Generational Wartime Behavioral Health Crises: Part One of a Preliminary Analysis

As the USA enters into its 12th year of war, the persistent drum beat of negative news headlines of unmet mental health and social needs of veterans fuels public perception of a twenty-first century military behavioral health crisis. For many Americans, the status quo harkens back to previous wartime crises. Wartime mental health crises continue to happen, despite the personal and financial consequences. This paper address this crisis by carefully tracking the critical decisions that lead to the current situation. This is the first of a two-part preliminary analysis of generational wartime behavioral health crises. We first define wartime mental health crises and how current and past conditions qualify as such a crisis. Next, we point out that there is a continual underestimate of war and post-wartime behavioral health needs. We then provide an extensive review of official military records, government investigations, and news media reports; a compelling evidence of a major crisis in the twenty-first century. In the final section of the paper, we discuss the themes that emerged from the review that both confirm the generational failure to learn fundamental war trauma lessons.     

Investigating Recurrent Generational Wartime Behavioral Health Crises: Part 2 of a Preliminary Analysis

This is the second of a two-part analysis of generational wartime mental health crises. Wartime mental health crisis has been defined as a sentinel public health event whereby mental health demand of the military population demonstrably exceeds the mental health system’s capacity to provide adequate access to timely, effective mental health and social support services during and/or after a period of war. The present study extends an analysis that substantiated a twenty-first century wartime crisis by investigating the hypothesis of repetitive mental health crises following every major American war since the 20th century. Compelling evidence of recurring generational crises is established by citing first-hand primary sources from wartime cohorts. A clear trend emerged, possibly linking the pattern of wartime crises with generations of self-reported failure to learn well-documented war trauma lessons (e.g., the need to adequately plan, prepare, and train for inevitable war stress casualties). The authors discuss the need for further research that would elucidate so-called “psychiatric lessons of war” and contribute to the prevention of cyclic crises.     

A Prescription for Violence: The Legacy of Colonization in Contemporary Forensic Mental Health and the Production of Difference

In this paper I will argue, through the example of the “treatment” of racialized minorities diagnosed with mental illness, that the mental health system (including its unique laws, production of different identity categories and ruling disciplines), with its dogmatic adherence to and reliance on alleged expert opinion and internal inquiry, allows for the erasure of subaltern voices. Often we hear about a tragic incident as reported by the media about someone diagnosed with a mental illness who has committed a crime. These representations routinely present the person as violent, aggressive, uncontrollable, and unpredictable. Repeatedly the voice of the accused is not represented; his or her social, historical, and political contexts are not considered relevant. The technologies of the criminal justice and mental health system’s use of physical or chemical restraint, coercive treatment, or practices such as deportation are also not reported, thus reproducing systems of harm. We don’t get to look inside the asylum. Patients’ voices are excluded from the discursive practices, disciplinary hegemony or dominant regimes of truth within the mental health system. This creates a system impermeable to criticism, where violence continues to prevail. Through a discussion of the disproportionate criminalization and deportation of the mentally ill, the false associations between mental illness and violence, the colonial ancestry of internal inquiry, and example cases from the media, this paper reviews how these particular technologies of violence owe their inheritance to the orientalising, discursive practices and disciplinary hegemony developed during colonization that when ignored, reproduce the dehumanizing outcomes upon which they were built.     

Examining fatal and nonfatal incidents involving the TASER

Research Summary According to TASER International, nearly 10,000 police departments in the United States have deployed the TASER as a less lethal force alternative in some capacity. Despite the TASER's increasing popularity, serious questions have been raised about the device's physiological side effects; in particular, Amnesty International has reported that more than 300 people have died after being subjected to the TASER. Although a growing body of research has examined the physiological effects of the TASER on animals and healthy human volunteers in laboratory settings, there has been virtually no empirical analysis of “real‐world” fatal and nonfatal TASER cases simultaneously. This article examines all media reports of TASER incidents from 2002 to 2006 through a comprehensive review of LexisNexis and New York Times archives. We compare TASER incidents in which a fatality occurred to TASER incidents in which a fatality did not occur and then employ multivariate analyses to identify the incident and suspect characteristics that are predictive of articles describing TASER‐proximate deaths. Policy Implications Several suspect factors were significantly associated with the reporting of a fatal TASER incident, including drug use (but not alcohol), mental illness, and continued resistance. Multiple deployments of the TASER against a suspect was also associated with the likelihood of the article describing a fatality—especially if the suspect was emotionally disturbed—which raises the possibility that the risk of multiple shocks might not be uniform for all suspects. More research is needed to explore the relationship between mental illness, drug use (illicit or therapeutic), continued resistance, and increased risk of death. In the meantime, police departments should develop specific policies and training governing the use of multiple TASER shocks against individuals who could be in these vulnerable physiological and psychological states.     

