Introduction

According to the recently-released DSM-V of the American Psychiatric Association, a mental disorder is defined as:

"A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or development processes underlying mental functioning.  Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities."
(DSM 5th Edition, 2013).

Recent decades have seen a major evolution in how the medical community views the causes and treatment of mental disorders.  For many years, mental disorders—and addictions—were seen as moral weaknesses, something to be punished in order to change behavior.  In contrast, mental disorders are now seen to be:

"…genuine neuro-biological diseases of the brain.  Just as in the case of diabetes, where no amount of willpower can make a diseased pancreas secrete appropriate amounts of insulin to control blood sugars, the functioning of the brain is essentially outside the direct control of the individual."
(Osher & Levine, 2005).

The causes of these brain diseases are complex and continue to be researched, however, there is an emerging understanding that there are biological, psychological, and social factors contributing to these disorders and that, in most cases, a genetic component is also present.  Effective treatment models may include the administration of psychotropic medications focusing on brain chemistry, psychotherapy and psychoeducational interventions, or integrated services to address co-occurring mental and addictive disorders.

Symptoms of mental disorders can be described in four broad categories:  anxiety; disturbances in perception and thinking; disturbances in mood, and disturbances in cognition.  Mental health professionals report that anxiety and disturbances in mood are the most common symptoms in offenders with mental illnesses (Osher & Levine, 2005).  Other symptom clusters may meet criteria for personality disorders (e.g., lacking impulse control or appropriate emotional responses). These symptom clusters are then assessed for their duration and resultant disability.  Diagnosing mental illnesses involves using assessment instruments and observations to determine patterns in behavior; the existence, frequency and duration of symptoms related to particular syndromes; and the associated disabilities that result in functional impairments.  Of course, the accurate diagnosis of mental disorders requires the involvement of a trained mental health professional—a psychiatrist or psychologist, using appropriate assessment tools and observational skills.  A particular diagnosis can suggest the nature of symptoms, but the key issue is how impaired is the individual as a result of these symptoms.  People with schizophrenia can be a successful college professor or find themselves destitute and homeless.  Parole officials should be most concerned about the level of disability associated with a particular mental disorder—as that degree of disability may impact the likelihood that an offender will be able to remain compliant and law abiding in the community.  For more basic information about the behavioral health disorders and the criminal justice population, click here.


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