Here is the case Matthew Broome, Matteo Mameli and I considered in our 2010 paper. A young man was convicted for assault on a neighbour and his sentence was affected by a previous diagnosis of schizophrenia.
Bill had been admitted to a psychiatric unit because he contacted the police, worried that he was acting weird and that he might test his invincibility by jumping off the balcony of his apartment. He reported that people he could not see were talking to him, that his upstairs neighbour had been banging and shouting, and that thoughts were being taken out of his head. After six weeks he was discharged, and initially cooperated with the community mental health team, but then refused to participate in the rehabilitation activities and was no longer compliant with medication. Bill claimed to have no symptoms, but reported feeling low and complained that his neighbour was making a lot of noise, keeping him awake at night. One week later, Bill was charged with burglary and grievous bodily harm with intent.
In an interview two months after the offence, Bill admitted to have stopped taking medication after the first week of discharge and reported that soon after he had started hearing banging and shouting from the apartment above. When he saw the door open in the apartment where he thought the noise was coming from, he went in and removed a set of keys, an axe and a hammer. He said he had removed the last two items because he didn’t want them to be used against him, and he had taken the keys in case he needed to access the flat at a later stage. In the following days, as he continued to hear noises, his anger and frustration increased and one night he got dressed and went upstairs. Bill said that he entered the flat with the intention to confront the neighbour verbally, but he lost his temper and ended up seriously injuring his neighbour.
At the time of his assessment, Bill was fit to plead. He understood the indictment, was capable of following the evidence submitted in his case, could instruct his legal team, could follow court proceedings, and could understand the role of the jurors and witnesses. Further, from what Bill can recall, it seems that, at the time of the offense, he was able to form specific intentions and he was aware that his actions may lead to violence and harm. At the time of assessment, though, he denied any formal plans to harm the tenant of the apartment above and was surprised at how events had escalated. Bill was able to realize that the actions he had committed were wrong and unlawful.
The opinion of his clinical team was that at the time of the offense he was relapsing from his psychotic illness. He had poorly engaged with his clinical team, and had been noncompliant with medication for several weeks prior to the offense. Further, he reported a recurrence of (probably hallucinatory) auditory experiences (e.g., banging, shouting) that had previously abated. In the end, Bill was found guilty and was sentenced to 2 years’ probation and a suspended custodial sentence. Because of his diagnosis of mental illness, the sentence was less severe than otherwise would be expected.
In the next post, I shall explore different ways in which a diagnosis of schizophrenia can impact on attributions of moral responsibility in a case like Bill's. Watch this space!