When someone goes on a journey, then he can tell something (Goethe)
In New York a minority of sensible mentally ill gathered in the Fountain House where they maintained that mental illness is no excuse for idleness, violent behaviour or drug abuse. The Psychiatric Emergency Unit in the nearby hospital was clean, nice and empty, and the majority of the mentally ill to be found round the corner, politely asking "Got some change please?"
At an international meeting in wonderful Tuscany with some very clever and hard working researchers from all over the world (USA, Canada, UK and elsewhere) it was realised that attitudes differed transatlantically. Most of the North Americans seemed to have no difficulty sending mentally ill people to prison as long as they were taken care of by special programmes, whilst the Europeans found it important to distinguish properly between the institutional settings for treatment and punishment. Another point that emerged was that the trend in general psychiatry from in- to out-patient services also makes itself felt in forensics, and this may well mean that the courts will become more and more reluctant to send offender patients to the mental health system, because security is very difficult to guarantee outside hospital walls.
Sheffield, industrial host of the IAFP conference, offered a nice re-visiting of old colleagues and friends. The idea of the IAFP however, is as young as ever – gewiss.
Budapest hosted a Group Analytic Symposium with central European grandeur. The big city has plenty of hot water in thermal baths, but also still bullet holes in many houses and perhaps in some people as well. The Hungarian participation in the symposium was small.
Finally, a delegation trip to the Republic of Macedonia. No bullet holes there but highways and airports marked by NATO forces – and some country to stay in. It has been treated like shit by its neighbours for centuries and yet has energy to keep its newly won independence, and in spite of conflicts of all sorts at the same time avoid open war. The poverty was striking, and the high professional medical and judicial standard on that background all the more impressive. Interesting to note was the pronounced difference between prisons and hospitals. In the hospital only very few doors were locked, and the one leading to the forensic unit was not, while the largest prison with some 700 inmates had only 5 escapes during the last 55 years, apparently due to high walls and on top of them armed patrolling prison officers. The atmosphere, however, was humane in both situations, and the Danish delegation could use its own interpreter and talk to anyone it chose – including the only two Macedonain lifers (death penalty was abolished in 1996 and the last execution took place in 1980). There seemed to be no doubt that mentally ill offenders were placed and treated in hospitals.
Meanwhile, the Danish courts blurred the gap between treatment and punishment. Until recently, the sanctions of treatment for mentally ill offenders, which according to the Danish Penal Code are time indeterminate and only to be finished by the court most often lasted as long as suggested to the courts by the psychiatrists, which meant that some, e.g. after homicide committed in depression – were of relatively short duration, while others, e.g. after shoplifting committed by a drug-abusing schizophrenic patient, could go on for years. The time indetermination seemed to have been based on the idea that mental illness itself is of uncertain duration. Now however the "proportional" view is spreading, meaning that the seriousness of the crime more and more determines the length of the sanctions of treatment. Too bad.
More than anything else perhaps, travelling tells you something about your home. Looking forward to seeing you from as many countries as possible in Boston next Spring