Module 2

Psychopath juvenile delinquency and conduct disorder

What Is a Psychopath?
The term "psychopath" is used to describe someone who is callous, unemotional, and
morally depraved. While the term isn’t an official mental health diagnosis, it is often used in
clinical and legal settings.
While psychopathy is not a diagnosis in and of itself, many of the characteristics of
psychopathy overlap with symptoms of antisocial personality disorder, a broader mental
health condition that is used to describe people who chronically act out and break rules. But
only a small number of individuals with antisocial personality disorder are considered to be
psychopaths.1
This article discusses psychopath characteristics, the history of the term, and how to
recognize if someone might be a psychopath. It also covers available treatments and things
you can do to cope.
Common Psychopathic Traits
Psychopathic behavior varies greatly from one individual to another. Some are sex offenders
and murderers. But others may be successful leaders. It all depends on their traits.
It’s important to distinguish between psychopaths and people with psychopathic traits. It’s
possible to exhibit several psychopathic traits without being an actual psychopath.2
People with psychopathic traits don’t necessarily engage in psychopathic behavior. Only
individuals with psychopathic traits who also exhibit antisocial behavior are considered to
be psychopaths.
Psychopathic traits commonly include:3
Antisocial behavior
Narcissism
Superficial charm
Impulsivity
Callous, unemotional traits
Lack of guilt
Lack of empathy
Psychopathic traits include antisocial behaviors, lack of empathy, disregard for others, and
narcissism. While such traits might indicate that someone is high in psychopathy, this does
not necessarily mean that they are a psychopath.
two tests that are most often used are the Psychopathy Checklist-Revised (PCL-R) and
the Psychopathic Personality Inventory (PPL).
Psychopathy Checklist-Revised (PCL-R): The PCL-R is a 20-item inventory most commonly
used to assess whether an individual exhibits certain traits and behaviors that could indicate
psychopathy. It’s intended to be completed along with a semi-structured interview and a
review of available records, such as police reports or medical information. It is often used to
predict the likelihood that a criminal may re-offend and their capacity for rehabilitation.
Psychopathic Personality Inventory (PPL): The PPL is an alternative test that was introduced
in 1996. This test is used to assess psychopathic traits in non-criminal populations. It may
still be used with incarcerated individuals, but it is more often applied to other populations,
such as university students.
Delinquency- behavior violating social rules or conventions. The term is often used to
denote the misbehavior of children or adolescents.
Juvenile delinquency refers to criminal acts performed by juveniles. Most legal
systems prescribe specific procedures for dealing with juveniles, such as juvenile detention
centers. There are a multitude of different theories on the causes of crime, most if not all of
which can be applied to the causes of youth crime. Youth crime is an aspect of crime which
receives great attention from the news media and politicians. Crime committed by young
people has risen since the mid-twentieth century, as have most types of crime. The level
and types of youth crime can be used by commentators as an indicator of the general state
of morality and law and order in a country, and consequently youth crime can be the source
of ‘moral panics’ [1] Theories on the causes of youth crime can be viewed as particularly
important within criminology. This is firstly because crime is committed disproportionately
by those aged between fifteen and twenty-five. [2] Secondly, by definition any theories on
the causes of crime will focus on youth crime, as adult criminals will have likely started
offending when they were young. A Juvenile Delinquent is one who repeatedly commits
crime, however these juvenile delinquents could most likely have mental
disorders/behavioral issues such as schizophrenia, post traumatic stress disorder or bipolar
disorder.
rates of delinquency are often under-representations of actual behavior. Because most
statistics rely solely on official contacts with law enforcement, all other illegal activity that is
undetected remains unreported. To enhance information obtained from official records,
self-report data from children and adolescents have become a beneficial component of
juvenile delinquency research. Arrest rates for violent crimes, including  criminal  homicide, 
robbery,  aggravated  assault, and forcible rape, increased from 1983 to 1993–1994. Factors
hypothesized to have played a significant role in this increase were youth involvement in
gangs, increased drug use, and access to and use of guns. Data from 1993 to 1999 have
shown a decline in arrests. The overall arrest rate for all crimes committed by juveniles was
2.4 million in 1999. During this time period, juveniles were involved in 16% of all violent
crime arrests and 32% of all property crime arrests. Another indicator of juvenile violence,
self-report of crime, showed no decrease in the amount of violent behavior between 1993
and 1999. One potential reason for this discrepancy between arrest rates and self-report of
problem behavior may be that there has been a decline in youth’s use of firearms and some
decline in gang membership that has resulted in less severe problem behavior that may not
be detected by the authorities. Other statistics show that 30% to 40% of boys and 16% to
32% of girls have committed a serious violent offense by the age of 17. There are differences
in arrest rates across gender and race, with significantly more boys than girls arrested and
significantly more African Americans arrested than whites or other minority groups.