The Media’s Coverage of Domestic Terrorism

Scholarly interest in terrorism has grown dramatically since September 11. One important line of inquiry within this body of research has been the media’s coverage of terrorism. Although there have been several important studies published on this topic, there has been little research examining media coverage of domestic terrorism. This study fills this gap by examining the media’s coverage of terrorism in the United States from 1980 until September 10, 2001. The analysis is based on a list of terrorist‐related incidents and New York Times articles pertaining to each incident. This study documents the amount and type of coverage received by domestic terrorism incidents, and identifies the variables influencing whether an incident is covered and how much space it receives. The results indicate that most terrorism incidents receive little or no coverage in the news, but a few cases are sensationalized in the press. There are several characteristics that consistently explain which incidents are covered and receive substantial news space. Incidents with casualties, linked to domestic terrorist groups, targeting airlines, or when hijacking is used as a tactic are significantly more likely to be covered and have more articles and words written about them. This study concludes with a discussion of the policy implications of these findings for the understanding of terrorism as a social problem.     

(MIS)Representing risk: Headline accounts of HIV-related assaults

The news media construct order by defining which events are sig-nificant and interpreting these events for the public. Sometimes, though, the media distort reality. The current study focuses on the media exaggeration of the threat posed by nonsexual HIV-related assaults. Although such assaults are widely perceived as serious threats, the likelihood of HIV being transmitted through a biting, spitting, or needlestick incident is quite small. Based on news accounts culled from 17 of the largest newspapers in the United States, the findings illustrate how headlines rely upon sensational language, negative stereotyping of offenders, and the cloak of “neutral and objective” court decisions to articulate a sense of order and morality while simultaneously exaggerating the threat people with HIV pose to the general public.     

Head banging as a form of self-harm among inpatients within forensic mental health and intellectual disability services

Introduction: ‘Head banging’ is a common form of self-harm, linked to numerous negative outcomes including significant brain damage. However, little research has investigated head banging behaviour and its correlates in clinical populations. Method: Head banging episodes were identified from the incident records (n = 5417) of two inpatient forensic services (one intellectual disability and one mental health), using relevant search terms. Rates were compared between individual patients, by gender, diagnosis and level of security. Incident accounts were analysed qualitatively using thematic analysis. Results: Head banging incidents occurred approximately every 3 days in each service, with 229 incidents recorded in 1 year. Individual patient rates varied widely, ranging from 1 to 38 incidents within 1 year. Women, and patients in higher levels of therapeutic security, were significantly more likely to engage in head banging. Qualitative incident reports indicated that head banging was associated with mental distress, anger and psychotic experiences. Discussion: Head banging occurs frequently in forensic services, and has documented associations with traumatic brain injury in affected individuals, thus negatively impacting progress through the care pathway and treatment outcomes. Further research should investigate short- and long-term management strategies and treatment approaches, in order to minimise harm.     

Do prior histories of violence and mental disorders impact on violent behaviour during encounters with police?

Despite sustained large-scale educational campaigns, public attitudes towards mental illness have remained persistently negative. Associated with this, recent research from Victoria, Australia, reported that police commonly associated violent behaviour with mental illness. The present study examined 4267 cases of police use of force and considered what differentiated and characterised violent from non-violent behaviours reported by police in the context of a use of force incident. The specific focus was to examine the effects that historical variables such as age, gender, prior violent offending and having a prior diagnosis of mental disorder, as well as incident specific factors such as exhibiting signs of mental disorder and substance intoxication have on violent behaviour during the use of force incident. The proximal factors of apparent mental disorder and alcohol intoxication were significantly associated with violent behaviour towards police, whilst having a history of prior violence and prior mental disorder diagnoses was not associated with violence. The results challenge traditional stereotyped views about the violence risk posed by people with prior contact with mental health services and those with prior violent offending histories. A service model that allows for psychiatric triage would be able to assist with streamlining police involvement and facilitating timely access to mental health services.     

The past, present and future of mental health law: a therapeutic jurisprudence analysis

This article uses a therapeutic jurisprudence perspective to review the evolution of mental health law in the Western world by examining developments at various stages in history, in particular the 20th century. It suggests that one of the major challenges for the future, from a therapeutic jurisprudence perspective, will be to help minimise the stigma, prejudice and discrimination associated with mental health law. The article concludes with the suggestion that the question of whether mental health law itself, because it contributes to discrimination against mentally disordered people, may be anti-therapeutic requires more investigation and consideration.     

