Medicalization of criminal behavior is a problematic political weapon

Patients committed to a Catonsville, Maryland psychiatric hospital have been consistently assaulting the hospital staff and generally causing chaos:

The chaos at the state’s largest psychiatric hospital, the consultant found, is fueled by a few patients who “prey upon patients and staff with relative impunity” after being ordered by courts to the hospital for psychiatric evaluation — sometimes with dubious symptoms.

The findings are contained in a report created for the Department of Health and Mental Hygiene in response to safety complaints from hospital staff. The report by Dr. Kenneth Appelbaum, an expert in forensic psychiatry at the University of Massachusetts Medical School, describes a number of violent incidents over the past year. It also highlights an ongoing dispute between judges and clinicians over patient admission standards.

Remember Rosenhan’s 1973 experiment? Rosenhan challenged the validity of psychiatric diagnoses by having sane “pseudopatients” fake symptoms to be admitted into psychiatric hospitals, then immediately cease simulating any symptoms of abnormality. The hospitals never recognized the pseudopatients’ sanity.

Diagnosing mental illness is plagued by ambiguity, and a diagnoses carry power. The combination of power and inherent ambiguity makes the institution of psychiatry a political weapon.

The Maryland criminal justice system faces latent incentives to medicalize criminal behavior. Maybe prisons are overcrowded, or there’s pressure to cook statistics so as to disingenuously minimize the number of crimes, or there’s something else going on. We may never know. Regardless, the violence to the hospital staff is another example of an unintended consequence when a government co-opts a nexus of power.

The Wire: The Musical perfectly describes the nefarious spontaneous order:

There are complex problems inherent in the bureaucratic institutions of the state, but there’s no one to blame. It’s a vast array of personal interests that conflict in a way that undermines the overall system.

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