What are the main causes of juvenile delinquency?
Leading Contributing Factors To Juvenile Delinquency
Poor School Attendance. Poor school attendance is one of the top factors contributing to
delinquency. ...
Poor Educational Standards. ...
Violence In The Home. ...
Violence In Their Social Circles. ...
Peer Pressure. ...
Socioeconomic Factors. ...
Substance Abuse. ...
Lack Of Moral Guidance.
Conduct dirorder
What Is Conduct Disorder?
Conduct disorder is an ongoing pattern of behavior marked by emotional and behavioral
problems. Children with conduct disorder behave in angry, aggressive, argumentative, and
disruptive ways. 
Conduct disorder in children goes beyond bad behavior. It is a diagnosable mental health
condition that is characterized by patterns of violating societal norms and the rights of
others. It's estimated that around 3% of school-aged children have conduct disorder. It is
more common in boys than in girls.1
It's important for kids with conduct disorder to get professional treatment. Recognizing the
early warning signs can help you take appropriate action.
Symptoms
Conduct disorder extends beyond normal teenage rebellion. It involves serious behavior
problems that are likely to raise alarm among teachers, parents, peers, and other adults. In
order to qualify for a diagnosis of conduct disorder, children must exhibit at least three of
these symptoms in the past year and at least one in the past six months:2
Aggression Toward People and Animals
Bullying, threatening, or intimidating others
Initiating physical fights
Using a weapon that could cause serious harm
Physical cruelty to people
Physical cruelty to animals
Stealing while confronting a victim
Forced sexual activity
Property Destruction
Deliberate fire setting
Other destruction of property
Deceptiveness or Theft
Breaking or entering a house, car, or building
Lying for personal gain
Stealing without confronting the victim (such as shoplifting)
Serious Rule Violation
Staying out at night before the age of 13 years
Running away from home overnight at least twice
Truancy beginning before the age of 13
Impact
Conduct disorder isn't just a challenge for caregivers—it actually impairs a child's ability to
function. Some areas where the condition may affect a child's life include:
Education: Children with conduct disorder misbehave so much that their education is
affected. They usually receive frequent disciplinary action from teachers and may skip
school. Children with conduct disorder may be at a higher risk of failure or dropping out of
school. 
Legal issues: Adolescents with conduct disorder are also more likely to have legal problems.
Substance abuse, violent behavior, and a disregard for the law may lead to incarceration.
Relationships: Children with conduct disorder also have poor relationships. They struggle to
develop and maintain friendships. Their relationships with family members usually suffer
due to the severity of their behavior.
Sex: They may also engage in risky sexual behavior. Studies show that teens with conduct
disorder are more likely to have multiple sexual partners and are less likely to use
protection.3
Diagnosis
Conduct disorder in children can be diagnosed by a mental health professional or a
physician. Often, a diagnosis is made after attempts to remedy behavior problems at school
and at home aren't effective.
A professional may interview the child, review records, and ask that parents and teachers
complete questionnaires about the child’s behavior. Psychological testing and other
assessment tools may also be used to evaluate the child.
Causes
Researchers aren’t exactly sure why some children develop conduct disorder. A variety of
biological, psychological, and social factors are likely involved. Quite often, those factors
overlap. Some that may play a role include:
Brain abnormalities: Imaging studies suggest children with conduct disorder may have some
abnormalities in certain areas of the brain. The pre-frontal cortex (which affects judgment)
and the limbic system (which affects emotional responses) may be impaired.
Cognitive deficits: Low IQ, poor verbal skills, and impairment in executive functioning may
make children more vulnerable to conduct disorder.
