Mental Illness, or Just Bad People?

If you or a family member suffer from a borderline personality disorder, please do not be offended by this topic…

I’ve noticed that over the last 5-10 years our attendance to violence associated with “Mental Illness” has increased drematically. In many cases these people have a genuine mental illness and are capable of being treated with medications and returning to normal and productive lives within society. However, unfortunately for people who do suffer with mental illness, there are many who either ‘fake’ mental illness, or are simply bad people.

The question however, is how do we differentiate between mental illness and just bad people?

Don’t get wrong, I’ve treated many patients who genuinely suffer with Mental Illness such as Pschizophrenia who I believe genuinely suffer with a mental illness and are good people…

However, I attend people time and time again who assault people, steal, hit, spit, puonch, etc… and are repeately taken back to hospital for treatment of disorders such as Borderline- Personality Disorders. How do we differentiate between these people and just bad people?

Here is a case…

16 year old male – found attempting to stab his sister with a fork. Called by police to treat a patient who has been diagnosed with “Anger Management Disorder” (although I can’t seem to find that in the DSM IV).

The 16 year old had litterally stabbed his older sister and was now claiming that he had a mental illness and wished to be treated. I talked to him, and he advised that he didn’t want to kill himself, but that he loses his temper and wants to kill his sister and mother regularly. When asked if he has an idea of how he is going to do this, he states: “I will stab them to death in their sleep…”

This person,first and foremost, irrespective of his potential mental illness needs to be sedated or locked up for the safety of the community and his family.

I asked the patient if he was willing to go to hospital, and he decline in no uncertain terms. He was eventually scheduled and forced to go to hospital. He was given the age old Ambulance offer of “Do you want to come in the Ambulance and behave or go with the police…” and he spat on my partners face… that made the decision clear for me. And I advised the police that they would be transporting him.

My decision was later reviewed when his mother complained that we had locked him up like a common criminal even though he was not a criminal but had a mental illness…

What does everyone else think about this?

To me, it seems clear, if you can’t behave in an Ambulance (whether this is because you have a mental illness, are in a drug induced psychosis or just a bad person) you don’t get the choice, you must be taken in a police wagon that is safe for you and for us.