Category Archives: Schizophrenia

Mental Illness: A Severe and Enduring Media Silence

Refreshing as it may be to see mental health on the telly every five minutes, are viewers seeing a rather sanitised version of ‘Mad’?

Photo of Cane Hill Hospital, Surrey
Cane Hill Hospital, Surrey Thanks to abandoned

For anyone growing up in Croydon during the 70s and 80s, Cane Hill Hospital was a local landmark of notoriety, intrigue and all manner of imagined horrors. Many a family car journey would be coloured by a quick peek at the gothic asylum as it rose up between the trees from the A23 London to Brighton Road. We wondered aloud at what darkness and derangement went on in that spookiest of buildings, and parents warned their offspring how they too could end up at Cane Hill if they didn’t eat their veg.

The closure of the Cane Hills and the advent of so-called community care should have meant a fundamental change in how mental illness was perceived by Mr and Mrs Normal on Normal Street. But it never really happened like that. If you wanted to see mental illness on TV, well you didn’t. Yes there was Hitchcock and The Shining on the big screen, but all Jack Nicholson and Psycho did was suggest mentally ill people ran around old hotels waving axes around or got all dressed up in the clothes of their decomposing parents stabbing the odd blonde. Combating stigma took a while to get going.

But fast forward a few years and switch on the telly. Mental health is ubiquitous. Not quite as ubiquitous as Midsomer Murders, but not too far behind.

Last Summer’s 4 Goes Mad season on Channel 4 was a bit of a mixed bag, and like everything else on television suffered from an over-reliance on celebrities. But among the comedians unpacking their pasts was more than one thought-provoking, stigma-challenging contribution to poke at the myths and stereotypes around mental health.

BBC3 is just coming to the end of it’s Mad World season which has focussed on the mental health of young people. Last week Channel 4’s Notes from the Inside featured classical pianist and former in-patient James Rhodes meeting and playing music for several long-stay residents of a large psychiatric hospital. And just to make sure we’re not solely talking about documentaries and flies on the wall, the much anticipated second series of My Big Fat Mad Diary made big waves and should be starting to film around about now-ish.

And for further chipping away at the stigma of mental illness, who better than top sportspeople such as Andrew ‘Freddie’ Flintoff to demonstrate how Depression (capital ‘D’) can chip away and even destroy even the tough, well honed psyche of the champion athlete?

All of this is of course brilliant and wonderful. But there is a ‘but’.

Earlier this week BBC3 broadcast the slightly ill-titled Failed by the NHS.  Several young people with histories of mental health problems described their experiences of being let down by mental health services, although perhaps it’s fair to say in most cases they had actually been let down by shoddy individual practitioners and a chronic withdrawal of resources, but that’s another story.

Like most of the documentary output from the ‘New Mad’ franchise, the contributors were not psychiatrists nor psychologists nor any other species of mental health professional. They were ordinary people who have themselves experienced mental health problems at first hand. We should celebrate this. But I took to Twitter to wonder aloud who was missing from this show and most of those that have come before. Are all users of mental health services articulate, intelligent, middle-class and white?

Where are the voices of those whose lives have been punctured by constant admissions and readmissions, often compelled by the Mental Health Act? Those whose psychosis has them on first name terms with every local copper and paramedic within a twenty mile radius? Or the patients of our Psychiatric Intensive Care Units (PICUs) who, to quote Will Self’s recent (and highly controversial) Guardian polemic ‘present a terrifying spectacle of seriously disturbed patients shouting, yelping, gurning and shaking – I know, I’ve seen them.’ Yes, Will. So have I. Up close and personal, but never on my flatscreen.

As a long in the tooth trainer running frequent Mental Health Awareness courses I can see how much has changed over the last fifteen years. Mental health is, if not quite mainstream, much, much better understood than it ever was before. We no longer have to spend a whole session explaining how Schizophrenia doesn’t mean ‘split personality’ or that ‘psychotic’ isn’t a by-word for serial killer. People seem to be ‘getting it’.

