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The "mad" vs. the "bad" revisited: managing predatory behavior.
1Bureau of Psychiatric Services, New York State Office of Mental Health, Albany 12229, USA.
The Psychiatric Quarterly
|August 24, 1999
Summary
Western democracies historically separated care for the mentally ill ("mad") from punishment for the criminal ("bad"). Recent legal changes blur this distinction, impacting public safety and mental health systems.
Area of Science:
- Forensic Psychiatry
- Public Policy
- Mental Health Law
Background:
- Western democracies traditionally maintained separate institutions for the mentally ill and criminal offenders.
- Recent social and policy shifts have led to legislation mandating the transfer of violent predators to mental institutions post-imprisonment.
Purpose of the Study:
- To analyze the policy changes blurring the separation between the 'mad' and 'bad'.
- To examine the implications of these changes on mental health systems and public safety.
- To propose alternative solutions.
Main Methods:
- Review of legal and policy changes leading to the blurring of 'mad' and 'bad' distinctions.
- Analysis of preparations within New York's mental health system.
- Assessment of dangers and drawbacks in states with mandated laws.
Main Results:
- Legislation, upheld by the Supreme Court (Kansas v. Hendricks, 1997), allows for the civil commitment of individuals deemed dangerous predators after prison.
- This has led to the blurring of the traditional separation between mental illness and criminality.
- Concerns exist regarding the impact on mental health systems and potential drawbacks in states with enacted legislation.
Conclusions:
- The legal blurring of 'mad' and 'bad' presents significant challenges to mental health systems and civil liberties.
- Alternative strategies are needed to maintain the distinction and ensure appropriate care and justice.
- The study details policy evolution, system preparations, and critiques existing mandates.