Friday, October 28, 2011

What I Learned Part I

Regular readers know that every year I tweet and blog from the conference of the American Academy of Psychiatry and Law. This group of forensic psychiatrists consists of about 1800 of the country's practitioners. Topics are quite diverse and sometimes rather unusual. It's a lot of fun. Here's just a small smattering of factoids I picked up yesterday:

  • The "sovereign citizen" defense can prompt a competency eval, but is not a delusion. The sovereign citizen movement is a recognized subculture of people who believe the government has no jurisdiction over them.
  • Of 200 defendants cleared by DNA, one-fourth had confessed to the crime.
  • According to FBI uniform crime reports, between 2001 to 2009 2.2% of police murders took place while responding to calls involving a mentally ill person.
  • The collection and selling of serial killer memorabilia is also a venue for potential fraud.
  • President Peter Ash gave an interesting and useful Presidential address about juvenile violent offenders. Persistent juvenile offenders tend to become more impulsive with age, not less. They commit an average of 30 to 70 previous offenses before they are caught for the index violent offense. They differ from adult violent offenders in that they tend to act in groups rather than alone, they commit impulsive rather than planned violence, and their criminal activities tend to be more diverse than adults. There is a .3 correlation between juvenile psychopathy scores and later adult psychopathy, but this only accounts for ten percent of the variance. Translation: most violent juvenile offenders do not become violent adults. Nobody knows for sure why.
  • There was frequent discussion of the hazards and pitfalls of involvement in social media, including discussion about using it to impeach or undermine witness credibility. So far though, when questioned nobody had actually seen this happen to an expert witness. Concern seems to be out of proportion to reality.

HIGHLIGHT OF THE DAY:

My favorite part of this first conference day was the luncheon speech by Pete Earley. Mr. Earley is a former Washington Post report and New York Times bestselling author who's son has a serious mental illness. His book Crazy is required reading in my training program. The book is a description of life inside of one state's broken forensic mental health system. He is passionate and compassionate, and a vigorous and outspoken advocate. The audience was clearly captivated by what he had to say, and at sometimes it was frankly hard not to stand up and shout 'amen'! when he made his points. (Take home quotes for me: "Never give up hope! People get better!" and "A single person can change the system.") I was thrilled to finally meet this very warm man whom I admire. And I'm not just saying this because he wrote a blurb for our book!

SUB-HIGHLIGHT:

I attended a presentation about psychiatrists in the media. The panel presented an interesting categorization of activities: psychiatrist as scientist (presenting and interpreting studies), educator, storyteller, celebrity commentator and curbside therapist. I was surprised and flattered to see the home page of Shrink Rap, and the cover of the book, as an example of "psychiatrist as educator" in the media. I'm glad to see we seem to be accomplishing something helpful.


So that's the first day. You can follow me on Twitter (see the sidebar). If you're here at the conference and want to #OccupyAAPL, drop me a note!

17 comments:

rob lindeman said...

I had never heard of the sovereign citizen movement, so I navigated to the Wikipedia link you provided. Their positions range from nonsensical to silly.

What's really interesting is that the American Academy of Psychiatry of Law even considered the proposition that a group of people espousing unpopular opinions may be subject to psychiatric scrutiny and dare I say, incarceration!

Do readers of Shrink Rap need any further evidence that psychiatry is, among other things, politics by other means?

wv = Minogin. Hero of the sovereign citizen movement. Arrested and jailed for espousing unpopular ideas, 1911.

jesse said...

Rob wrote: "What's really interesting is that the American Academy of Psychiatry of Law even considered the proposition that a group of people espousing unpopular opinions may be subject to psychiatric scrutiny and dare I say, incarceration!"

What Clink said was that the use of the Sovereign Citizen defense at a trial can prompt a competency evaluation. This is not "espousing an unpopular position." And "can prompt a competency evaluation" simply means that the person who raises that as a defence might well be not competent to stand trial (for instance, assist in his own defence), but that Sovereign Citizens is a recognized subgroup and adherents not mentally ill per se.

