(That was sarcasm, just in case you missed it)
I’m not against the sentiments of the Mind report, I consider many people with mental illness to have a ‘vulnerability’ that requires constant monitoring and sympathetic consideration. But I have some concerns about the data that backs the report which are similar to TheShrinks response to the original posting.
I do not find the report all that useful or, after only a brief review, as “shocking” as it makes out. Such a posting may be sounding morally inappropriate to some. Nevertheless, I shall attempt to explain why I am disappointed with the report and have taken a whole new posting to do so.
Firstly, the publication has let itself down by stooping to ’sensationalist tabloid’ grammatical reporting such as;
“Our findings highlight a stark reality” “.. such an overwhelming majority…” “Shockingly only 56 per cent of people saw their home as a safe place to be…”
The first thing to get straight is, of the 5,100 questionnaires sent out; only 304 responded. That’s 6%.
Does this mean that the 94% that didn’t respond weren’t a victim of crime or didn’t feel that being a victim of crime and mentally ill was a problem or even related to the problem? That would be a pretty good commendation of the services. But the ’statistics’ don’t tell us this.
When carers were also invited to respond: 1100 questionnaires were sent out. 84 responded. That’s just 8%.
The trouble with questionnaires that set out to identify people’s issues is - only those with issues are likely to respond. Hence such low return rates and such high statistics from those that did respond.
The 6% of those who were completely satisfied with the overall response of the authorities does nothing to inform us of how good or bad the police or criminal justice services are. 94% of 304 obviously weren’t happy. But that’s why they responded - because they weren’t happy. For most respondents, I would suggest it wasn’t a survey or questionnaire they saw - it was a ‘complaints form’ and an opportunity to have their say. The survey was sent out to only people on the Mind network.
6% responding to say they were ‘completely satisfied’ with overall is actually higher than I would have expected! It’s much like asking people to phone in and vote on “I like phone-in vote polls - Yes or No?” guess what - nearly 100% will say YES! (”Nearly”, because there’s always someone with extra credit to get rid of and nothing better to do, or those who dial the wrong number and vote “No”).
The report does not identify the number of the 304 respondents who replied saying they had no problem whatsoever and were wholly satisfied with everything but I’d hazard it was pretty close to nil.
But wait! There’s more.. “Two-thirds of victims of crime who reported the incident said they were completely or somewhat dissatisfied with the overall response..”
Recent publishings (2000) show that about 75% of all offences go undetected - I’d doubt that has significantly changed and I would call that a “dissatisfaction”. But every person suffers that statistic - not just mentally ill persons. That’s three-quarters. So a dissatisfaction of two-thirds for those with mental illness may actually indicate a superior service above the average?!
(stats at : http://www.homeoffice.gov.uk/rds/pdfs/hosb1200.pdf)
The study has taken discriminately collated data from those who had something to say and used it to propagate a report that does not have a control group or even a fair representation.
Simple studies such as this one are informative to the point of letting us know where there might be a problem, and it is a problem I am not comfortable with. But the report does not present “a stark reality” or “an overwhelming majority” or even a “shocking 56 per cent”. It says that some people weren’t happy in some way; 304 out of 5100 (6%) - that’s still not good - but it’s not in the sensationalist proportions that Mind has represented.
I would like to see some actual quality analysis of the various studies rather than simple quantitative statistics of a handful of people who are likely to have something to say. Perhaps something a little more than “Others complained of being told that “harassment is too much paper-work” by police officers or of being dismissed as “mad as a bunch of frogs”. Tho these occasions are definitely issues to address they are more anecdotal reflections and not sophisticated analysis.
There is without doubt some worthwhile information within the report but it leaves too many opportunities for chicken & egg debate here and it would be a far better thing to conduct qualitative meta-analysis of mental illness crime rates (victims & perpetrators) against non-mentally ill crime rates (victims & perpetrators) that actually looks beyond the statistics and gives some meaningful and purposeful argument. As TheShrink suggests, there is no background study to compare.
So, how much of the crime against those with mental illness is because they are housed in low socio-economic areas and nothing to do with their illness - other than the fact that is the only place they could afford or be housed? How does it compare in the area and with non-mentally ill people?
The report: “Nearly 90 per cent of respondents living in local authority housing had been victimised” Now there’s something worth following up on.
