28 Mar 2023

31 January 2023

 

Channel NewsAsia


Not schizophrenic men, men with Schizophrenia


On 13 Jan 2023, Channel NewsAsia (CNA) published an online article titled “4 schizophrenic men acquitted of murder or attempted murder confined further after review”.

 

The College of Psychiatrists would like to use this opportunity to address certain misperceptions about mental illness (in particular Schizophrenia) and to allow the public a better understanding of Schizophrenia, the term “unsoundness of mind” and what it means to be acquitted of a crime but still be detained for further assessment and treatment.

 

Schizophrenia is a form of mental illness and patients suffering from Schizophrenia have varying degrees of affliction. The effacement of identity and the stigma attached from having this condition is magnified when people are labelled as schizophrenic instead of saying that the person is suffering from Schizophrenia. Having this illness doesn’t take away the identity of the person and there have been many instances of patients with Schizophrenia functioning well and leading fulfilling lives especially with current evidence-based treatment. Also, it has been shown by research that the risk of any individual with Schizophrenia committing a violent offence is extremely low.

 

When a person suffering from Schizophrenia commits an offence, a psychiatrist will assess whether that individual was laboring under active psychotic symptoms when the offence was committed and to what extent the symptoms contributed to the offending. To lead to an acquittal, the symptoms would have been so severe that it led directly to the offence being committed, what is otherwise known as a causal link. In such circumstances, the accused would have been so unwell as to be unable to appreciate the nature of his/her actions or the consequences of such actions. This is the meaning of unsoundness of mind and this state of mind is often the exception rather than the norm. However, when unsoundness of mind leads to a serious offence, in the case of murder or attempted murder, then further treatment is necessary.

 

The 4 men suffering from Schizophrenia are being confined for another 12 months at IMH or Changi Prison, with comprehensive assessments at appropriate intervals, adequate support and adjustments to enable them to effectively participate in the criminal justice system and the assurance of regular review by legal services whilst they are rehabilitated at IMH or at Changi Prison, all of which are safeguards against arbitrary and indefinite detention. With treatment, it is hopeful that some of them will have remission from their symptoms. This process is stringent and provides a humane approach towards those suffering from a serious mental illness who have committed a crime that is a product of their condition.

 

Future reforms of laws would need to allow us to strike a balance between public safety and ensuring fairness that the length of detention is proportionate to the crimes these patients suffering from Schizophrenia have committed. As our society becomes more aware and knowledgeable of mental health conditions, there is also a need for forbearance when such unfortunate circumstances occur and allow the necessary time for healing to take place.

 


Dr Lambert Low
Chair, Section of Addiction Psychiatry
College of Psychiatrists, Academy of Medicine, Singapore