Then "Do readers of Shrink Rap need any further evidence that psychiatry is, among other things, politics by other means?"

Does this conclusion even relate to the data?

rob lindeman said...

Let me try again. I'll change some words a bit we'll see if you start to get what I'm saying:

"The 'Libertarian' defense can prompt a competency eval, but is not a delusion. The Libertarian movement is a recognized subculture of people who believe the government has the monopoly on use of coercive force, and should be therefore limited to the least use of that force"

"The 'Liberal' defense can prompt a competency eval, but is not a delusion. The Liberal movement is a recognized subculture of people who believe that the government has the responsibility to redistribute wealth as it sees fit, from each according to his abilities, to each according to his needs."

"The 'Conservative' defense can prompt a competency eval, but is not a delusion. The Conservative movement is a recognized subculture of people who believe that the government has the responsibility to promote so-called 'traditional values'."

In case any readers fail to grasp what I'm getting at here, I'll spell it out in monosyllables:

"Sovereign Citizens" say weird things so they could be nuts. Let's do a test and see if they're nuts.

wv = anyapp, will do at this point

jesse said...

Rob, they are not in court because they say weird things, they are in court for something they have done or not done, such as not having paid taxes, or not having followed other laws while expressing that the U.S. government has no right to require them to follow such laws. Behavior, not opinions.

And Clink said the use of such a defense in court, that the government has no right to even try them in court, "can" prompt a competency evaluation. Not must, not always. And the request for such an examination comes from the prosecutor or the public defender, not from the psychiatrist doing the examination.

And you go from this to an indictment of American psychiatry. The Academy of Psychiatry and the Law should not even talk about such things!

rob lindeman said...

Indeed, psychiatrists gathered for meetings ought not to discuss political ideology of criminal defenses simply because politics is not the business of psychiatry!

If you will insist that utterances by members of the Sovereign Citizen movement 'can' prompt a competency evaluation, then you agree explicitly that psychiatrists ought to have something to say about defendants with bizarre political views. I insist that psychiatrists have nothing whatsoever to say on such matters.

I thought you guys gave up on this stuff after the Goldwater debacle. The horrific history of 'treatment' of dissidents in the Former Soviet Union should have sufficed.

wv = verba - defunct part of speech, designeda to makea your sentence makea more sense.

Anonymous said...

I don't see how anyone actually believes that "utterances" lead to a psych eval, unless you walk onto a plane and tell the steward that your bomb won't fit in the overhead bin. It seems pretty clear that if you kill a cop ,or anyone else for that matter, and claim as your defense that you are a sovereign citizen, a psych eval probably is not a bad thing. Yes, such a claim could take form of an utterance but only after a crime was committed.
And Rob, I am surprised that you used the word utterance at all since no one her but you is capable of deciphering anything multi-syllabic, but thank you for the first five minutes of poli sci 101.

Alison Cummins said...

“If you will insist that utterances by members of the Sovereign Citizen movement 'can' prompt a competency evaluation, then you agree explicitly that psychiatrists ought to have something to say about defendants with bizarre political views.”

Well, yes. A significant part of a psychiatrists’ business is people whose thought processes are sufficiently bizarre that they cause problems for them. I really don’t see what the issue is here.

Thoughts per se are not judged as bizarre or not bizarre. Inferences are drawn about the person’s ability to think in ways that are usefully connected to reality by looking at both the thoughts and the context. “Also, for beliefs to be considered delusional, the content or themes of the beliefs must be uncommon in the person's culture or religion.” http://www.minddisorders.com/Br-Del/Delusional-disorder.html

For instance, the Catholic teaching about the Eucharist is pretty bizarre — the wine and bread look, smell and taste like wine and bread but after they are consecrated there is absolutely no wine and blood left, despite all evidence to the contrary, because they have been transfomed into the actual blood and flesh of Jesus. However in our society today, believing this doesn’t make you delusional. Your thought process might not be perfectly logical but it is not disordered, because your bizarre-seeming belief is simply one common to your cultural group.