But how many non-mentally ill people in local authority housing have been victims of crime? Would a similar study asking non-mentally ill people who had been victims of similar crimes reveal a close or similar finding?
What the report is saying is that; the highest proportion of people with mental illness who feel offended against - live in local authority housing. There’s a worthwhile and valid point to make but it is not the suggestion, due to the low return rates and discriminatory geographical bias (check the targeted areas) of the responses. Perhaps it isn’t just about policing or criminal justice. Perhaps it’s about where these people live and the social culture of the areas in which mentally ill people find themselves?
46% said they felt “always safe” or “mostly safe” when out and about in their local area.
56 % said they felt safe in their own home.
Only 8% said they rarely feel safe at their own home - that’s about 25 people out of 304.
How different is that for the mainstream living in local area housing?
The largest proportion of all residences represented was 27%. That was for people who have privately owned accommodation.
Comparatively, a 2002 report from the Office of National Statistics, which is limited to “the psychiatric morbidity of adults aged 16 to 74 living in private households in Great Britain.”
(http://www.statistics.gov.uk/STATBASE/Product.asp?vlnk=9411) actually reports the difference to be:
Three of the six specified life events were twice as likely to be experienced by those with a mental disorder compared with those with no mental disorder: separation or divorce (44% compared with 23%), serious injury, illness or assault (40% compared with 22%), and having a serious problem with a close friend or relative (27% compared with 13%). (Table 5.1)
This Mind reports suggests 48% (n=145) did not report the incident. That’s almost half of people with mental illness that do not report crime. Are we to understand then, with these two reports, that we can double the 40% of reported serious injury and assaults to 80% of people with mental illness who suffer? Yet only 6% overall responded to the Mind survey. This suggests 74% of the Mind network mentally ill users who may likely have been victims of crime are not having their say. Why?
These two reports can be taken to suggest several things.
It is also possible to suggest that “mentally ill people owning their own home are twice as likely to be victims of crime” and “a lot of people with mental illness who report crimes own their own home”. I’m not sure about how meta-analyis works, but is this now telling me it is a statistically higher probability for people with mental illness to be a victim of crime if they own their own home? What does that have to do with the police and criminal justice system? More idiotically, shouldn’t they just sell up and rent to reduce their chances? What is it about this particular anomoly that hasn’t been said - and why?
Statistcs are only half a story.
Another example within the report demonstrates how wide then net was cast when calling for responses, and reflects how useless this report is in determining the actual prevalence rates in select groups (such as elderly, mentally ill, personality disorders, etc):
“A support worker in Wales said that there clients with mental health problems were targeted for their medication’. There is a secondary link to mental illness here, but the primary motivator is the drugs. Mental illness may make them more vulnerable or susceptible. But to include drug-motivated offences as being ‘mental illness’ victimisation? It’s pretty tough to call because anyone who ‘looks’ or ‘acts’ mentally ill is likely to attract the attention of the drug-seeking offender because they know the probablilities are high. That’s not to say people with need for drugs also used for dependency should be discriminated against and their increased risks ignored. But it does promote the use of psychological therapies as an alternative treatment to benzo’s - can you imagine someone breaking in to steal your psychoanalyst?
“One woman did not realise that she was raped until a few days after. But she said that she would not be believed if she reported it. She was high at the time”.
Yes, there are mental health issues this woman probably needs a lot of support with.
No, I’m not suggesting that raping anyone is a defensible thing or is “ok” to do to anyone who engages in “getting high”, but….
…my tax paying money is already responsible for trying to make sure you don’t get yourself into a mess but, if you do, we should make sure we give our tax-paid police time to accommodate you in every way, despite your “getting high” actions being illegal or, at minimum, clearly identified as being a bit of a silly choice.
No, I don’t have an issue with people using drugs.
Yes, I have an issue with people using drugs, holding everyone but themselves as responsible for when it goes bad, expecting everyone but themselves to fix it and being allowed to do it again despite the best efforts of the limited services and then saying how crap the whole world is because it doesn’t solve their problems.
But if she was high and did not report it, who has done any wrong to her other than the rapist? Who is responsible for this person’s vulnerability in the community? Known to mental health services, I presume? Has some drug problems possibly? Likely to be sharing a place with other users? People with anti-social and psychopathic traits maybe? Can’t get a decent place to live? Can’t get a job because of her mental health and associated drug issues? There’s a lot more to this person’s issues than ’social stigma’ or that the police might not take her seriously. Or am I just “stigmatising”?
