By assuming that mental disorder is a cause of crime, the role of the acting subject and his individual responsibility is left suspended. Though this may come as a relief to some perpetrators or those affected by the crime, it is more likely to be percieved as abolishing or reducing human responsibility. Even if penal law exceptions or provision of special treatment for those considered mentally disordered may spare an offender punishment, there is a price to pay. In my experience from Sweden, where the prison system is secure and sentences comparatively short, a majority of subjects referred for pretrial forensic psychiatric examinations wish to be considered non-disordered and to avoid court-ordered in-patient psychiatric care.
There are several reasons for this, ranging from the practical to the philosophical. Forensic psychiatric care is of unlimited duration and renders the patient dependent on professional expertise, which will often lead to longer periods of incarceration. It reduces autonomy to a far greater extent than in conventional corrective institutions. Pharmacological and other treatments can be given without consent. And a court declaration of insanity (or similar terms) will mean a lack of responsibility or reductions that will taint the human person as a whole.
Even if, as we have seen throughout this series, we as humans certainly have unfairly distributed abilities and chances to refrain from destructive acts, a decision that someone has lacked insight or the ability to control his behaviour will detract from his dignity and human rights.
Also everyman’s perspective on crime and criminals is belittled and silenced in the presence of expert opinion. Public opinion is often mocked as uninformed and revengeful but may contain a commonsensical understanding that is not always apparent in subcultures of experts. Humility is certainly called for in forensic psychiatry.
This blog post, the final entry in the series on "mental disorder is a cause of crime", is partly based on the paper "Mental disorder is a cause of crime" I co-authored with Susanna Radovic, Christer Svennerlind, Pontus Höglund and Filip Radovic in 2009. This study is based on interviews with offenders, who may have a stronger belief in free will and responsibility than experts.