Healthy living * Mental wellbeing

People who carry out horrific crimes do not have to be mentally ill

People who carry out horrific crimes do not have to be mentally ill Anders Breivik case highlights mental illness misconceptions, says expert

People who carry out horrific crimes such as Anders Breivik do not have to be insane, a leading expert says.

In a commentary in today's Lancet medical journal, Professor Simon Wessely, of the Institute of Psychiatry, King’s College London, says the Breivik case highlights two widespread misconceptions about mental illness.

These are that "outrageous crimes must mean mental illness," and that a psychiatric diagnosis is seen as some sort of soft option used to "get people off."

Professor Wessely said: "When people struggle to comprehend what lies behind the mass murder of adolescents gathered for a weekend of discussions and campfires, the simplest response is that the killer 'must be mad.'

"The inexplicable can only be explained as an act of insanity, which by definition cannot be rationally explained. The act was so monstrous, the consequences so grievous, that the perpetrator had to be insane."

He said that he and other psychiatrists were surprised when Breivik was diagnosed as suffering from schizophrenia.

"For schizophrenia to explain Breivik's actions, they would have to be the result of delusions," the professor said.

"The meticulous way in which he planned his attacks does not speak to the disorganisation of schizophrenia.

"My colleagues in forensic psychiatry struggle to think of anyone who has had the foresight to bring along a sign stating 'sewer cleaning in progress' to avoid drawing attention to the smell of sulphur from the home made explosives in the back of his vehicle," he added.

As for the public perception that psychiatry helps people avoid punishment, the professor said: "In the UK, however, if you commit murder and want to spend as little time in detention as you can, putting forward a mental illness defence may mean that you will spend more—not fewer— years behind bars."

He also added that most of the prison population have the same prejudices towards mental illness as those outside prison, and that offenders would rather take their chances in prison than be what they call being "nutted off."

Professor Wessely concluded: "The widespread anger when it seemed that Breivik was going to be sent to hospital rather than prison reminds us that liberal attitudes to mental illness are still often only skin deep."

This article was published on Fri 27 April 2012

Image © Gillotte -

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