Patient and prisoner experiences : major mental illness and masculinity in the context of violent offending behaviour

Abstract

Traditional understandings of violence by the mentally disordered largely look to mental illness to explain such behaviour. More recently, research has begun to examine the role of alternative factors in driving violent offending in this context. Masculinity is one such factor to which little consideration has thus far been given, in spite of a wealth of literature which associates the construction and maintenance of a masculine identity with violence in the non-mentally disordered context. This thesis proceeds from these current understandings, and examines the nature of the relationship between mental illness, masculinity and violent behaviour. In order to examine this issue, interviews were conducted with a group of 10 male patients diagnosed with major mental illness and with violent offending histories, in a medium secure forensic psychiatric hospital in Scotland. A group of 10 male prisoners serving life sentences in a Scottish adult male prison following convictions for homicide offences were also interviewed, and acted as a comparator group. Following an analysis of these interviews, findings emerged in relation to three key areas of patients’ and prisoners’ accounts: past experiences of violent offending, present experiences of institutional settings, and future hopes for recovery and desistance. In particular, significant similarities and divergences in the experiences of the two groups were apparent, and this thesis advances two key arguments in light of this. Considering first the similarities in patients’ and prisoners’ experiences, it is posited here that for both the mentally ill and non-mentally ill male population the task of constructing and maintaining a masculine identity is a particularly pervasive force in their life histories. It will be demonstrated that for patients and prisoners in this study, masculinity plays a significant role in past violent offending, as well as having important implications for adaptation to present institutional settings, and the creation of a recovered and desisting identity for the future. Second, in looking to the divergences in patients’ and prisoners’ accounts, it is asserted that where major mental illness is present it serves to intercede in these three areas of men’s lives. Extracts from interviews with male patients will illustrate the interceding role of mental illness in violent scenarios from their pasts. In addition, it will be demonstrated that patients’ and prisoners’ respective present situations in institutional settings vary, as diagnosis of mental illness leads patients to be placed in a secure hospital rather than the prison, and the differing nature of these environments results in divergences in adaptation to these settings. Finally, in relation to the future, while prisoners focussed on their hopes for desistance from offending, the diagnosis of mental illness led patients to place recovery from such disorders as the primary process at this point.