Genetics: Studies suggest that inherited genes may be responsible for about half of anti-
social behavior.4 Researchers aren’t sure which specific genetic components contribute to
conduct disorder.
Social issues: Poverty, disorganized neighborhoods, poor schools, family breakdown,
parental mental illness, harsh parenting, and inadequate supervision are all strongly linked
with conduct disorder.
Treatment
Treatment for conduct disorder depends on several factors, such as a child’s age and the
severity of behavior problems. The most common treatment methods include:
Family therapy: Parents, siblings, and other family members may be invited to attend
therapy with the child. Sometimes, improving the relationship between parents and a child
may improve family interactions.
Medication: There isn’t a medication that specifically treats conduct disorder. But
sometimes doctors may prescribe medication to treat the disorder's symptoms or to
address other underlying mental illness.5
Parent training: Treatment often involves caregivers and parents. Parents may be
taught behavior management strategies and techniques to increase safety in the home if a
child is aggressive or violent.
Psychotherapy: Individual therapy may be helpful when a child could benefit from learning
new skills, such as anger management and impulse control.
Residential placement: In cases where a child or adolescent's behavior has become out of
control, treatment in a residential program may be necessary to keep everyone safe. A
therapeutic environment may address substance abuse issues, sexualized behavior, or
violence.
Early intervention is key to getting the most effective treatment, so it’s important for
parents, educators, and physicians to be aware of the signs of conduct disorder in children
so that appropriate referrals and interventions can be put into place.
Coping
Research suggests that taking part in psychosocial treatments can help both children and
families cope with the effects of conduct disorder. Such approaches often involve working
with parents and caregivers to help them find effective ways of managing their child's
behavior. This may include such things as:
Creating structure
Enforcing limits
Providing clear instructions
Rewarding positive behaviors
Using time-outs after inappropriate behaviors or outbursts
The ultimate goal of such training is to help parents and children interact more effectively.
This can lead to less conflict and help children better regulate their behavior. 
Signs of a Psychopath
Psychopathic traits may emerge during childhood and grow worse over time.5 The following
are some of the most common signs of a psychopath.
Superficial Charm
Psychopaths are often likable on the surface. They’re usually good conversationalists, and
they share stories that make them look good. They may be funny and charismatic as well.
Need for Stimulation
Psychopaths love excitement. They like to have constant action in their lives, and they
frequently want to live in the "fast lane."
Quite often, their need for stimulation involves breaking rules. They may enjoy the thrill of
getting away with something, or they might even like the fact that they could "get caught"
at any moment. Consequently, they often struggle to stay engaged in dull or repetitive tasks,
and they may be intolerant of routines.
Pathological Lying
Psychopaths tell lies to look good and get out of trouble. But they also tell lies to cover up
their previous lies. They have difficulty keeping their stories straight sometimes as they
forget what they’ve said. If challenged by anyone, they simply change their story again or
rework the facts to fit the situation.
Grandiose Sense of Self-Worth
Psychopaths have an inflated view of themselves. They see themselves as important and
entitled. They often feel justified to live according to their own rules, and they think that the
laws don’t apply to them.
Manipulative
Psychopaths are really good at getting other people to do what they want. They may play on
a person’s guilt while lying to get someone else to do their work for them.
Lack of Remorse
Psychopaths don’t care how their behavior affects other people. They may forget about
something that hurts someone, or they may insist that others are overreacting when their
feelings are hurt. Ultimately, they don’t experience any guilt for causing people pain. In fact,
they often rationalize their behavior and blame other people.
Shallow Affect
Psychopaths don’t show many emotions—at least not genuine ones. They may appear cold
and unemotional much of the time. But when it serves them well, they might exhibit a
dramatic display of feelings. These are usually short-lived and quite shallow.
For example, they may show anger if they can intimidate someone, or they might show
sadness to manipulate someone. But they don’t really experience these emotions.
Lack of Empathy
Psychopaths struggle to understand how someone else might feel afraid, sad, or anxious. It
just doesn’t make sense to them as they’re not able to read people. They’re completely
indifferent to people who are suffering—even when it’s a close friend or family member.
