Construcción del prototipo a escala 1:

Researchers, policymakers and mental health professionals assumed that knowledge of uncontrollable causality and the absence of responsibility would elicit emotional responses of sympathy, pity and compassion.92 If mental illness could be made comparable in the public mind to Alzheimer’s disease for example, blame, anger and social avoidance would decrease.93 It simply requires an acceptance of socially

90 _{Steven Pinker, ‘Why nature & nurture won't go away’ (2004) 133 Daedalus 5, 7.} 91

Walter Sinnott-Armstrong et al., ‘Brain Images as Legal Evidence’ (2008) 5 Episteme 359.

92 _{Bernard Weiner, Judgments of Responsibility: A Foundation for a Theory of Social Conduct (Guilford Press,}

1995) 20.

93

Mental illnesses are ‘illnesses just like any other: heart disease, diabetes, asthma. Yet the traditions of flowers, sympathy and support provided to people with a physical illness are often denied to those with a mental illness’. ‘What is mental illness?’, Department of Health and Ageing, Australian Government website,

<http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-w-whatmen-toc~mental- pubs-w-whatmen-myth>

unacceptable behaviours as manifestations of an illness that is a ‘disease like any other’.94

The moral ‘blame’ for the abnormal behaviour would shift from the individual to the science of mental illness: ‘brain blame’.95

The U.S. Congress declared the decade beginning January 1, 1990 as the Decade of the Brain.96 Thus began a global campaign to enhance public awareness as to the benefits to be derived from brain research. In conjunction with the resolution, the U.S. Surgeon General issued a landmark report on mental health in 1999 which explained that if the conditions of the mind could be better explained by a scientific ‘cause-and-effect’ relationship, then the stigma associated with mental illness would wane.97 The normal emotional response toward any person judged responsible for a negative life situation is to attribute blame.98 It is a habitual response99 that leads to anger and social avoidance.100 The assumption was that if the person was perceived as a victim of a biological disorder beyond their control, they would not be blamed for their condition, or its symptoms.101 However, studies show that the like-minded belief that mental illness is about weak people making bad choices still persists, and that the people who believe that mental illness is caused by ‘weak wills’ and ‘bad character’ are more inclined to stigmatise.102

In deciding legal issues of competency or capacity, courts rely on the opinions of mental health experts who are given broad leeway to express their opinions about the ultimate issue before the court.103 The psychiatric way has been, and continues to be regarded by the moral authorities as the only way because it is viewed as the

94

Dale L Johnson, ‘Schizophrenia as a brain disease: implications for psychologists and families’ (1989) 44

American Psychologist 553.

See also Patrick W Corrigan, Fred E Markowitz and Amy C Watson, ‘Structural levels of mental illness stigma and discrimination’ (2004) Schizophrenia Bulletin 481.

95

David H Barlow and Vincent M Durand, AbnormalPsychology: An Integrative Approach (Wadsworth Cengage Learning, 2011) 569.

96

House Joint Resolution 174.

97

Mental Health, Report of the Surgeon General, 1999

<http://www.surgeongeneral.gov/library/mentalhealth/chapter1/sec1.html>

98

Weiner, above n 92, 16.

99

Daniel N Robinson, Praise and Blame (Princeton University Press, 2002) 7.

100

Weiner, above n 92, 16.

101 _{Reuven Bar-Levav, ‘The stigma of seeing a psychiatrist’ (1976) 30 American Journal of Psychotherapy 473.}

See also Richard A Schwartz and Ilze K Schwartz, ‘Reducing the stigma of mental illness’ (1977) 38 Diseases of the Nervous System 101.

102

Matthias C Angermeyer and Herbert Matschinger, ‘Causal beliefs and attitudes to people with schizophrenia: Trend analysis based on data from two population surveys in Germany’ (2005) 186 British Journal of

Psychiatry 331.

103 _{Matthew Large, Olav Nielssen and Gordon Elliott, ‘Reliability of psychiatric evidence in serious criminal}

matters: fitness to stand trial and the defence of mental illness’ (2009) 43 Australian and New Zealand Journal of Psychiatry 446.

way of scientific truth. Despite it being shown in Chapter Two that there is very little science and very little ‘truth’ in psychiatry,104

it is psychiatric opinion that informs the legal system. After more than a century of psychiatry and psychology’s acceptance of theoretical models that have had poor family socialisation and

individual character weakness as central to the genesis of mental illness,

stigmatisation became embedded in the core of the helping disciplines.105 Mental illness has long been considered the domain of the weak willed and morally defective,106 a perception that appears to have been little altered by the ‘brain blame’ paradigm.

3.2 Nurture

In the first half of the 20th century, psychiatry embraced the ideas and teachings of Sigmund Freud, founder of the psychoanalytic school of psychiatry.107 Prior to Freud’s revolutionary theories on the nature and functioning of the unconscious mind, a form of positivism had existed in which it was believed that a person only needed to make the choice to act in the right way and live a moral life informed by religion, or a rational life informed by science. This positivist approach never entirely lost its appeal to psychiatry as is evidenced in the classification of homosexuality as a mental disorder up until the 1970s.108

Freud’s theory that pathogenic parental care was responsible for the development of certain mental illnesses109shifted the ‘control’, and therefore the ‘blame’ away from the individual. It began the psycho/social era of ‘there are no bad children, only bad parents’. Health professionals and social workers were trained to view children as mere products of their environment: intrinsically good children were influenced to be otherwise through pathogenic parenting.110 Ostensibly, this era has passed

104

Thomas S Szasz, ‘The Lying Truths of Psychiatry’ (1979) 3 The Journal Of Libertarian Studies 121. See also Els van Dongen and Sylvie Fainzang (eds), Lying and Illness: Power and Performance (Het Spinhuis, 2005).

105

Hinshaw and Stier above n 9.

106 _{Angela K Thachuk, ‘Stigma and the politics of biomedical models of mental illness’ (2011) 4 International}

Journal of Feminist Approaches to Bioethics 140.

107 _{Volker Hess and Benoît Majerus, ‘Writing the history of psychiatry in the 20th century’ (2011) 22 History of}

Psychiatry 139.

108

Robert L Spitzer, ‘The diagnostic status of homosexuality in DSM-III: a reformulation of the issues’ (1981)

138 American Journal of Psychiatry 210.

109 _{Robert B. Ewen,An Introduction to Theories of Personality, (Lawrence Erlbaum and Associates, 2003)} 110

Michael Rutter, ‘Maternal Deprivation Reconsidered’ (1972)16 Journal of Psychosomatic Research 241, 241.

although the belief in nurture blame can still be found in current social campaigns such as ‘Violence is a Learned Behaviour’.111

Cohen discounted parental responsibility for mental illness and emotional problems in children, arguing that genetic influences were more powerful than the influence of either good parenting or bad parenting.112 Understandably, the genetic/disease model found strong support amongst the ‘blamed’ families who have, in recent decades, evolved into politically powerful advocacy organisations, advising and influencing governments on mental health policies.113

3.3 Nature

The campaign to change the public’s causal perceptions from moralistic ‘poor choices’ and ‘weak wills’ to mental illness being ‘an illness like any other’ resulted in a flood of evidence based research supporting biochemical, neurological and genetic causations. This evidence, strongly suggesting that genetic predispositions underlie many of the major mental disorders, is said to have been responsible for the reascension of the medical model of mental illness.114 Although there has been keen academic debate arguing that the terms ‘illness’ and ‘disease’ do not

necessarily imply a biological cause exclusively, the impetus for the promotion of ‘mental illness is an illness like any other’ is based precisely on such an

implication.’115