This document discusses the relationships between mental illness and crime. It covers several key topics: 1. It examines the association between specific psychiatric diagnoses like schizophrenia, substance abuse disorders, and violence. Studies show an increased risk of violence in individuals with these conditions. 2. It discusses different legal tests for insanity defenses, like the M'Naghten Rules and American Law Institute test, as well as other diminished responsibility defenses. 3. It provides examples of Malaysian law regarding detention of offenders with mental illness under the Criminal Procedure Code. This includes provisions for psychiatric examination and detention in hospital if unfit to stand trial or found not guilty by reason of insanity.

1. Zahiruddin Othman
1

2. • Mental illness-Crime Relationships
– Crime in specific mental illnesses
• Criminal Responsibility
• Defenses for mental illness
– Insanity defense & diminished responsibility
• Malaysian’s Law
– Criminal Procedure Code (CPC)
2

3. 3

4. 0
2
4
6
8
10
12
14
Mental
retardation
Psychosis Neurosis Personality
disorder
Alcohol dep drug dep
Psychiatric diagnosis
Psychiatric diagnosis
4

5. • All homicides and
attempted homicides in
West Germany 1955-64
• Mental disorder was
associated with 5% of
these
• The rate of mental
disorder in the community
was 3-5%
• Homicidal violence
rateschizophrenia = 5/10,000
– Schizophrenics were 100x
more likely to commit
suicide than homicide
• Homicidal violence
rateaffective = 6/100,000
– Affective disorders were
1000x more likely to commit
suicide than homicide
5

6. 0
5
10
15
20
25
30
35
schizophrenia (SCZ) Substance abuse (SA) SA + SCZ
Violence
Violence
are associated with an increased risk of violence
6

7. Causal
Correlation
Coincidence
7

8. • There is an increased
likelihood of other
psychiatric symptoms and
disorders
• Homicide risk is increased
10x in someone with an
8https://www.youtube.com/watch?v=1UEkH15wjNc&t=333s

9. •Offences against
property are
associated with the
need to pay for drugs
•Rates of drug abuse
are increased among
prisoners
9

10. 10
ADNAN Mat Jusoh (kanan) dibawa ke
Mahkamah Majistret Kota Bharu
semalam untuk dihadapkan atas
tuduhan membunuh dan membakar
teman wanitanya Januari lalu.
Artikel penuh
KOTA BHARU 23 Jan. - Seorang penganggur dihadapkan ke Mahkamah Majistret di sini hari ini atas tuduhan
membunuh dan membakar teman wanitanya, pada 6 Januari lepas.
Adnan Mat Jusoh, 35, dari Kampung Pasir Jelatang, Pasir Hor, Kubang Kerian, didakwa membunuh Mastura
Kamarul Jamal di sebuah rumah tanpa nombor di kampung itu kira-kira pukul 11.30 malam.
Dia dituduh melakukan kesalahan mengikut Seksyen 302 Kanun Keseksaan iaitu membunuh dengan niat
dan jika sabit kesalahan boleh dikenakan hukuman mati mandatori.
Ketika jurubahasa mahkamah membacakan kertas pertuduhan kes, Adnan mengangguk-anggukkan kepala
sebagai tanda memahami pertuduhan ke atasnya.
Timbalan Pendakwa Raya, Azman Abdullah, memohon kepada mahkamah untuk menangguhkan kes ini
selama satu bulan setengah bagi mendapatkan laporan ujian DNA daripada Jabatan Kimia.
Majistret Khairul Anuar Wahab menetapkan 8 Mac depan sebagai tarikh sebutan semula kes ini.
Mengikut laporan akhbar, Mastura yang berasal dari Jalan Pantai Irama, Bachok, dipercayai ditikam
menggunakan senjata tajam sebanyak enam kali di bahagian tengkuk, dada dan perut sebelum dibakar.
Adnan yang dikatakan bersenjatakan golok panjang mengamuk dan cuba menghalang pasukan bomba dan
penyelamat daripada mengawal kebakaran dua buah rumah yang dibakar.
Dia yang bersembunyi selama tiga jam di dalam Sungai Pasir Hor tidak jauh dari tempat kejadian ditahan
polis pukul 3.40 pagi keesokannya.
http://www.kehakiman.gov.my/judgment/file/adnan%20mat%20jusoh%20d-05-41-04.pdf

11. Alcohol and crime are related in 3
important ways:
1. Alcohol intoxication may lead to
charges related to public
drunkenness or to driving
offences
2. Intoxication reduces
and is strongly associated with
crimes of violence, including
murder
3. The neuropsychiatric
complications of alcoholism may
also be linked with crime
11
Seberang Jaya: Seorang lelaki warga asing berusia 25 tahun maut ditikam dengan
pisau oleh rakannya di Taman Sembilang, di sini, jam 11.50 malam tadi. Dalam
kejadian itu, mangsa dari Vietnam ditikam di dada kiri oleh rakannya selepas
berlaku pertengkaran antara mereka. Sumber polis berkata, sebelum kejadian
mangsa dan beberapa rakannya mabuk sebelum berlaku pergaduhan antara
mereka. Beliau berkata, mangsa ditikam rakannya di dada kiri dengan pisau
pemotong sayur sebelum disahkan meninggal dunia di Hospital Seberang Jaya
(HSJ). Polis menahan suspek yang juga rakannya dari Vietnam berusia 35 tahun
dan lelaki itu mengaku menikam mangsa