Parasitic Lifestyle
Psychopaths may have sob stories about why they can’t earn money, or they might often
report being victimized by others. Then, they take advantage of the kindness of others by
depending on them financially. They use people to get whatever they can with no regard for
how a person may feel.
Poor Behavioral Controls
Psychopaths struggle to follow rules, laws, and policies much of the time. Even if they set
out to follow the rules, they usually don’t stick to them for long.
Promiscuous Sexual Behavior
Since they don’t care about the people around them, psychopaths are likely to cheat on
their partners. They may engage in unprotected sex with strangers. Or they may use sex as a
way to get what they want. Sex is not an emotional or loving act for them.
Early Behavioral Problems
Most psychopaths exhibit behavioral problems at an early age. They may cheat, skip school,
vandalize property, misuse substances, or become violent. Their misbehaviors tend to
escalate over time and are more serious than their peer’s misbehaviors.
Lack of Realistic, Long-Term Goals
A psychopath’s goal might be to become rich or be famous. But quite often, they have little
idea about how to make these things happen. Instead, they insist that somehow they’ll get
what they want without putting in the effort to get there.
Impulsivity
Psychopaths respond to things according to the way they feel. They don’t spend time
thinking about the potential risks and benefits of their choices. Instead, they want
immediate gratification. So they may quit a job, end a relationship, move to a new city, or
buy a new car on a whim.
Irresponsibility
Promises don’t mean anything to psychopaths. Whether they promise to repay a loan or
sign a contract, they aren’t trustworthy. They may shrug off child support payments, get
deeply in debt, or forget about obligations and commitments.
Psychopaths don’t accept responsibility for the problems in their lives. They see their issues
as always being someone else’s fault. They frequently play the role of the victim and enjoy
sharing stories about how others have taken advantage of them.
Many Marital Relationships
Psychopaths may get married because it serves them well. For example, they may want to
spend a partner’s income or share their debt with someone else. But their behavior often
leads to frequent divorces as their partners eventually see them in a more accurate light.
Criminal Versatility
Psychopaths tend to view rules as suggestions—and they usually view laws as restrictions
that hold them back. Their criminal behaviors can be quite varied. Driving infractions,
financial violations, and acts of violence are just a few examples of the array of crimes one
might commit. Of course, not all of them get incarcerated. Some may operate under shady
businesses or engage in unethical practices that don’t lead to an arrest.
Revocation of Conditional Release
Most psychopaths don’t adhere to the rules of conditional release when they are released
from prison. They may think they won’t get caught again. Or they may find ways to excuse
their behavior. They might even blame "getting caught" on other people.
Recap
A person who is manipulative, dishonest, narcissistic, unremorseful, non-empathetic, and
exploitive may be a psychopath. Criminality, promiscuity, and lack of responsibility are also
common traits associated with psychopathy.
Psychopath vs. Sociopath
While "psychopath" and "sociopath" are sometimes used synonymously, they have different
meanings and different patterns of traits and behaviors. 
Psychopaths lack a conscience and don't feel empathy for others. They may pretend to care,
but often maintain a normal facade to cover up cold-hearted or even criminal behaviors.6
Sociopaths may experience some limited empathy and remorse for their actions. They
struggle to maintain normal behaviors and routines and can be impulsive and overly
emotional. They may recognize that their actions are wrong, but find ways to rationalize
their impulsive and harmful behaviors.

Sex offenders serial killers and rampage killers

A rampage involves the (attempted) killing of multiple persons at least partly in public space
by a single physically present perpetrator using (potentially) deadly weapons in a single
event without any cooling-off period.
This list should contain, for each category, the first fifteen cases with at least one of the
following features:
Rampage killings with 6 or more dead
Rampage killings with at least 4 people killed and at least ten victims overall (dead plus
injured)
Rampage killings with at least 2 people killed and at least 12 victims overall (dead plus
injured)
An incidence of rampage killing shall not be included in this list if it does not include at least
two people killed.
In all cases the perpetrator is not counted among those killed or injured.
Spree Killers
Spree killers (sometimes referred to as rampage killers) murder two or more victims, but at
more than one location. Although their murders occur in separate locations, their spree is
considered a single event because there is no "cooling-off period" between the murders.
Differentiating between mass murderers, spree killers, and serial killers is the source for
ongoing debates among criminologists.
