having these labels gives the people in charge or rehabilitation a bit of a head start with finding a way to help people improve their behavior. People with borderline symptoms should go to Dialectical Behavior Therapy, people who’s crimes revolve around alcoholism should go to one of the dozens of programs that help with alcoholism, and there are many cases where that helps a lot.

Medical research helps with this kind of thing as well. There was one case where a very normal man was arrested for pedophilia related crime. He had no history of any related behavior and he said that the urges were very new. In the first few days of jail, he complained of severe headaches and was sent to the hospital. There, they found that he actually had a pretty substantial brain tumor, and operated immediately. After that, the urges were gone. Years later when he started having urges again, he went to his doctor and they found that the tumor was coming back, and they were able to prevent another episode. Cases like these help us understand how different causes of the same behavior justify very different treatment.

So I got a little off topic, but instead of saying that the offenders I’ve worked with commit crimes because of their mental disorders, I’d say their crimes are part of a larger pattern that we label as a mental disorder, which is very helpful when I start working with them because it gives me an idea how I should start getting to know them. It gives us an educated guess what they might have not yet told us about the life and nurture of the offender and allows us to proceed with a sense of understanding, which just about everyone needs, criminals or not.