12. • Most offences committed by those
in the borderline to mild ranges of
learning disability
• The mentally retarded are more
likely to be caught
• They may commit offences because
they do not understand the
implications of their behavior, or
they are susceptible to exploitation
by others
• Association with indecent exposure
and arson
12

13. Ted Kaczynski, also known as the Unabomber (University
and Airline Bomber), had an IQ of 167, and is probably the
ultimate serial killer genius. A math prodigy, he was accepted
into Harvard at just 16 and later became a mathematics
professor. In 1969, he abandon his academic career to
pursue a primitive lifestyle. To take a stand against modern
technology he mailed bombs, mostly to professors, and
between 1978 and 1995, these killed 3 and injured 23.
He would leave messages encrypted with mathematical
codes that not even the FBI could crack. He managed to
escape capture for 17 years, a feat showing genuine
intelligence. What finally did him in? When his manifesto was
released, his brother and sister-in-law recognized the writing
style and tipped off the FBI.
13https://www.youtube.com/watch?v=xMUI6qdN0uY

14. • Severe illness may lead to
homicide
– The depressed person is usually
acting on delusions
– Family member is usually the
victim in altruistic homicides
– The killer often commits suicide
afterwards
• Sometimes associated with
shoplifting
14
KUALA LUMPUR 27 Sept. – Kakak diberi racun atau dadah sementara adiknya pula dihentak di
kepala. Itu kemungkinan yang sedang disiasat polis berhubung punca kematian dua beradik
yang ditemukan maut bersama bapa mereka di sebuah rumah di tingkat dua Apartmen Nova,
Sri Sinar Segambut, di sini semalam. Difahamkan, Cheah Kai Sze, 3, yang dipercayai telah
diberi racun atau dadah, mati seminggu sebelum mayatnya ditemukan sementara adiknya,
Cheah Kai Wen yang berusia tujuh bulan dipercayai maut akibat kepalanya dihentak dengan
benda tumpul dua hari selepas kakaknya meninggal dunia. Bapa kedua-dua beradik itu pula,
Cheah Hing Soon, 34, dipercayai mati akibat memakan racun atau dadah pada Sabtu lalu iaitu
dua hari sebelum mayatnya ditemukan oleh isterinya.
http://www.utusan.com.my/berita/jenayah/adik-dihentak-kakak-8232-diracun-atau-diberi-dadah-1.388053#ixzz5TbfbHYnM

15. 15

16. Bipolar Illness
• Offending is more common than in depression
• Manic patients may spend excessively, hire cars and fail
to return them, or steal cars
• May be charged with fraud or false pretences
• Prone to irritability and aggression, though any resulting
violence is seldom severe
16

17. Schizophrenia
• more likely to commit non-violent as well as violent crimes
• minor offences more likely than serious offences
• most criminal behaviour followed the onset of schizophrenia,
although crime is frequently a result of personality difficulties and
social incompetence
• risk of homicide is moderately increased in schizophrenia
compared to the general population
17

18. 18

19. • violence in schizophrenics may be associated
with any of:
– great fear and loss of self control associated with
non-systematized delusions
– systematized paranoid delusions of persecution
– irresistible urges
– instructions from hallucinatory voices
– unaccountable frenzy
• risk of violence is greatest where delusions are
accompanied by strong affect, and when the
person has made efforts to try to confirm the
truth of the delusions
http://www.thestar.com.my/news/nation/2012/07/12/khalils-brother-fears-for-safety/
http://www.sinarharian.com.my/semasa/pengakuan-suami-isteri-saya-terjerat-dalam-fantasi-khalil-1.66517
http://www.sinarharian.com.my/semasa/amuk-pengakuan-suami-muhdalina-bahagian-ii-1.66562
http://www.sinarharian.com.my/semasa/muhdalena-percaya-lelaki-amuk-itu-imam-mahadi-1.250667
19