While many experts agree with the general description of a spree killer, the term is often
dropped and mass or serial murder is used in its place.
Robert Polin is an example of a spree killer. In October 1975 he killed one student and
wounded five others at an Ottawa high school after earlier raping and stabbing a 17-year-old
friend to death.
Charles Starkweather was a spree killer. Between December 1957 and January 1958,
Starkweather, with his 14-year-old girlfriend by his side, killed 11 people in Nebraska and
Wyoming. Starkweather was executed by electrocution 17 months after his conviction.
William Balfour, known for the Jennifer Hudson family murders, also fits the spree killer
pattern.
Sex offender
A sex offender (sexual offender, sex abuser, or sexual abuser) is a person who has
committed a sex crime. What constitutes a sex crime differs by culture and legal jurisdiction.
The majority of convicted sex offenders have convictions for crimes of a sexual nature;
however, some sex offenders have simply violated a law contained in a sexual category.
Some of the serious crimes which usually result in a mandatory sex-offender classification
are sexual assault, statutory rape, bestiality, child sexual abuse, incest, rape, and sexual
imposition.
Sex offender registration laws in the United States may also classify less serious offenses as
sexual offenses requiring sex offender registration. In some states public urination, having
sex on a beach,[1] or unlawful imprisonment of a minor also constitute sexual offenses
requiring registration
In looking at various types of offenses, an example of a digital obscenity offense is child
pornography. In the modern world of technology, many jurisdictions are reforming their
laws to prevent the over-prosecution of sex offenders and focusing on crimes involving a
victim. The term sexual predator is often used to describe a sex offender or any of the "tier
offenders"; however, only the category just below sexually-violent sexual predator is
reserved for a severe or repeated sex offender: sexual predator.
The common sex offenses fall into the following categories:
Crimes against adults: rape, sexual assault and marital rape
Crimes against relatives: incest
Crimes against children: pornography, exploitation, molestation, abduction
Crimes against nature: indecent exposure, sodomy, bestiality
Crimes against sex for sale: prostitution
Child sex abusers
Child sexual abuse is the use of force/coercion of a sexual nature either when the victim is
younger than age 13 and the age difference between the victim and the perpetrator is at
least five years, or when the victim is between 13 and 16 and the age difference between
the victim and perpetrator is at least 10 years. In this definition, coercion does not
necessarily imply a direct threat. Child sexual abusers often develop a relationship with a
child to manipulate him or her into compliance with the sexual act, which is perhaps the
most damaging component of child sexual abuse (John Jay College, 2004). Indeed, a defining
feature of child sexual abuse is the offender's perception that the sexual relationship is
mutual and acceptable (Groth, 1983).
Differences Between Child Sexual Abusers and Rapists
Child sexual abusers have been difficult to classify as they vary in economic status, gender,
marital status, ethnicity and sexual orientation. Child sexual abusers are often characterized
as exhibiting poor social skills, having feelings of inadequacy or loneliness, having greater
sexual problems or being passive in relationships (Cortoni & Marshall, 2001; Groth, 1979;
Maniglio, 2012; Marshall, 1993; Whitaker et al., 2008). They differ from rapists with respect
to thought processes and affect, and often describe their offending behaviors as
uncontrollable, stable and internal; whereas rapists attribute their offenses to external,
unstable and controllable causes (Garlick, Marshall & Thorton, 1996). Indeed, Whitaker et
al.'s (2008) meta-analytic review of 89 studies indicates child sexual abusers have fewer
externalizing behaviors compared to rapists. Child sexual abusers display deficits in
information-processing skills and maintain cognitive distortions to deny the impact of their
offenses (e.g., having sex with a child is normative; Hayashino, Wurtele & Klebe, 1995;
Whitaker et al., 2008). In contrast, rapists display distorted perceptions of women and sex
roles, and often blame the victim for their offense (O Ciardha, 2011; Polaschek, Ward &
Hudson, 1997). With respect to affect, child sexual abusers assault to alleviate anxiety,
loneliness and depression. Rapists typically assault as a result of anger, hostility and
vindictiveness (Polaschek, Ward & Hudson, 1997). Many of these characteristics have been
incorporated into the typologies of rapists and child sexual abusers (Camilleri & Quinsey,
2008; Groth, 1979; Knight & Prentky, 1990).