But there does remain a deep-rooted curiosity about the effects of mental illness at it’s severe, debilitating worst. The short-term effects of terrifying delusions. Thought disorder that renders conversation all but impossible. Voices of people known and not known in real life, some friendly, some nasty, some commanding their victims to do quite appalling things. The sort of bizarre, incomprehensible public behaviour that has people phoning 999 and crossing the road in a hurry.

And then there are the long term effects of severe and enduring mental illness. The appalling mortality rates and physical ill-health. The homelessness, petty crime, substance use and social withdrawal. Whether we call Severe and Enduring Mental Illness Schizophrenia, Bipolar Disorder, Depression or whatever is increasingly open to conjecture. Whether some of the worst effects of SEMI are as much to do with harmful medication regimes as the illness itself is another debate. But what is not in dispute is that this is a significant population who aren’t sat talking to camera crews in coffee shops drinking skinny lattes. This is a population about whom we see or hear very, very little.

Let’s celebrate the fact that mental illness is probably far less mysterious, stereotyped and misunderstood than it was. But at the same time maybe it’s time to take more than just a quick peek at mental disorder and really throw the doors wide open. Let’s see the otherwise unseen. The real, visceral and yes, frankly bloody horrible side of severe mental illness that is yet to see the light of day and stays ever more mysterious and frightening as a result.

Connor Kinsella
Lead Trainer, JCK Training

For further information on training and services, contact JCK Training at or call 0208 133 9458

* Many thanks to @McLikey for the Twitter chat that inspired this blog. Sometimes 140 characters just isn’t enough!

The Occasional Tragedy of Mental Health

A Problem of Understanding
I used to work with people who had committed the most serious and often disturbing of crimes. All in all I spent twelve years in very close proximity to patients in secure psychiatric units. I played cards with killers, badminton with rapists and darts with men you had last seen played by an actor on Crimewatch.

I’ve been shopping with people who hadn’t seen a town centre for twenty years. I’ve handed out tissues to those still haunted by what they had done, and locked up patients in small secure rooms as the voices commanded them to kill anyone within range of a pool cue.

I’ve had the sort of conversations you could and should never forget with fellow human beings who have done unimaginable things. But one thing I have never done is to understand.

Not for want of trying or because I wasn’t clever enough. I ‘got’ the psychopathology of the psychopath. I ‘got’ the biochemistry of psychosis. I ‘got’ the medical model and the social model. But faced with someone who had tortured a child, blown off a neighbours head with a shotgun, or knocked nails into someone’s skull, I simply failed to truly understand.

Thirteen-year old Casey Kearney was walking through a park on her way to a friend’s. She was stabbed by a woman walking in the opposite direction. It wasn’t a frenzied attack, just one brief blow with a one of two kitchen knives purchased earlier that day by a woman called Hannah Bonser, who simply continued on her way before turning up at a local mental health resource to confess to what she called “a silly thing” and hand over her knives.

This was an appallingly random act of extreme violence. Bonser would have expended more time and energy stopping to ask her victim for the time. For any parent to imagine the deliberate killing of a child is not only incomprehensible, but entirely unimaginable for any more than the most fleeting of dark moments. But Casey Kearney’s family have had to deal with this reality since February 14 this year, and have no doubt tried and failed to make sense of the senseless.

Making Sense of the Senseless
Hannah Bonser was yesterday convicted of murder and sentenced to life imprisonment. She will serve an absolute minimum of twenty-two years before being able to seek parole. Those not involved with the case might have been surprised that Bonser did not receive a Mental Health Act hospital order and a conviction for Manslaughter rather than Murder.

After all, this was a bizarre and random killing committed by someone well-known to mental health services for some time before the event. Her legal defence argued she was suffering from Paranoid Schizophrenia at the time of the offence, and that her responsibility for the crime was therefore ‘diminished.’ The jury did not accept this argument.

But as with all homicides involving mental health service users, an independent inquiry will now take place in the aftermath of the trial. Like the dozens that have preceded it since the mid-1990s (when such inquiries became mandatory) the report will provide a public and detailed account of Bonser’s relationship with mental health services in the months and years prior to February 14th 2012.