How is vilifying the criminal justice system , the police attitude and awareness and reprimanding the public social stigma meant to address this when the victim places themselves in vulnerable position and the service is unable to provide anything but half way accommodation or places people in vulnerable positions because that’s all they can afford? None of those people are responsible for the situation that was created wherein a crime was committed.
If I leave my car unlocked or the keys in it - the insurance won’t pay out and don’t have to, the policy holders like that because it means insurance premiums stay down regardless of how stupid I am, the police don’t spend all night looking for my car because they’re busy trying to prevent crime, but they keep an eye out for the registration, make and model, and the courts, having found the perpetrator to have “a problem with drugs”, then send him to rehab in hospital and I get no financial remedy because he’s broke. I really just shouldn’t have left my keys in the car.
Why am I to be discriminated against by social justice and stigma for my ‘mistakes’ yet others can be vindicated for theirs? Why won’t anyone understand it was just a mistake and please put it right for me? Where exactly do we cut off from one person’s stupid mistakes to another person’s unlucky misfortune and who decides? Does the absence of a ‘mental illness’ makes a difference to my rights, though I was ‘absent-minded’? Remember, without a mental illness, I’m one of the three-quarters, not two-thirds, who don’t get a satisfactory overall result.
Is the cause of the crime purely because they are targeted for being mentally ill? I’m sure in many cases it might be, due to vulnerability, and in particular to the victimisation of name calling, throwing food at the house or general bullying as identified in the report. But many instances can probably be ruled out as having little or nothing to do with being mentally ill. Living in the wrong area, being in the wrong place, having poor social/educational/economic background or just mixing with the wrong people may be secondary to mental illness (or causative to mental illness) but it is not the primary factor that caused them to become a victim when these other factors are predisposing. Does this report tell us anything new?
Unless the true reasoning is established as to the causality or relationship of crimes against the mentally ill and the other relational issues, such as poor housing, culture or deprived socioeconomic areas, and they are compared with other comparative community statistics or for those not deemed mentally ill, the solution will not be identified and the brandishing of meaningless “statistics” does nothing more than tabloid journalism and “bad science” does for the counter argument to stigmatise mental illness.
If media reporting has to be sensible, transparent and honest, then so does the balance.
If we expect high standards of research and studies from our service research, then it is only right we expect the same from our watchdogs.
Nevertheless, some of the report recommendations sit good with me and probably didn’t even need the ’statistics’ to validate them. Some variation or caveats (which I won’t discuss here, having noticed how much this posting has amassed to already) would make me more comfortable.
I will, however, say I’m a tad confused about the call to keep complainant’s mental health history out of it - then ask for stronger monitoring of mental health information of respondents and to use it to add weight to any sentencing against the defendant.
It all seems a bit much like “having your cake and eating it” - where mental unsoundness is already used as a ‘defense’ against criminal liability, the Mind report also advocates that mental soundness cannot be questioned in relation to any complaints against others.
The defendant has a right too, which is not abrogated or superceded by the presence or suggestion of mental illness in the alleged victim. Mental illness can both mitigate and demonstrate culpability. The recommendation I would prefer to see address the issue is to that the courts be able to admit or retain an expert independent advice as to whether the mental health history of the plaintiff is relevant to the case or likely to be biased by the representation given. Consider, if the plaintiff and defendant were both ‘mentally ill’, the report recommendation suggests changing the law so that, while the defendant’s mental history can be submitted in both mitigation and causality of the alleged offense, the plaintiff’s mental health can not be so examined. A diagnosed bi-polar woman living with a known psychopathic man - he winds her up; she stabs him. Her history can be banded about the court, yet his is suppressed. That would require some ethical and moral reasoning I am incapable of without the full knowledge of the circumstances.
I strongly agree with recommendation 7 of the report to strengthen obligations of mental health and social services in working with the CJS and perhaps the Court Liaison roles that many health care trusts now have in place should consider expanding to this role?
I expect some of this will not go down well with others. I accept and respect that.
But I agree there’s a problem with the vulnerability issue that ought be addressed, but it is not helped by exacerbated and generally bad statistics.
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One Comment
This is a much richer, more reasoned and eloquent articulation of my thoughts!