Pedophilic and Nonpedophilic Distinction

The most important distinction among child sexual abusers is whether they are pedophilic
or nonpedophilic, because pedophilia has been shown to be a strong predictor of sexual
recidivism (Hanson & Bussiere, 1998). Not all individuals who sexually assault children are
pedophiles. Pedophilia consists of a sexual preference for children that may or may not lead
to child sexual abuse (e.g., viewing child pornography), whereas child sexual abuse involves
sexual contact with a child that may or may not be due to pedophilia (Camilleri & Quinsey,
2008). According to the Diagnostic and Statistical Manual of Mental Disorders, 5th
Edition (American Psychiatric Association, 2013), a diagnosis of pedophilia requires an
individual to have recurrent, intense and sexually arousing fantasies, urges or behaviors
directed toward a prepubescent child (generally 13 years of age or younger) over a period of
at least six months; to have acted on these urges or to be distressed by them; and to be at
least 16 years old and at least five years older than the child victim. The World Health
Organization, which publishes the International Statistical Classification of Diseases and
Related Health Problems (WHO, 2010) defines Pedophilia as a sexual preference for
children, boys or girls or both, usually of prepubertal or early pubertal by an adult.
Female Sexual Offenders
Differences between male and female sexual offenders are identified in the literature. In
contrast to male sexual offenders, female offenders are more likely to sexually assault males
and strangers (Allen, 1991; Vandiver, 2006). Female sexual offenders report different
offense-supportive cognitions than males. Specifically, their beliefs are gender-specific; they
perceive female abuse as less harmful, men control women and their partner's needs are
paramount (Gannon, Hoare, Rose & Parrett, 2010). Studies have also shown that female
sexual offenders are less likely than male sexual offenders to sexually reoffend (Freeman &
Sandler, 2008). For example, Cortoni and Hanson (2005) found a female sexual recidivism
rate of 1 percent over a five-year average follow-up period with a sample of 380 females.
Internet Offenders
The widespread availability of pornography on the internet has facilitated the development
and maintenance of sexual deviance (Delmonico & Griffin, 2008; Quayle, 2008). The internet
has been used as a vehicle for child sexual abuse in at least three ways: viewing
pornographic images of children, sharing pornographic images of children and luring or
procuring child victims online (Robertiello & Terry, 2007). Individuals download
pornographic pictures of children to aid arousal and masturbation, as a collecting activity, as
a way of facilitating social relationships and as a substitute for child sexual contact (Quayle
& Taylor, 2003).
There is no such thing as a "typical" sex offender, however most tend to be manipulative,
deceptive, narcissistic, sexist, and secretive, with feelings of entitlement. Sex offenders
come from all backgrounds, ages, socioeconomic and ethnic groups. The majority of
offenses are committed by someone the victim knows.

Role of Psychology/Counselors in dealing psychological disorders and criminal behavior

Clinical psychology is the branch of psychology concerned with the assessment and
treatment of mental illness, abnormal behavior, psychiatric problems and emotional
disturbance and it includes scientific study and application of psychology for the purpose of
Understanding, preventing and Relieving physiological based distress or dis function and to
promote subjective well-being and personal development.
American Psychological Association defines clinical psychology as a clinical discipline that
involves the assessment, diagnostic, treatment, prevention and consultative service to the
patients.
Categories of clinical and Experimental Psychology include: Social Psychology, Forensic
Psychology, Biopsychology, Cognitive Psychology and Counseling Psychology. This field is
first begun in 1896. The first psychological clinic is at the University of Pennsylvania by
Lighter Witmer. Advances in clinical health psychology are to include number of physical
disorders and diseases. Psychologists contribute directly to the prevention and treatment of
among other diseases, Diabetes, hypertension and aids
Characteristics of Clinical Psychology includes: Emphasis on science, Emphasis on
maladjustment, Emphasis on individual, Emphasis on helping.
Parameters to define Practice in Clinical Psychology
Procedures: Assessment, Intervention, Consultation, Research, Problems/Issues,
Populations.