As both a practitioner and trainer who has read with depressing regularity how tragedy has resulted from the failure of various services involved in mental health care over the years, I very much hope we will not be hearing from the usual suspects. Failures of communication, lack of information sharing, poorly motivated professionals, bureaucracy. All these and more have become depressingly familiar to readers of such reports, but seldom appear to change the way we work with potentially dangerous people.

What’s in a Diagnosis?
For some months prior to the killing, a close friend of Hannah Bonser had noted how her behaviour had become increasingly unusual. She claimed that her flat was possessed by demons. Her self-care deteriorated and she travelled down to London, where she slept rough and searched for a character called ‘Simon of Lambeth’. She was detained under the Mental Health Act before being transferred back to a Doncaster hospital, but was discharged shortly afterwards. Life appears to have become increasingly disjointed and chaotic. Shortly before Casey’s death, her killer had presented to mental health staff stating she was hearing voices commanding her to harm others.

Her legal defence was that her actions were driven by severe mental illness. It’s well beyond the scope of a short blog post to attempt to describe what we mean by this, but on current evidence we could state the following. That at the time of the offence her brain was showing signs of abnormal structural and biochemical functioning and was interacting with an environment which to Hannah Bonser would be a very, very different place to how most of you reading this would experience that environment. It may have been quite a terrifying place. Perhaps terrifying enough to randomly stab a complete stranger.

The prosecution argued that Bonser was not psychotic but suffered from a Personality Disorder. We know even less about the inner workings of PD than Schizophrenia, and argue about it a great deal more. This diagnosis would imply that the person is fully aware of one’s actions and knows exactly what they are doing, even when what they are doing is indescribably unpleasant.

The Sadness of Madness v Badness
The difference between severe mental illness and personality disorder is characterised by some as the ‘mad versus bad’ dichotomy. This is a very false dichotomy. In fact, it’s not a dichotomy at all.  The opposite of ‘mad’ is ‘sane’ and the opposite of bad is of course ‘good’. It’s an old and rather stale argument often used by lazy mental health professionals to characterise the difference between behaviours which are driven by ‘genuine’ and ‘proper’ mental illness on the one hand, and behaviours which are apparently ‘manipulative’ or ‘attention seeking’ on the other.

Being ‘Mad’ is beyond both the conscious control of the sufferer, and the moral judgement of others. It warrants our intervention, diagnosis and treatment, particularly with pharmacological means which offer a quick and relatively simple solution to ‘Mad.’

But ‘Bad’ is just, well, bad. If it isn’t ‘Mad’, isn’t a psychiatric problem, we needn’t offer an intervention. Personality Disorder is ‘Bad’ and this is what Hannah Bonser is now judged to be. She’ll go to prison not hospital.

The jury at Doncaster Crown Court accepted medical evidence suggesting Bonser suffered from a Personality Disorder. Essentially, she knew what she was doing.

The conception from both the public and aggrieved families is often that a ‘proper’ sentence is infinitely more acceptable than the apparently soft option of a psychiatric bed. Part of the argument around this case was that the stabbing of Casey Kearney was a calculated and manipulative act designed to achieve Bonser’s demands for hospital admission. To have received a Mental Health Act section might have been seen as a triumph for Bonser’s manipulation, and one could understand how that might be seen as unacceptable by many.

To Inquire or Not Inquire?
Nonetheless, an inquiry will now take place and the report will tell us something of how a family have lost a 13-year old girl who just happened to be in the wrong place at the wrong time. The court has already delivered it’s verdict on Hannah Bonser, but the inquiry will hopefully reveal a highly complex interaction between a twenty-six year old woman, her troubled background, her environment, her mental state, the services she turned to for help and the killing of Casey Kearney.

There are some who now call for the end of mandatory inquiries into each and every mental health related homicide. I wouldn’t disagree. It’s a hugely expensive procedure which, as we’ve already seen, throws up very similar conclusions time after time without seemingly making much difference.