Medical diagnosis of legal culpability: the impact of early psychiatric testimony in the 19th century English criminal trial

Fast-paced developments in psychiatry, neuroscience and emerging neuroimaging technologies place continual pressure on the legal recognition of mental illness and disease across jurisdictional boundaries. Nevertheless, the Canadian legal definition of exculpatory mental disease in the context of criminal liability has remained largely static, sheltered from the immediate influence of medical theory and advancements. In order to effectively reflect on the intersection of mental health and criminal justice systems in this area, it is important to understand its historical development and the English common law origins of the current approach. Specifically turning to the early 19th century, documented history and accounts of early medical witness testimony on the mental state of the accused provide a unique opportunity to understand the initial collision between fundamental concepts of moral and legal culpability and new scientific understandings of mental function and disease. In this article, I suggest that early psychiatric testimony to the accused's mental state challenged the evolving criminal law of 19th century England to reconcile its restrictive definition of "insanity" with expanding scientific reasoning and accounts of mental disease. The trial of Edward Oxford, an attempted royal assassination case of 1840, is examined as a symbolic height in this conflict prior to the first common law pronouncement of the current approach in 1843. As debate continues on the role of medical advancement in the identification of exculpatory medical disorders in law, this historical perspective may serve as a touchstone in balancing the enforcement of legal culpability with our society's greater appreciation for mental illness.     

Huntington's disease and the law

Huntington's disease (HD) is a relentlessly progressive and fatal neurological condition that is inherited. It has serious and disabling physical and mental components. As such, it impacts upon those who have HD, those with the potential to inherit it, and those who care for those with HD in a wide variety of ways. These can have many legal ramifications including in relation to evolving impairments of capacity which can have an outcome in terms of involuntary status as mental health patients, testamentary capacity and the need for guardianship and administration. It can have effects upon fitness for parenting, obligations for spousal maintenance, and the quantum of compensation from a tortious incident to which a person is entitled. It has repercussions for criminal liability and culpability. This article reviews case law from a number of countries in relation to such matters, noting the broader radiation to others of the effects of HD, and reflecting on the need for legal and medical professionals to be aware of the legal consequences of HD for them to be able to discharge their responsibilities holistically, sensitively and informedly.     

Police Misconduct,Media Coverage,and Public Perceptions of Racial Profiling: An Experiment

The purpose of this study was: (1) to assess the impact of an incident of racial profiling on residents’ attitudes about profiling; and (2) to examine the effects of exposure to a video clip of deliberation about the incident on residents’ beliefs about the causes of profiling. All residents, White and minority, were less likely to believe that Chicago police officers engaged in profiling after the incident. These findings suggest that attitudes about the prevalence of racial profiling are susceptible to the manner in which the media construct incidents of police misconduct. Exposure to the video clip was not related to differences in residents’ beliefs about the causes of profiling, but was related to differences in perceptions of the dangerousness of traffic stops. The findings highlight the need for more research on how media constructions of police misconduct influence attitudes about profiling and impact community–police relations.     

仿真世界中的媒介权力:鲍德里亚传播思想解读

法国当代思想家鲍德里亚以独特的视角透视了现代媒介及其技术造成的后现代社会虚拟代替现实的严峻境况。他认为,当代社会是由大众媒介构建的“仿真”世界,在这个世界中,电子媒介改变了传播的交流情境,新的言语情境和话语结构对主体产生了构建意义。大众媒介通过编辑机制和传播技术为人们生产文化意义,广告则通过提供各种消费符号和影像制造着欲望和诱惑。大众媒介在当代社会中扮演着生活指南的角色,强化了对受众的塑造和影响。     

Legal narratives as significant news sources about mental illness and violent crime

Media coverage about people affected by mental illness is an area of research that is extensively examined. Many scholars argue that the media depicts people with mental illness as inherently violent and dangerous within sensational narratives. These depictions are criticized for reinforcing the social stigma and disadvantages many of the mentally ill face. The media does, however, require news sources and, in the context of crime and mental illness, the courts are a significant source. Through qualitative content analysis of Australian newspaper articles, this research examines an under-researched and incompletely theorized area. In doing so, it demonstrates that media depictions of some mentally ill offenders reflect and heavily draw upon legal narratives and what is argued in court about these offenders in the context of criminal responsibility and legal insanity.     

