"Law & Order: SVU" Addresses the Stigma of Mental Illness

Patient Expert

A recent episode of NBC's "Law & Order: SVU" addressed  the stigma  of mental illness.  Additionally, there were some excellent moments during this show that reflected the national debate about whether mentally ill criminals should be sent to prison or a state-run mental health facility.

This particular storyline focused on a man with schizophrenia who had committed numerous violent  crimes while off his medication.  He had recently  stopped taking his Risperdal prescription because  it made him feel like he was "walking through wet cement."  However, once he dicontinued this medication, he started to experience vivid hallucinations that triggered him to commit a series of crimes in New York and Louisiana. The TV show's detectives  initially sought the harshest punishment available: the death penalty.

I was fascinated by  the range of arguments and opinions put forth about mental illness, its relationship to crime, and the potential to rehabilitate mentally ill criminals.  It was particularly  powerful to hear both sides of this debate expressed on Prime Time. The prosecution  argued that he was  too  "crazy"  to  be ever  allowed back  out into society;  his defense team  countered that he was not competent to stand trial and that the crimes committed were not his fault. The end result was that he was sentenced to the mental health section of Riker's Detention Facility.

It's difficult to say whether or not the mentally ill are ultimately responsible for their actions in  situations like this. In the case of the character on "Law & Order: SVU", yes, he is responsible because he is the person who committed these acts in the first place. On the other hand, he did not understand what he was doing because of his psychosis. In fact, he didn't even realize what he had done until he was back on his medication.

One especially compelling observation made during the show pointed out that far too many people with mental illness are sent to prison rather than receiving the mental health  treatment they need. This topic  has been  garnering more attention by the  mainstream media. Current authors have been addressing the "criminalization of the mentally ill." Two authors write about this subject in their books: Pete Earley and Crazy: A Father's Search Through America's Mental Health Madness;and E. Fuller Torrey Out of the Shadows: Confronting America's Mental Illness Crisis.

This particular episode of "Law & Order: SVU"  brought to light many thoughts and beliefs that we, as a society, hold but  do not always publically express. I give  the  program  a lot of credit for  addressing  how both the justice system and general public perceive the mentally ill. This is a popular show and it may just get people talking more openly  about this scenario and mental health in general.

What do YOU think? Is a person in this type of position responsible for the crimes he or she commits while off critcal medication? What is a fair punishment? Should this person go to prison or a mental health facility? Both? Neither? I look forward to hearing your comments.