Conclusions

Although relationships between psychiatric disorders and offending are complex, a number of conclusions can be drawn.

• People with mental illnesses make a tiny contribution to the overall crime rate, particularly in countries with a high base rate for crime.

• In the generality of offending, biological factors contribute to criminality in combination with social, demographic, and economic factors.

• The extent to which people with severe mental illness enter the criminal justice system is governed in part by the services available, and the legal processes, for mentally disordered offenders.

• Prisons have become a readily available institutional resource for offenders with a range of psychiatric disorders, often in association with alcohol and substance misuse.

• When psychiatric phenomena contribute to offending, they do so in combination with other personal, situational, and victim-related factors.

• Certain concepts in criminal and mental health law have no theoretical or practical foundation in clinical psychiatry.

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