Post 2: Building my expertise in researching Mental Health – The Overarching System

In focusing my interests of mental health into its complex relations and history with violence and law enforcement, I’ve discovered two scholarly articles that critically examines this particular area – a thorough review of literature publications concerning the perpetration of violence and violent victimisation of severe mentally ill persons written by Jeanne Y. Choe, Laura A. Teplin and Karen M. Abram, and an comprehensive journal article on police’s management on dealing with encounters with the mentally ill written by Fanny de Tribolet-Hardy, Dragana Kesic and Stuart David Michael Thomas.

Choe, Teplin and Abram’s review, Perpetration of Violence, Violent Victimisation, and Severe Mental Illness: Balancing Public Health Concerns (2008), is one that critically examines U.S. empirical studies that has been published since 1990 in concerns with the perpetration of violence and of violent victimisation of people with severe mental illness. The authors themselves are either PhD professors and/or researchers who work in the field and share interests of mental health, criminology, psychiatry and behavioural sciences. A note of affiliation on the review states that they are affiliated with the Psycho-Legal Studies Program in the Department of Psychiatry and Behavioural Sciences at the Feinberg School of Medicine in Chicago.  Each has an online profile that shows experience in writing publications that cover these areas. Thus, this review in particular is no different to the rest in their history.

The aim of the review is to reveal these findings in hope of improving contemporary research practices relating to mental health and violence, as well as reducing negative stereotypes and stigmatisation of mental health. They do this through having an exhaustive look into previous publications’ studies and research, discussing discrepancies and analysing the methodologies of each study. Accompanying this is three tables that organise their findings of prevalence of violent perpetration, violent victimisation and then a combination of studies that looked into both. While the tone of the review is blunt and straight forward that lets the tabulated data speak for itself, the underlying argument that develops throughout the review is one that “does not support the stereotype that persons with severe mental illness are typically violent. ” The conclusion leads up to this, with an in-depth discussion of the “small attributable risk of severe mental illness to perpetration of violence” and the negative stereotypes that persist despite this. Not only do they offer suggestions for future research such as focusing into victimisation and, investigating community populations and not only persons in treatment, but they identify steps needed to reduce perpetration and victimisation such as encouraging mental health centres to assess the risk as well as developing programs for mental illness and comorbid substance use disorders.

On the other hand, Kesic, Thomas and de Tribolet-Hardy’s journal article, Police management of mental health crisis situations in community: status quo, current gaps and future directions (2013), compares, contrasts and examines the approach styles and deescalation strategies in both psychiatric and police contexts in order to identify ways of improving police practice when encountering a mentally ill person. The three authors are registered psychologists and/or professors working in forensic mental health, psychology and behavioural science. A small note of affiliation on the article states that Tribolet-Hardy works in the Centre for Forensic Psychiatry in Zurich; Kesic in the Centre for Forensic Behavioural Science in Melbourne; and Thomas in the Legal Intersections Research Centre at Wollongong. Thus it is no doubt that this article is written from both experience and well-researched evidence as per each of the authors’ expertise.

In comparison to the review by Choe, Teplin and Abram, this article was surprisingly more interesting and easier to read and understand. The article has a structure that systematically explains and justifies its argument of the need for interpersonal and therapeutic communication styles in policing and in psychiatric practices. They do so by using a plethora of in-text referencing to relevant studies to slowly develop their argument while writing in a style that despite speaking generally on the topic, they reference cases and evidence that come from different countries to come to an objective and international perspective. The authors analyse both services in their management of aggression, explaining their processes in detail and discussing the many factors that complicate each in order to find their shared commonalities. This approach intends to challenge common critical opinions on police management of mental health persons that states that they aren’t prepared or trained successfully in dealing in mental health crises in hope to bring to light the complexities behind law enforcing and the mental health.

Despite writing about different areas on mental health and violence, each text shares a common argument – there are faults in the overarching system of society in how it handles mentally ill persons and how mental health is perceived. Even empirical studies on mental health that would have been considered reliable for an objective perspective by the majority, is revealed to have inaccuracies through narrowed and vague research methodologies. Social workers who are supposed to be trained to deescalate aggressive mentally ill persons through means of therapeutic communication, are rather resorting to restraining methods at the first opportunity; and yet law enforcement is publicly criticised and pressured to change their practices.  Moreover current models such as the Crisis Intervention Team (CIT) implemented by the police that bring mental health clinicians along through encounters are reported to having varied success. Thus it brings me to question whether there is a perfect way to handle the mentally ill, effectively mitigating fatalities, violence and danger to surrounding persons all the while not adding to its already harsh stigimatisation.

Abram, K.,Choe, J., Teplin, L. 2008, ‘Perpetration of Violence, Violent Victimization, and Severe Mental Illness: Balancing Public Health Concerns’, Psychiatric Services, vol. 59, no. 2, pp. 153-164.

Kesic, D.  Thomas. S, de Tribolet-Hardy, F. 2013, ‘Police management of mental health crisis situations in community: status quo, current gaps and future directions’, Policing and Society: An International Journal, vol. 25, no. 3, pp. 294-307.

Header Image:
Malland, J. 2016, Range Ta Chambre (Clean Up Your Room), arrestedmotion, viewed 10 August 2016, <http://arrestedmotion.com/2016/07/recap-seth-range-ta-chabre-teatro-india-999-contemporary/?images=1&gt;

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