But perhaps we should continue to study events such as these which, incredibly rare as they are, remain sufficiently horrific to merit the deepest scrutiny and may help us to at least try to prevent the preventable in future.

The Mad, Mad World of Psychiatric Diagnosis

Is it time to tear up the rule book and design a system of mental health diagnosis that is user-friendly, scientific and weighs less than a small fridge? Connor Kinsella thinks we’re long overdue.

You’ve dimmed the lights, lit the candles, chilled the wine, smoothed down the Egyptian Cotton and put Barry White on repeat shuffle. But your partner seems far more interested in catching up on this week’s hot new blog from You forlornly pick up the CD cover and whisper “Sorry Barry. Not tonight.”  But you see, it’s not you, it’s your partner. Or more precisely, their HSDD. Eh? Oh sorry, I meant to say Hypoactive Sexual Desire Disorder.
I’m not making this up. This is a genuine diagnostic label plucked from the weird and labyrinthine world of psychiatric classification, where the everyday and the humdrum of human behaviour becomes labelled and filed as a ‘disorder’ and not your partner’s lack of enthusiasm for scented candles and a set of clean sheets.
There are two classification systems in use throughout the world of mental health care. In the UK and Europe, clinicians generally refer to the ICD-10 Classification of Mental and Behavioural Disorders published by the World Health Organisation, but clinicians and researchers worldwide also refer heavily to the American Psychiatric Association’s DSM-IV system.
Both systems provide a means of reference to both practitioners and research scientists, and have made considerable progress in moving mental health diagnosis away from ‘a case of the vapours’ or ‘nervous exhaustion’ and toward a scientifically valid and standardised means of being able to tell a patient they suffer from Schizophrenia, Bipolar Disorder or Anorexia Nervosa. Diagnostic classification has also paved the way for researching mental health conditions which, unlike most physical illnesses, are invisible to the blood test or scanner.
As a nurse I’ve spent many valuable hours helping people understand their emotions, thoughts and behaviours within the context of a psychiatric diagnosis and the treatment that is being offered to them. People who are unwell are generally more than happy to know exactly what is wrong with them. They want to be able to put a name to their collection of signs and symptoms, even where those signs and symptoms are clouded (as is often the case with mental health) by more than a little subjectivity. Psychiatrists can and do get it wrong for all sorts of reasons, but our current evidence base is certainly strong enough to be able to offer a firm and often reassuring definition to most people suffering most of the common mental disorders.
The American Psychiatric Association has for some years been working on the latest version of the DSM franchise, a term not inappropriate by way of the rather large financial income the AMA receives from its publication. The robustly named DSM-IV Task Force has been taking hits from all directions while it’s exclusively medical membership (itself a bone of contention) have sat on the various sub-committees coming up with shiny new diagnoses such as Disruptive Mood Dysregulation Disorder, which as far as I can glean could just as well be described as ‘Stroppy Teenagers Being Stroppy Disorder’. There is also a proposal  for a new Apathy Syndrome (a possible explanation for X-Factor’s less than sparkling viewing figures these last few weeks?) and another little beauty aiming straight at the heart of anyone reading this. Yep, you guessed it. Internet Addiction Disorder.
The critics are not just critical but fully tooled up with an arsenal of brickbats with which to slap the DSM-V Task Force hard across the buttocks, a phrase destined to have this blogger labelled with Sado-Masochistic Smutty Reference Disorder or it’s nearest relative. The British Psychological Society and the American Psychological Association have both weighed in with extensive criticisms of the proposed DSM-V prior to it’s publication in the Spring of 2013. But there are many, many more missiles being aimed at the Task Force and, lets face it, it’s hardly a moving target.
With diagnostic toolkits so loaded with the potential to change peoples lives, deny or facilitate state benefits such as Disability Living Allowance or Incapacity Benefit, and the template by which researchers worldwide base what is a growing and increasingly useful body of good science, do we really want labels based on a single case report written by an obscure psychiatrist which has no basis in research evidence nor any form of genuine scientific validity?

