Crimes by people with schizophrenia in Korea: comparison with the general population

Guilty or not guilty by reason of insanity? a comparative study of murderers referred for psychiatric examination by court order

BACKGROUND

Some murders are committed under the influence of a psychotic state resulting from a mental disorder, mainly schizophrenia. According to the law in many countries, people with mental disorders do not have criminal responsibility. They are defined as not guilty due to insanity (insanity defense) and therefore cannot be punished. In Israel, in recent years, more lawyers are requesting psychiatric opinions for the murder defendants they represent. This study aims to explore the differences between two groups of murderers: individuals who committed murder and were found not guilty by reason of insanity (NGRI) and individuals who committed murder and were found responsible and guilty. The comparison is made from a broad perspective by examining sociodemographic factors and psychiatric factors as well as criminological and forensic factors.

METHODS

This study, conducted in Israel, analyzes the sociodemographic and forensic differences between 72 individuals who committed murder and were found not guilty by reason of insanity (NGRI) and 56 individuals who committed murder and were found responsible for their actions and fit to stand trial (guilty).

RESULTS

The findings show that NGRI participants were more likely to be from central areas, to be Jewish (rather than Arab), to be diagnosed with schizophrenia and have a background of hospitalizations before committing the murder, to have remained at the murder scene and/or called for help, and to be less likely to have committed the murder with a partner.

CONCLUSIONS

The study's findings are explained and the limitations discussed. The findings add to the existing knowledge base about murder by reason of insanity and the differences between NGRI and criminal murderers. The characteristics of the NGRI group found here can help to identify risk groups and to develop and implement prevention programs for people with mental disorders who are at risk of violent behavior.

The impact of the Mental Health Act revision for deinstitutionalization in Korea on the crime rate of people with schizophrenia

This study examined changes in the crime rates of people with schizophrenia in Korea in comparison with the general population after the Mental Health Act revision for deinstitutionalization in 2017. The crime rates of people with schizophrenia and the general population were calculated from 2012 to 2021 using the Korean National Policy Agency crime statistics. The effects of the law revision in 2017 on the crime rates were assessed using the interrupted time series and difference-in-difference analyses. The crime rates of people with schizophrenia tended to be lower than the general population except for murder and arson, which were 5.3 and 11.4 times, respectively, that of the general population. While no significant effect of the revision was found in the interrupted times series analysis, the difference-in-differences analysis indicated that the total crime rates and the rates of violence and public order crime increased among people with schizophrenia compared with the general population. The revision of the Mental Health Act for deinstitutionalization did not lead to an increase in the murder rate of people with schizophrenia as is commonly thought. However, the increases in overall crime and violence rates of people with schizophrenia suggest that the deinstitutionalized patients may not have been successfully relocated into the community. The increase in crime after the revision should be interpreted as a call for well-resourced community care rather than the reason for re-transfer of patients to hospitals.

Structural Model Analysis of Discriminatory Behavior Toward People With Severe Mental Illness

OBJECTIVE

This study aimed to determine how prejudice and attitude toward people with severe mental illness, formed through exposure to the mass media, affect discriminatory behavior toward them.

METHODS

Between September and November 2019, demographic data were collected using an online survey of 622 adults residing in South Korea. The scales used in this study were taken from the 2008 survey by the National Human Rights Commission of Korea. Structural equation modeling was performed for a comparative analysis of the direct and indirect effects.

RESULTS

Virtual experience through mass media exposure had a statistically significant effect on prejudice against people with severe mental illness. Direct experience had a positive influence on reducing prejudice and discriminatory behavior. The direct effects of prejudice on discriminatory behavior were significant. In terms of indirect effects, the full mediating effect of prejudice was significant for the virtual experience through the mass media-prejudice-discriminatory behavior path, and the partial mediating effect of prejudice was significant on the direct experience-prejudice-discrimination behavior path.

CONCLUSION

This study recommends more careful reporting of mental illness in the media, promoting anti-stigmatization programs that provide opportunities for direct contact between the public and people with severe mental illness.

Human Rights of Persons With Mental Illness After the Korean Mental Health Act Revision: A Qualitative Study

After the Constitutional Court of Korea ruled that the provision of involuntary admissions was unconstitutional, as it violates personal freedom, the Mental Health and Welfare Act was amended in 2016. The current study explores involuntary admission and discharge experiences, after the law's revision, from a patient-centered perspective and suggests future directions to protect human rights. Data were collected from seven persons with mental illness and three family members through in-depth individual interviews and analyzed using thematic analysis. Persons with mental illness were still not guaranteed full autonomy and the right to receive proper treatment due to lack of mental health resources. The burden on family caregivers was amplified by stricter admission requirements. These results indicate the need for human rights-friendly emergency services, including peer crisis shelters and procedural assistance services. The government should develop community-based mental health services to ensure continuity of care without imposing public responsibility on family members. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Current and Future Trends in Hospital Utilization of Patients With Schizophrenia in Korea: A Time Series Analysis Using National Health Insurance Data

OBJECTIVE

This study aimed to investigate trends in hospital utilization of patients with schizophrenia during the last 10 years in Korea and to predict future trends using time series analysis.

METHODS

We determined the numbers of patients receiving outpatient or inpatient treatment for schizophrenia per month between 2010 and 2019, using National Health Insurance claims data. Facebook's Prophet was used to fit time series models based on observations for the previous 120 months, and to predict trends over the next 36 months.

RESULTS

The number of hospitalized patients per month has declined rapidly since 2015, but the monthly number of outpatient visits has steadily increased. Monthly hospital utilization has increased in patients aged ≤29 and ≥50 years, but has declined rapidly since 2014-2015 in patients in their 30s and 40s. The upward trend in overall hospital utilization has slowed considerably in recent years. These trends are expected to continue over the next few years.

CONCLUSION

This study revealed some notable changes in the hospital utilization patterns of patients with schizophrenia in recent years. There is a need to closely monitor and anticipate potential problems caused by these changing trends.