Mental health and rising kin murders

 “We are witnessing too many cases of people being murdered by own family members lately. I have seen all manner of reasons fronted for this including mental illness but one wonders how such ailment can be spotted early to end the madness. Are there tell-tale signs of someone likely to get murderous due to mental breakdown?”

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Your question has taken me back to 1977 when my then teacher, Prof John Gunn wrote the following words in the British Journal of Psychiatry. “The main problem in discussing any relationship between criminal behaviour and mental disorder is that the two concepts are largely unrelated.”

That statement remains largely true today and the debate you have now ignited is likely to go on for a long time.

A few facts are not in dispute in most parts of the world.

For example, most crime is committed by people who do not have a mental illness. Also worth stating is that most people with mental illness do not commit any crimes. If you take nothing else from this answer today take these two points, and my job is done.

A few more facts might help you understand why there is so much controversy in this, most times generating more heat than light. Did you know that 75 percent of people who commit murder do not have a mental illness?

Portrayals in movies would have you believe that most murders are committed by lunatics, which is the derogatory word for people with mental illness. This is indeed the essence of your question.

So, when you tell us to end ‘This madness’ and you seek to find tell tale signs, you are looking not at signs of mental illness but in realty criminals who do not have a mental illness but nonetheless commit crimes. A few more anecdotes will make this point clearer.

There are, in most jurisdictions more people with mental illness in prisons than in hospital. When we visited a remand prison as members of the Mental Health Taskforce, we were able to confirm that there is a significant number of people in the criminal justice system who would be better off in hospital than in prison.

The fact is that society as a whole would rather hide mental health offenders away from the help they most need. Jails are the new hospitals is the slogan so common in America!

Things are even worse than you can believe. In many studies, it has been shown that people with mental illness are the subjects of criminal acts by families and the police.

In other words, having a mental illness exposes one to exploitation by society. It gets worse. If you have a mental illness and you feel that life is so desperate that you wish you were dead, then any attempt to kill yourself to escape misery, is a criminal offence that will take you to jail. There you are likely to suffer even more because the depression you would be suffering from would be neither recognised nor treated! In this case there is no escape.

It might surprise you to know that mental illness; in particular disorders such as schizophrenia and Bipolar mood disorder are only related to crime if complicated by drug or alcohol use.

So, next time you read in the papers that a person killed his parents or other relatives, you will be right to expect that alcohol and or drugs were somewhere in the mix.

You might also like to know that in some studies, countries with few beds for patients with mental disorders have many beds for prisoners. Those with many beds for patients for in psychiatric hospitals, have small number of beds in prisons! What a paradox. Action in required most urgently.

This is a task that requires that we engage in the kind of dialogue that your question has raised.

For example, efforts are under way to decriminalise attempted suicide and to ensure that people who have mental illness are treated in hospital rather than take to jail.

The Mental Health Taskforce recommended that Mathari National Teaching and Referral Hospital be turned into a self-governing parastatal. That has already come to be and the hospital is now run by an independent board. The taskforce also recommended that the hospital be rebuilt. The government has already allocated land for the construction of new proposed hospital.

Many more activities including increased funding for mental health are in place at both national and county level.

As you can see, and in spite of the gloomy picture painted by your question, there are glimmers of hope that a new dawn for mental health will follow the nightmare of the dark night we are going through right now as well illustrated by your question.