Do we really need, as is proposed by the DSM-V Task Force, even lower thresholds for diagnoses such as the already controversial Attention Deficit Hyperactivity Disorder, a ‘condition’ which has already made huge profits for the pharmaceutical industry and is set to become even more profitable with the suggested lowering of the bar?
For the jobbing mental health professional it is safe to say that a large percentage of both ICD-10 and DSM-IV is already of little or no use to anyone other than the odd psych-nerd playing Mental Health Trivial Pursuit with their psych-nerd friends. What both professionals and those who come to them for help really need is a diagnostic system which actually reflects this salient fact. Psychiatric diagnosis really isn’t rocket science.

Medics worldwide may secretly fantasise about that ’House moment’ where they wander into the clinic eating a sandwich and looking as if they’ve just got out of bed, casually saving the patient’s life just as they flatline with an incredibly obscure diagnosis that nobody else has heard of.

But in real life I would challenge any mental health professional to come up with more than a dozen clearly delineated, well researched diagnostic labels used in day-to-day psychiatric practice. Hippocrates came up with a quite reasonable psychiatric classification while most of us were still throwing spears at mammoths, so how have we managed to come up with such a convoluted and often meaningless plate of spaghetti as DSM and ICD?

Our diagnostic systems are already unwieldy, unscientific and wildly over-inclusive. Revised models ought to be filtering out the nonsense and returning us to some semblance of science and common sense. But DSM-V is scaring the pants off far too many well qualified observers for the critiques to be merely a hobby horse of those still clinging to battered copies of The Divided Self

Psychiatric diagnoses are big labels applied to many, many people and are far too important to be based on bad science, personal ego and a book that is often of more use as a door-stop than a frame of reference.

Right. I’m off to my analyst via the scented candle shop. Wish me and Barry luck. 

Jared Loughner and the Gabrielle Giffords Incident: Schizophrenia Unravelled

This is an image of Jared Lee Loughner taken shortly after his arrest for the attempted assassination of US Congresswoman Gabrielle Giffords, the killing of six others including a nine-year old girl and the shooting of twelve other victims.

Remind you of anyone? The shaved head, the staring eyes and that entirely inappropriate smirk. A movie director couldn’t come up with a more perfect casting for the role of the classic, crazed lunatic. Jack Nicholson may have had more hair but his character in The Shining is not a million miles away from the caricature of Loughner’s grinning, haunting image. But unlike Nicholson’s Jack Torrance, Loughner killed and maimed people for real. And this is one tragedy fuelled not by ghosts, but by a severe and devastating illness called Schizophrenia.

Yesterday Loughner was judged by an Arizona court to be ‘unfit to plead’. The UK mental health system is in many ways very different to that in most American states, but it’s a basic fundamental of most judiciaries that an accused cannot stand trial if they’re unable to understand the workings of a trial or to be able to communicate meaningfully with their legal defence. It is reported that Loughner has been ‘paranoid’ and distrustful toward his legal representatives, and his bizarre behaviour in court yesterday would certainly suggest someone who would struggle to co-operate with the rigours of any trial, let alone a case as high profile as this.

Medical reports submitted to the court reveal that Loughner has been diagnosed with a severe mental illness called Schizophrenia. He may be many thousands of miles away but Schizophrenia is Schizophrenia in whichever part of the world it manifests, generally at a rate of around one in a hundred of the population.

And other than the fact that he was able to buy weapons and ammunition as easily as we in the UK can pick up a pair of scissors, the history, the behaviour, the disturbed thoughts and the resulting tragedy are as familiar to us as the language we share. But it’s the stigma and misunderstanding surrounding conditions such as Schizophrenia which also struck me as being a common theme to both sides of the Atlantic. A quick summary of comments left on the Yahoo News website suggested that many Americans believe Loughner should be strapped to the nearest electric chair and plugged into the national grid. Asap. Crazy or otherwise.