西方自由主义影响下的新闻自由——从17世纪以来西方政治传播学历史文献的角度

17世纪以来,投身于英国资产阶级革命的西方政治哲学家们对个人自由和新闻自由进行了深入的思考和论证,自由主义延伸到新闻传播中自然便提出了思想自由、言论自由以及出版自由等问题。17世纪以来的西方政治哲学家们基本上都将上述自由归因于天赋人权。英国思想家弥尔顿强调人是理性动物,保护言论和出版自由是因为只有允许人们公开辩论才能够发现真理,20世纪以来依靠公开辩论发现真理这一观念最终导致了思想和意见的自由市场理论的产生,它们成为支撑新闻自由理论的基石。在西方,新闻自由被人们视为一项绝对的精神权利,理论的倡导最终也导致了实践中的立法保障。回顾新闻自由的发展过程,有助于我们理解20世纪以来自由主义复兴的西方当代社会语境中,新闻自由所面对的进退维谷的现实。     

Parent–child contact problems and family intensive interventions: The crisis of adolescent suicidality and the role of social media

Although clinicians, educators and parents have been alarmed by the decline in the mental health of children and adolescents commensurate with the Covid-19 pandemic, statistics indicate there has been a downward spiral over the last decade. This has been evident in the overall increase in suicide rates for young people. For legal and mental health professionals working in the Family Court system, this has provided unique challenges. Most vulnerable has been those children and adolescents embroiled in high conflict divorces, especially those exhibiting parent child contact problems. This article focuses upon that population exhibiting parent child contact problems, and their treatment, specifically Family Intensive Intervention. Building Family Resilience is an Intensive family treatment program that has had to address this deterioration in child and adolescent mental health and increase in suicidality. The role of social media in both exacerbating and/or ameliorating mental health issues is explored.     

Complex Suicide by Self‐stabbing with Subsequent Drowning in the Sea

The paper presents a unique case of a complex suicide committed by a young man, mostly probably triggered by a disappointment in love. The uniqueness of the suicide lies in the fact that the victim inflicted several deep stab wounds on himself, in the chest and abdomen, while standing partly submerged in the sea and, having done so, he dropped and disappeared in the water. The postmortem examination showed, apart from deep wounds in the trunk, characteristics of drowning that manifested itself in the form of aqueous emphysema of the lungs. Suicide was clearly determined on the basis of the circumstances preceding death, the location, and arrangement of the trunk wounds and the testimony given by a witness of the incident. The circumstances preceding the suicidal act clearly suggest an underlying undiagnosed mental disorder.     

Assessing Newspaper Coverage of Corporate Violence: The Dance Hall Fire in Qoteborg, Sweden

The media disproportionately focus on conventional crime while neglecting the impact of corporate misbehavior. The present research examines U.S. newspaper coverage of a deadly fire at a dance hall in Goteborg, Sweden. This particular incident facilitates an examination of how newspapers treat issues involving culpability of conventional offenders (arsonists) and white collar offenders (the owners of the nightclub and the promoters of the dance). It was found that newspapers disproportionately focused on the direct harm associated with the fire, and generally neglected the role played by the organizers/promoters. Suggestions are offered regarding the need for more complete media coverage of crime, particularly white collar crime. This revised version was published online in July 2006 with corrections to the Cover Date.     

Mental health policy in the liberal state: the example of the United States

Mental health policy arises out of the interaction of many different variables. These include (but are not limited to) the composition of the population of persons with severe mental illnesses; the means of dealing with disease and dependency; concepts of the etiology and nature of mental disorders; the organization and ideology of psychiatry; funding mechanisms; and existing popular, political, cultural, and professional values. But an often neglected but crucial factor in shaping policy is the very structure of the American political system, which played a crucial role in shaping mental health policy. Rather than emphasizing the neo-liberal theory and its accompanying hostility toward "unsuccessful" people and disdain of welfare, this article suggests that an understanding of mental health policy in the latter half of the twentieth century is better served by an examination of what actually happened. Theory, however attractive, rarely can encompass the messy data of reality.     

Wounding effects of the AK-47 rifle used by Patrick Purdy in the Stockton, California, schoolyard shooting of January 17, 1989

The limited disruption produced in tissue simulant by the rifle and bullets used in the Stockton, California, schoolyard shooting is entirely consistent with the autopsy reports on the five children who died of their wounds. It is also entirely consistent with well-documented battlefield studies and with previous tissue-simulant studies from many laboratories. It is inconsistent with many exaggerated accounts of assault-rifle wounding effects described by the media in the aftermath of this incident. This information should be documented for the historical record. However, the critical reason for correcting the misconceptions produced by media reaction to this incident is to prevent inappropriate gunshot-wound treatment.