Roles and Responsibilities of Clinical Psychologist
Clinical psychologists meet with clients to identify problems such as emotional, mental and
behavioural in their lives. Through observation and by using specific methods the
psychologist will diagnose any existing or potential disorders and they are able to
understand and they know how to treat people suffering from psychological problems
Psychologist do not engage knowingly in behaviour that is harassing to the person to whom
they interact in their work based on such factor such as age, gender.
Goals of Clinical Psychologist
They help people, frequently through talk therapy resolve a variety of emotional,
behavioural and mental health problems. To meet this goal, they first determine a person's
condition and how serious it is by asking some questions and sometimes providing
psychological tests.
Mental health counselors can offer advice, support, and a safe space to talk about the
problems a person is struggling with.
For example, they can help someone:
understand their feelings
identify issues that affect their mental health
discover ways to overcome them
learn new skills and coping strategies
set goals for personal growth
learn more about mental health conditions
All qualified counselors have received training to recognize the symptoms of anxiety,
depression, and low self-esteem.
Specific conditions or life events that counselors can help someone cope with include:
grief or loss
phobias
addiction
anger management
bereavement
eating disorders
relationship and family difficulties
obsessive-compulsive disorder
Some counselors specialize in one or more of these areas. Counselors can also receive
specific training to help people who have recently experienced trauma, sexual assault, or
domestic abuse.
Counseling typically focuses on addressing the main symptoms or problems a person or
group finds distressing. By doing this, counselors can help people overcome challenges,
obstacles, or events that have affected their mental well-being.
Mental health counselors can teach a person healthy coping strategies or self-help
techniques, or they can simply give people a space to work out solutions for themselves.
If appropriate, a counselor may also refer their client to other services that may help, such
as a doctor, dietitian, or support group.
It is not necessary to experience severe symptoms to see a counselor. Many people attend
counseling because they feel a benefit from talking about their concerns with a
compassionate and nonjudgmental professional.
According to the National Alliance on Mental Health, it takes 11 years, on average, for a
person with symptoms of a mental health condition to receive treatment.
However, seeking help early can reduce the impact that mental health conditions can have
on a person’s health, career, and relationships.
Mentally ill offenders
Those in the criminal justice system often find themselves dealing with individuals that have
mental health issues.
While sometimes the crimes involved are minor and merely the result of unusual or strange
behavior, there are also times in which mental illness leads individuals to commit crimes of
significant violence.
One initial option for individuals in crisis is an involuntary commitment.
A person can be involuntary committed to an approved mental health facility for 120 hours
if it can be shown that they are a clear and present danger to his or herself or others, or
unable to care for his or her own needs. This includes the threat of suicide or the threat of
mutilation.
• A physician, officer, or anyone authorized by a county administrator can take a
person to an approved facility for an emergency examination. The person can then
be held for up to 120 hours without a hearing.
• If a person is found to be in need of emergency treatment, he or she must be
discharged after 120 hours or when treatment is no longer needed.
• The only exception is if the person is admitted for voluntary treatment or a
certification to extend the involuntary treatment is filed.
• People 14 years of age and older can sign themselves into voluntary treatment.
• Additionally, parents or guardians of minors under 14 may sign a child into voluntary
treatment.
• For an involuntary commitment, a conference can be held prior to the expiration of
the 120 hours, under which the patient may continue to be be committed for up to
20 days. If this happens, the patient can appeal and must have a hearing in the Court
of Common Pleas within 72 hours.
• Furthermore, after a more formal hearing, a patient can be held involuntarily for up
to 90 days, in inpatient, partial or outpatient treatment. For this continued hold, the
person must continue to be a danger to themselves or others. After this, a hearing
can be held under which a person can be committed for 180 days, with court
approval. The commitment will then be reviewed every 180 days to ensure that the
patient does not get forgotten.
• If a person with mental health issues is incarcerated on criminal charges, they can be
hospitalized for up to 60 days for treatment, during which time they will be
examined to see if they are competent to stand trial.
• If a person is found to be unable to understand the nature of the proceedings
against him or her, or be able to participate and help in his or her defense, that
person will be deemed incompetent to be tried, convicted, or sentenced, for as long
as the incapacity continues. A person in this situation can be involuntarily treated for
up to 60 days, if such treatment is likely to make him or her able to stand trial.