If you’re already convinced there’s no such thing as a psychiatric defence even to a crime as horrific as Loughner’s, then you may as well click away now and take a look at Photoshopped cats dancing to Justin Bieber. 

But as a UK mental health trainer I’d like to take you on a brief tour around an illness which very, very occasionally leads to events like this, but more often results in despair, loneliness, shattered lives and in some cases death. Not of other people but of the Schizophrenic him or herself. If you’re willing to persevere, read on.  

What is Schizophrenia?
Schizophrenia is a severe, psychotic illness which affects approximately 1% of the population worldwide, including Jared Loughner. ‘Psychosis’ or ‘psychotic’ is one of those horribly misused words beloved of tabloid sub-editors as a shorthand for ‘dangerous’ or deranged’. To be psychotic is to be detached from reality, usually as a result of a mental illness, to the extent that the person becomes trapped in a mental world which is not only very real (and often terrifying) to them, but bizarre and incomprehensible to those of us on the outside not sharing this strange reality.

There are critics who object to the labelling of someone like Loughner as ‘Schizophrenic’. They would rather see mental illness as a complex collection of problems and expressions of distress as opposed to a neat little box of medical symptoms. While it’s certainly true that our key diagnostic ‘bibles’ such as DSM-IV and ICD-10 promote disorders such as Oppositional Defiant Disorder (aka moody teenager) or Hypoactive Sexual Desire Disorder (aka your partner doesn’t fancy a shag), the tendency for psychiatry to medicalise the tiniest tic of human behaviour does at times lead itself to ridicule and there are plenty of examples of the psychiatric ‘system’ treating the diagnosis rather than the person.  

Personally I have little problem with the term Schizophrenia. It’s a distinct form of mental illness clearly describing for hundreds (if not thousands) of years much of the disordered thought, conflicting emotions and perplexing behaviour of people like Jared Loughner.

What are the effects (or symptoms) of Schizophrenia?
Auditory hallucinations are perhaps the first common feature of Schizophrenia to be happily reeled off by the exam room student psychiatrist. The rest of us just refer to ‘hearing voices’.

Voices are neither ubiquitous nor necessary for a diagnosis of Schizophrenia. If you’re hearing the voice of your partner right now telling you to get off that bloody laptop and go do something a little more useful, this may be for real (in which case you’d better save the rest of this for later and do as he or she says!) or the sort of imaginary voice that many of us hear or live with without need for particular concern.

It is difficult to tell outwardly that a person is hearing voices. Unless they’re responding verbally to their voices or laughing/grimacing at what they can hear, or decide to actually tell someone about the voice(s) in their head the soundtrack of Schizophrenia is often a private conversation.

Interestingly, the word ‘hallucination’ may have become something of a misnomer. We are now aware that the brain’s audio pathways respond to ‘hallucinations’ in the same way it responds to sounds that are as real as the radio playing away in the background as I write this. So the voice of God, or Barack Obama or Satan may be a little more real to the Schizophrenia sufferer than the term ‘hallucination’ may suggest. 

Jared Loughner’s psychiatric notes were not released to the public so we have no way of knowing whether he heard voices. It is quite feasible that he was receiving what are known in the trade as ‘command hallucinations’ to do what he did. 

What is not in dispute is the very strange, erratic behaviour he was presenting to everyone that came across him in the years and months prior to the shooting of Gabrielle Giffords and the eighteen other targets of his rage. For some years following his premature departure from college he was reported as displaying an increasing preoccupation with politicians and their shortcomings. Now he definitely isn’t alone on this one. While this doesn’t warrant a psychiatric diagnosis on it’s own merit (imagine the waiting lists for a consult), the significant aspect here is the increasingly focused descent into an all-encompassing obsession, where all that mattered where his own particular objects of attention. As can be seen in what has become a macabre YouTube hit, Loughner became fixated on subjects such as ‘grammar’ and ‘currency’ and the descent of the American dream.

