Thursday, 30 June 2016

Mental Health and the Criminal Justice System: A Social Work Perspective

In this post, Ian Cummins (pictured below), introduces his new book Mental Health and the Criminal Justice System: A social work perspective. The book was published in March 2016 by Critical Publishing.

I am a Senior Lecturer in Social Work based at Salford University. I trained as a probation officer and worked as a mental health social worker in Manchester before taking up academic posts.  My main research revolves around the experiences of people with mental health problems in the criminal justice system. This includes all areas of the criminal justice system but I have focused on policing and mental illness.  I argue the criminal justice system has become, in many incidences, the default provider of mental health care. These issues are examined in my new book.

The book essentially explores the interaction between two of the most significant social policy developments of the past forty years - deinstitutionalisation (or the closure of large psychiatric institutions) and mass incarceration (or the expansion of the use of imprisonment).  The failure to develop properly resourced community mental health systems has seen the de facto criminalisation of the severely mentally ill and the abandonment of a social state sense to support some of most vulnerable members of society.  The book explores the way that mental illness can be a factor in a decision making across the criminal justice system, from interactions between police officers and citizens on the street to decisions about the appropriate sentences for those who are mentally ill but convicted of offences. 

My approach is influenced by Wacquants analysis of processes of advanced marginality. In particular, I see both the failure of community care and the development of mass incarceration as part of the wider neo-liberal political project’s shift towards more punitive responses to social problems. I argue that these developments are tied to the trope of individualism that is at the heart of neo-liberal political ideas. 

Tuesday, 28 June 2016

Failing to Self-ascribe Thought and Motion - Part II

This post is by David Miguel Gray (pictured above), currently Assistant Professor of Philosophy at Colgate University and in the Spring of 2017 will be Assistant Professor of Philosophy at the University of Memphis. David’s research interests are in the philosophy of cognitive psychology (in particular cognitive psychopathology), as well as philosophy of mind, and philosophy of race and racism.

In this post David will address some theoretical issues with n-factor accounts of monothematic delusions. This post, and his previous one, will draw on his recent paper ‘Failing to self-ascribe thought and motion: towards a three-factor account of passivity symptoms in schizophrenia’, published in Schizophrenia Research.

Cognitive-level theories of monothematic delusions have become heavily discussed, significantly in part to the work of Max Coltheart, Robyn Langdon, and Martin Davies (e.g. see Davies and Coltheart 2000, Davies et al. 2001, Coltheart et al. 2007, Coltheart 2013). Theirs is a ‘two-factor’ theory in that it claims there are two impairments that must be explained for all monothematic delusions. The first factor that must be explained is why a delusional hypothesis is a 'prima facie reasonable response to the subject’s experience' and the second factor to be explained concerns how one can adopt and maintain a delusional hypothesis given its 'utter implausibility and the uniform skepticism with which other people greet it' (Davies and Coltheart 2000).

Leaving the second factor aside, I argue that the explanatory project involving the first factor is ill defined in that it combines the requirement to explain cognitive abnormalities (viz. abnormal experience) with the requirement to explain the inferential process that results in a delusional hypothesis. Whereas the first of these explanatory demands counts as a ‘factor’, as defined above, the second may or may not, depending on whether the inferences that lead to the delusional hypothesis could be described as abnormal. Other n-factor theorists (e.g. one factor theorists like Phil Corlett and two factor theorists like Coltheart), think these inferential processes are normal and rational. I agree. So why is explaining these processes important?

Thursday, 23 June 2016

Mind, Madness and Melancholia

On 10th May 2016 the Royal Society of Medicine hosted a one-day conference on Mind, Madness and Melancholia: Ideas and institutions in psychiatry from classical antiquity to the present. I attended the two morning sessions which focused on the concept of madness and melancholy in ancient Greece, ancient Rome, and in the golden era of Arab medicine.

The first speaker was Glenn Most (pictured below), professor of Greek Philology at the Scuola Normale, Pisa, Italy. He started by challenging the view that there was a smooth transition from mythos to logos in the Greek thought, that is, that phenomena previously regarded as mysterious and supernatural were then explained by human reason. When it comes to mental phenomena concerning insanity, for a long time a multiplicity of methods and approaches co-existed. People who manifested strange behaviour could be 'treated' in phases: confined first, asked to try physical remedies second, conceived of as possessed by the gods and subject to religious rituals third, and then left to simple prayer. Thus, madness could be approached medically by the ancient Greeks, but was also given some religious and moral significance, as if being mad were a punishment by the gods.

Plato in the dialogues distinguished between illness of the body and illness of the soul, further dividing the latter into mania and melancholia. A gradual medical approach to illnesses of the soul followed, with Hippocrates developing a humoral theory of them (according to which illnesses are causes by imbalances among elements such as yellow bile, black bile, phlegm and blood), and Galen identifying the brain as the organ where problems arise. Although Galen studied the anatomy of the brain, his remedies were not based on such investigations, but more akin to modern 'talking therapies'.

Tuesday, 21 June 2016

The Intrasubjectivity of Self, Voices, and Delusions

This post is by Cherise Rosen (pictured above). Cherise is an Assistant Professor in the Departments of Psychiatry and Public Health at the University of Illinois at Chicago. She has conducted extensive research on issues involving the symptoms and longitudinal course of psychosis. 

Her research has focused on the phenomenological aspects of psychosis, hallucinations, delusions, metacognition, and self-disturbances. Much of her research follows mixed-methods research designs to elucidate findings that include the subjective experience. 

Additionally, her research investigates the underlying epigenetic mechanisms of psychosis. In this post, Cherise summarises her recent paper (co-authored with Nev Jones, Kayla A. Chase, Hannah Gin, Linda S. Grossman, and Rajiv P. Sharma) 'The Intrasubjectivity of Self, Voices, and Delusions: A Phenomenological Analysis', published in Psychosis. 

In our recent study, we focused on the phenomenologically complex and nuanced interrelatedness of self, voices, and delusions. We investigated the prevalence of co-occurring Auditory Verbal Hallucinations (AVHs) and delusions in schizophrenia compared to bipolar disorder with psychosis; the correlations between AVHs and forms of delusions; and if there are sub-categories/clusters of AVHs and forms of delusions that are distinct and identifiable and what is the symptom presentation of these sub-categories/clusters?