• If a person remains incompetent to stand trial, criminal proceedings can be stayed
for a period of time up to the maximum sentence of incarceration that would be
imposed for the crimes charged, or ten years, whichever is less. However, charges of
first or second degree murder have no time limitation, and thus can be stayed
indefinitely.
• During a criminal trial, mental illness may be asserted as mitigation or as a complete
defense. If the judge or jury finds that a person is guilty of the offense, and was
 mentally ill (but not legally insane) at the time the offense was committed, the
verdict should be guilty but mentally ill.
• If at the time of sentencing, the defendant is severely mentally disabled and in need
of treatment, he or she will be provided treatment, either in prison or in a mental
health facility. Upon his or her release, the defendant could be placed on probation
or parole.
• If a person is found to be legally insane at the time of the offense, to the extent that
he or she did not know what he or she was doing, or did not know that it was wrong,
the person will be found not guilty by reason of insanity, and could be subject to
commitment and treatment under the mental health provisions described above.
Insanity defense
• The insanity defense, also known as the mental disorder defense, is an affirmative
defense by excuse in a criminal case, arguing that the defendant is not responsible
for their actions due to an episodic or persistent psychiatric disease at the time of
the criminal act.
• This is contrasted with an excuse of provocation, in which the defendant is
responsible, but the responsibility is lessened due to a temporary mental state.
• It is also contrasted with a finding that a defendant cannot stand trial in a criminal
case because a mental disease prevents them from effectively assisting counsel,
from a civil finding in trusts and estates where a will is nullified because it was made
when a mental disorder prevented a testator from recognizing the natural objects of
their bounty, and from involuntary civil commitment to a mental institution, when
anyone is found to be gravely disabled or to be a danger to themselves or to others.
• In the United Kingdom, Ireland, and the United States, use of the defense is rare.[4]
Mitigating factors, including things not eligible for the insanity defense such as
intoxication[5] (or, more frequently, diminished capacity), may lead to reduced
charges or reduced sentences.
• The defense is based on evaluations by forensic mental health professionals with the
appropriate test according to the jurisdiction.
• Their testimony guides the jury, but they are not allowed to testify to the accused's
criminal responsibility, as this is a matter for the jury to decide.
• Similarly, mental health practitioners are restrained from making a judgment on the
"ultimate issue"—whether the defendant is insane.[6]
• Some jurisdictions require the evaluation to address the defendant's ability to
control their behavior at the time of the offense (the volitional limb).
• A defendant claiming the defense is pleading "not guilty by reason of insanity"
(NGRI) or "guilty but insane or mentally ill" in some jurisdictions which, if successful,
 may result in the defendant being committed to a psychiatric facility for an
indeterminate period.
Five patterns among mentally disordered persons-
• Five patterns among mentally disordered offenders are distinguished by the
relationship between mental disorder, on the one hand, and criminality, on the
other.
• Pattern 1 offenders are those for whom crime is a response to psychotic symptoms,
most often delusions or hallucinations.
• Pattern 2 offenders commit crimes motivated by compulsive desires, such as sex
offenses by paraphiles and offenses regarded as evidence of disorders of impulse
control.
• Pattern 3 offenders are those with personality disorder for whom the crime is merely
one example of a maladaptive pattern of voluntary and knowing behavior.
• Pattern 4 offenders have coincidental mental illness that is unrelated to the crime.
• Pattern 5 offenders are those who become mentally disordered or feign mental
disorder as a result of their crimes, such as those who dissociate upon seeing what
they have done, those who become depressed in prison, those who become
psychotic on death row, and those who malinger mental illness. Although these
categories do not determine whether offenders are responsible for their behavior,
some unknown proportion of Pattern 1 offenders do meet legal criteria for insanity,
depending on the facts of each case and the applicable legal standards. It is arguable
whether or not Pattern 2 offenders ever meet legal criteria of insanity. Offenders
evidencing only Patterns 3, 4, or 5 are not candidates for an insanity defense.
Can a mentally ill person be convicted?
• In rare cases, people with mental health problems may be found unfit to stand trial,
or not guilty due to their mental impairment. However, in most cases, people with
mental health problems will stand trial (or plead guilty) in the ordinary way and if
convicted, they will face the normal sentencing process.2