In ancient Malaysian culture, amok was a state entered by warriors on the battlefield, when hantu belian, an evil tiger spirit, would possess the body and cause them to commit heinous acts: hence the phrase ‘to run amok’. The warriors were known throughout eastern Asia for being especially brutal and frenzied in combat, and were treated well afterwards, as the nature of the demonic possession meant they weren’t responsible for their actions.
Agency, defined here as the amount of control over one’s actions, has been arguably the most considered and thought-provoking concept throughout the history of the criminality of mental illness. Hundreds of court cases have, and still do, rely on the notion that those with mental disorders may not have complete control over their actions; their inhibited mental capacity is used as an explanation for their crimes, and the barrister’s role is to argue this to gain a more lenient sentence. The above detail about the inhabitation of the Malay warriors provides a valuable insight into the earliest human thoughts on this topic.
The ‘demonic possession’ is arguably the result of some form of mental illness, perhaps psychosis or bipolar disorder. The Malay people’s ascription of the frenzy to external possession is a sign that they believed the rage was outside of the warrior’s conscious control and should therefore be excused. Today, this translates to a tendency of individuals to assume the cause of crimes that provoke serious outrage – anything from machete attacks to violent quasi-religious cults – that the individuals’ mental health has at least a part to play in the events.
This seems reasonable; the idea that the brutal murder of passers-by with a machete is the conscious decision of a sane individual seems laughable, so it makes sense that society distances itself by targeting mental health as a cause for the behaviour. This means that those without mental health conditions can rest easy, knowing that they are far less likely to commit crimes like this, attributing the crime to some unseeable, fundamental difference in physical makeup. Social psychologists call this attribution bias.
However, as is the case for many phenomena that surround mental health, the case at hand is comparatively more complicated. The patients on psychiatric wards often have explanations for the crimes they have committed; their rationalisations can even seem feasible, albeit with some suspension of reality and questionable initial assumptions. For example, I witnessed a man in a psychiatric ward round justify his crime of assault on an individual by claiming that the year was 1918, and the individual he assaulted was the cousin of Haile Selassie (the former emperor of Ethiopia, the Messiah to Rastafarians, who was assassinated in 1975), whom he’d had an altercation with. The consulting psychiatrist didn’t question this story; he understood that the world had revealed itself phenomenologically to the patient that way, and that the actual logical process was perfectly sound. The treatment he was receiving, therefore, was to correct his initial assumptions, and not his logical faculty, the difference between ‘the world isn’t as you think’, and ‘don’t commit crime’, the former being a much deeper and profound treatment.
The presentation of mental illness as a cause of crime, it can be argued, can be detrimental to popular perceptions of mental illness as a whole. The issue arises when minority examples of arguments of inhibited cognitive faculty in the case of crime perfuse into general persons with mental disorders. We see the same assumption of lack of agency being displayed popularly in the case of ‘sectioning’; more formally, detainment under various sections of the Mental Health Act of 1983.
The unwilling detainment of mentally ill people has been practiced over the centuries, proving controversial in both contemporary and modern circumstances. The ‘lunatic asylums’ of the Victorian era haunt the practice of psychiatry, occasionally being used as an argument against psychiatry itself; that the past denial of basic freedoms is immoral, and vestiges of the practice still cling to it today. This is reflected in popular culture; the film ‘A Beautiful Mind’, which depicts Nobel Prize-winning mathematician John Nash’s struggle with paranoid schizophrenia, presents the mental hospital in which he was treated as a prison; he is shown strapped to a bed covered in electrodes, writhing against his bounds. Many have objected to this treatment; French physician Philippe Pinel is heralded as the founder of moral treatment; the concept that psychiatric patients shouldn’t be denied basic human rights, based on the observation that they have confused decision-making faculties. In 1797 he and his assistant began controversially freeing patients literally from their chains at the men’s and women’s asylums in Paris, the start of a movement that revolutionised the conditions in asylums in the west.
The question of agency, then, is complex. There are two opposing themes present; firstly, portraying the mentally ill as purely victim, a puppet through which the illness acts grievously, and secondly, the portrayal as a relatively normal individual, subject to the authoritarian whim of the consulting physician. As is so often the case when considering a subjective experience, neither narrative is especially helpful in successfully capturing and conveying the actual viewpoint of those whose illnesses society is trying to understand. While persons with a mental illness may find it helpful to partially identify with either side of the argument in various situations, it is vital to remember that mental illness is fundamentally phenomenological; it changes the way in which the world is revealed to the patient, meaning in order to treat them we must assume that their symptoms are ‘real’ in the sense that they are to the patient. We must therefore assume that the patient’s view of the world is their own, albeit through a flawed lens.