This sort of odd, incomprehensible behaviour is driven by what mental health professionals call thought disorder. Loughner’s strange, jumbled and rather macabre videos paint a picture of just the sort of thought disorder that will be familiar to anyone who has known or worked with a Schizophrenia sufferer. What is said, done (and in Loughner’s case) written may seem like a random collection of words and repetitive ideas, but in the mind of the Schizophrenic they make perfect sense. It’s the thought disorder and behaviour propelled by those thoughts which, often accompanied by voices, become the visible face of someone suffering a severe psychotic illness.

What causes Schizophrenia?
Neuroscience, genetic heredity and good old ‘nurture’ all appear to play an important role in the development of the illness, but long-term studies suggest that a genetic potential for the illness is by no means a guarantee that the symptoms will erupt into Schizophrenia.

When Schizophrenia does emerge, it does so usually in late adolescence or early adulthood. We have known for many years how the environment of a younger person who may already be susceptible to Schizophrenia can play a vital role in flicking the ‘On Switch’ for the effects of psychosis.

It is well reported that Loughner had quite a troubled childhood and was an enthusiastic teenage user of Cannabis and hallucinogenic substances such as Magic Mushrooms, although his use of drink and drugs came to an abrupt end some years before the murders, quite possibly as a response to the increasingly puritanical and quasi-religious ideas that were coming to dominate his thoughts, feelings and behaviour. It has been widely reported that drugs can ‘cause’ Schizophrenia, but this has yet to be proved and is almost certainly not the case. What is looking more likely is that heavy substance use does play a role in impacting an individual’s susceptibility to mental illness, particularly where the young brain has yet to physically mature.

How come he’s ‘mad’ but could drive a car, buy a gun, make videos and post them on YouTube?
If you’ve seen Loughner’s YouTube postings and read or seen the accounts of his descent into illness from people who knew him well, you may well wonder how someone this ill can possibly drive a car, buy ammunition from a Walmart, deal with a traffic cop who stopped him for jumping a red light, and know that a particular politician will be in a certain place at a certain time one Saturday morning. He also has the skills to upload his video contributions to the world wide web.

Well, Schizophrenia involves an unravelling of the personality (not a split personality) and a brain which almost certainly would look slightly malformed and peculiar to the expert eye armed with an MRI scanner. But it only takes a quick skim through Google or YouTube to see that mental illness has little effect on an individual’s ability to perform tasks such as using the internet, uploading a video or driving a car. 

In the UK, one of our most well-known serial killers drove an articulated lorry during a killing spree which led to the violent death of thirteen women. Peter Sutcliffe claimed to have killed his victims as a direct command from the voice of God and was diagnosed with Schizophrenia shortly after his conviction. He remains in a maximum security mental hospital many years later and will never be released. Severe mental illness is not necessarily a barrier to performing complex tasks.

In Conclusion
It may seem strange to a British mental health professional that someone so clearly unwell and tormented by psychosis has not yet been treated with, for example, anti-psychotic medication during the four months of his incarceration, but a severe and chronic shortage of in-patient psychiatric beds means we in the UK are in no position to moralise over this state of affairs.

It would appear from reports that Loughner will now be located at a secure psychiatric facility in an attempt to relieve enough of his symptoms to allow further attempts at a trial later in the year.

A mental illness such as that experienced by Jared Loughner is not to be wished on anyone. Our current drug and psychological treatments are far from perfect and will probably remain so for many years until psychologists and neuro-scientists are better able to advance the understanding of what causes the sort of cataclysmic events seen in Arizona this January. If it’s true that Loughner had a troubled childhood this would have corollaries with many mentally ill people who in turn become violent and just goes to show we cannot look purely at neurotransmitters and genes in explaining his extreme aggression.

It should also be stated very clearly that for every Jared Loughner there are hundreds if not thousands of people just as disordered, distressed and bewildered who will be far more likely to harm themselves either by violence or self-neglect than injure another human being.

This man suffers from a severe mental illness and may possibly have other underlying personality problems. He has planned and committed a crime which has ruined the lives of many, many people, but I hope this post has made you condemn a little less and understand a little more.