Madness as the Foundation of Non-Culpability

Sammanfattning: Doctoral dissertation Abstract Background The relation between mental illness and accountability, may at its best be described as unclear. A negative correlation them between was established thousands of years ago, and has since formed a more or less self-evident supposition. This dissertation is an effort to test this construction. Aims and hypothesis The overall aim of this thesis is to clarify the relation between mental illness and accountability and to scrutinize which variables may be considered to be of importance and significance when deliberating on someone’s criminal responsibility. Methods Initially some central notions were conceptually analysed. The next step consisted of interviews with Swedish forensic psychiatric patients (n=46) and professionals (n=150). Patients were asked to describe their experience of the circumstances leading up to the crime. Professionals were asked to assess 12 psychiatric diagnostic in terms of negative influence on accountability. Results Swedish forensic patients (i) point to other circumstances than mental illness as the main cause of their crime and (ii) regardless of main psychiatric diagnosis sued to have been aware of the nature their action, stressing (iii) damaged action control and inability to identify attractive action alternatives. Swedish forensic professionals (i) stated to a large extent that they never before had acknowledge this relationship and (ii) regardless of sex, age, working experience, education and geographical location no significant differences was found in the result of their assessments. Conclusions The (i) understanding, (ii) diagnostics and (iii) treatment of persons with dysfunctional behaviour patterns will most certainly benefit from a paradigm shift, in which unconscious consensus and self-evident artefacts are replaced by first person experiences and skilled professional responsiveness.