If someone announces that they are not subject to law, that might be evidence of a disordered thought process. If it turns out that this belief is part of a subculture, it’s possible that the individual has incorrect beliefs but that their thought process is pretty much intact. Cultural clues are important for distinguishing between someone whose brain works normally (incorporating the irrational beliefs of a subculture is something that healthy brains normally do) and someone whose brain is not doing so well (generating its own irrational beliefs).

“I insist that psychiatrists have nothing whatsoever to say on such matters.”

On what grounds? Insisting don’t make it so.

rob lindeman said...

Alison,

If we stipulate that individuals who share bizarre group-thoughts are not delusional, then how can we justify performing psychiatric evaluations on Sovereign Citizens and not on Catholics?

On what grounds? First amendment grounds. Political speech, no matter how bizarre, is supposed to be free. When psychiatrists act as agents of the state, they often act as instruments used to punish individuals who exercise their right of free (political) speech.

wv = permag: Newspeak for those throwaway journals that continue to arrive at your office even after you plead with the publisher to cease and desist.

Alison Cummins said...

Rob,

That’s the whole point. By noting tht a subculture exists, Sovereign Citizens and Catholics can be treated the same way. A distinction is NOT being made.

rob lindeman said...

I'll try again:

"The 'Catholic' defense can prompt a competency eval, but is not a delusion. The Catholic movement is a recognized subculture of people who believe that Jesus of Nazareth is the son of God, etc."

The difference between Sovereign Citizens and Catholics is that we tolerate (finally!) the latter, and we don't the former. So it doesn't seem to trouble us that the Sovereign Citizens are subjected to competency evaluations because they make political statements that we find abhorrent. I argue that this should trouble us.

wv = demardys; bar and grill on Causeway St., facing bankruptcy now that there may be no NBA season this year

jesse said...

Rob, I too will try again, but that will be it for this topic. The other posters are explaining it much better than I can.

If someone robbed a bank and then insisted that because he was Catholicthe U.S. had no jurisdiction over him, but only the Holy Father, and so refused to help in his own defense, I suspect that this, combined with other attributes of the individual, might give prosecutors or public defenders a hint that a competency evaluation might be a reasonable idea.

The subject of what can trigger a competency examination might be a pertinent topic for forensic psychiatrists to discuss.

On this your responses are agonizingly close to troll-like behavior, in my opinion, which is not ex cathedra.

Iluvcats said...

I have a relative (in-law) who is about to lose his house because he refuses to pay his property taxes because he is a sovereign citizen. The court told him they were " etc. His house is totally paid for and he built it with his own two hands. I am very upset by this. He is paranoid about everything, but I don't think he is seriously mentally ill where it would be any sort of defense. It would be impossible to talk him out of this.

And I am the bipolar one in the family who ends up in the mental hospital all the time.

Iluvcats said...

ooops, I made a mistake. Here is what got deleted

The court said they were going to take his house for taxes, but he thinks they are just trying to scare him so he will back down, because he is sure that he is right. my husband asked "don't you think you should pay for plowed roads and fire protection?" and he thinks the gas tax pays for that.

Anonymous said...

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Maggie said...

I motion to declare Jesse's opinion ex cathedra. That particular "opinion" seems more like a statement of the obvious.

Liz said...

thank you so much for mentioned the book by peter earley. i agree wholeheartedly.

http://pocketshrink.blogspot.com

Anonymous said...

Clink,

My own shrink blew me off to attend this Conference. I guess I'll forgive him because it sounds like it was a good one. But I really decompensated during a crisis while he went to the Park Plaza (which is only a 45-minute drive) from his practice area.