20. Muhdalena kongsi delusi dengan 'Imam Mahadi' 20

21. PUTRAJAYA - Tiada apa yang mampu diucapkan oleh Muhdalena Ahmad selain
rasa syukur apabila Mahkamah Sesyen di sini semalam melepaskannya
daripada tuduhan mengamuk menggunakan pedang samurai di pekarangan
Kompleks Jabatan Perdana Menteri (JPM) di sini dua tahun lalu.
Bagaimanapun, Hakim Mohamed Kamil Nizam memerintahkan bekas penuntut
jurusan Ilmu Wahyu di Universiti Islam Antarabangsa berusia 29 tahun itu
ditahan dengan selamat di Hospital Permai, Tampoi, Johor sehingga mendapat
perkenan Yang di-Pertuan Agong.
Ketika ditemui, Muhdalena yang sedang mengandung lima bulan turut mengakui
yang dia tidak pernah terfikir untuk melakukan perkara pelik apatah lagi
mengamuk menggunakan pedang samurai bersama blogger, Khalil Afendi Abdul
Hamid, 47.
"Semua itu berlaku tanpa disusuli dengan fikiran waras. Saya bersyukur dengan
keputusan itu kerana sebelum ini memang saya terpengaruh dengan Khalil Afendi
yang mendakwa sebagai Imam Mahdi," kata ibu kepada dua anak itu ketika
ditemui selepas selesai prosiding di Mahkamah Sesyen di sini semalam.
Terdahulu, Hakim Mohamed Kamil Nizam ketika membacakan keputusan kes
berkata, pihak pembelaan berjaya membuktikan tertuduh mengalami kemurungan
psikotik yang menyebabkannya tidak dapat mengetahui bahawa tindakannya itu
menyalahi undang-undang mengikut Seksyen 84 Kanun Keseksaan pada
imbangan kebarangkalian.
Katanya, di peringkat membela diri, tertuduh bukan sahaja tidak menafikan
kesemua tuduhan yang dihadapinya, malah mengaku berada di tempat kejadian
selain turut memegang senjata.
http://ww1.kosmo.com.my/kosmo/content.asp?y=2014&dt=0620&pub=Kosmo&sec=Negara&pg=ne_04.htm

22. Evil intent
mens rhea
Evil deed
actus rheus
CRIME
22

23. 23

24. Events or state of the affairs of the crime
State of the mind of the crime
e.g. murder
24

25. Children below 10
25

26. McNaughten Determines whether the person
understand the nature and quality
of his actions, and if so, whether
he knows that the action was
wrong
The strictest test, and
the standard criterion in
most jurisdiction
American Law
Institute (ALI)
Model Penal
Code
•Cognitive prong – determines
whether the person appreciate the
wrongfulness of his behavior
•Volitional prong – determines
whether the person is able to
conform his conduct to the
requirements of the law
After the Hinckley case,
most jurisdiction that
used this test dropped
the volitional prong
Durham Evaluates whether the person’s
criminal behavior is the “product”
of a mental illness
The most lenient test, it
has been abandoned in
almost all jurisdictions
Reference: High-yield psychiatry, pg:146
26

27. 27

28. e.g., if he believed that man was
attempting to kill him, and he kill that
man, as he thought, in self defence, he
would be exempt from punishment
28

29. 1. Every man is to be presumed to be sane and to possess a
sufficient degree of reason to be responsible for his crimes, until
the contrary be proved.
2. An insane person is punishable "if he knows" at the time of crime.
3. To establish a defense on insanity, the accused, by defect of
reason or disease of mind, is not in a position to know the nature
and consequences.
4. The insane person must be considered in the same situation as to
responsibility as if the facts with respect to which the delusion
exists were real.
5. It was the jury's role to decide whether the defendant was insane.
29

30. SANE
Everyman is to be presumed to be sane
INSANE
Defect of reason because disease of mind
“TEST OF KNOWING”
Not knowing nature or consequence of the act
RESPONSIBILITY
Is as if the delusions were real
JURY’S ROLE
Decide whether the defendant was insane
30

31. 31

33. • Charge of murder  manslaughter
• Abnormality of mind as substantially impaired his mental
responsibility for his action
33

34. 34

35. 35

36. AUTOMATISM
• If a person has no control over an act, he
cannot be held responsible for it – the
• Concept is similar to being ‘briefly
insane’
• It is a legal term, and has no connection
with epileptic automatisms
• Verdicts of not guilty have been returned
when acts of violence were judged to
have been committed as ‘sane
automatisms’
36

37. Sane Automatism
• Leads to a full acquittal
• Seen to be due to an
‘external cause’
• Includes:
– absent-mindedness (in
association with
depression)
37

38. Insane Automatism
• Automatism thought to arise from a
‘disease of the mind’ – the appropriate
defence is then insanity and the
McNaghten rules apply
• Are due to an ‘internal cause’ because
the conditions may reoccur
• Includes:
– epileptic automatism
– hypoglycaemia, hyperglycaemia
– sleep-walking
– arteriosclerosis
38

39. Fitness to Plead
1. Understand the nature of
charge
2. Understand the difference
between a plea of guilty and
not guilty
3. Instruct counsel
4. Follow evidence in presented
in court
5. Challenge jurors
39

40. • In prisons
– 1/3 of sentenced prisoners have a psychiatric disorder
and 2% have a psychosis (Gunn et al 1991)
• In hospitals
– For indeterminate length of stay or under ruler’s
pleasure
• In the community
– When a non-custodial sentence is passed
40

41. Criminal Procedure Code
Detention of offenders in psychiatric hospital
• Person suspected of unsound mind to be examined
Section 342
• Person of unsound mind found not fit to stand trial
Section 344
• Person of unsound mind found not guilty by reason
of insanity
Section 348
41

42. 42

43. 43

44. 44

45. HospitalBahagia
HospitalPermaiHospitalSentosa
HospitalMesra
45