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Vem ska ta hand om galningen? Ett arbete om påföljder för psykiskt störda lagöverträdare

Eriksson, Emilie LU (2011) JURM01 20111
Department of Law
Abstract (Swedish)
Frågan om hur man bör se på straffansvar och påföljder för personer som begår brott under inflytande av en allvarlig psykisk störning är omdebatterade och därtill mycket komplicerad. Intresset av att personer som begår brott möts av en adekvat reaktion på brottet ställs här emot behovet av att tillräckligt beakta gärningsmannens psykiska tillstånd och behov av behandling. Principen att vissa personer bör ges straffrättslig särbehandling på grund av sin psykiska status gäller sedan lång tid, både i vårt land och i andra länder.

I svensk rätt förutsätts för straffrättsligt ansvar inte att den tilltalade är tillräknelig, en allvarligt psykiskt störd lagöverträdare anses inte bara kunna föröva brott utan också dömas till påföljd för... (More)
Frågan om hur man bör se på straffansvar och påföljder för personer som begår brott under inflytande av en allvarlig psykisk störning är omdebatterade och därtill mycket komplicerad. Intresset av att personer som begår brott möts av en adekvat reaktion på brottet ställs här emot behovet av att tillräckligt beakta gärningsmannens psykiska tillstånd och behov av behandling. Principen att vissa personer bör ges straffrättslig särbehandling på grund av sin psykiska status gäller sedan lång tid, både i vårt land och i andra länder.

I svensk rätt förutsätts för straffrättsligt ansvar inte att den tilltalade är tillräknelig, en allvarligt psykiskt störd lagöverträdare anses inte bara kunna föröva brott utan också dömas till påföljd för brottet. Huvuddragen i den nuvarande regleringen av påföljder för psykiskt störda lagöverträdare kom till när brottsbalken infördes år 1965. Genom en reform i början av 1990-talet började en ny lagstiftning om psykiatrisk vård av lagöverträdare att gälla. Reformen innebar bland annat att begreppet allvarlig psykisk störning infördes i lagstiftningen.

Enligt den nuvarande ordningen framstår i vissa fall påföljderna för psykiskt störda lagöverträdare som oproportionella i förhållande till brottets straffvärde. Det kan leda till att psykiskt störda snabbt kommer ut i samhället efter att ha begått och fällts till ansvar för grova brott eller blir föremål för omfattande frihetsinskränkningar vid mindre allvarlig brottslighet. Detta har man försökt komma till rätta med genom bland annat en lagändring i Brottsbalken 2008. Det tidigare gällande fängelseförbudet för personer som begått brott under påverkan av en allvarlig psykisk störning, byttes då ut mot en presumtion för att annan påföljd än fängelse ska väljas. Fängelse får därför numera dömas ut för allvarligt psykiskt störda personer om det finns synnerliga skäl.

För närvarande pågår en utredning som skall göra en översyn av lagstiftningen avseende psykiskt störda lagöverträdare. De har som uppgift att göra lagstiftningen så pedagogisk och lättillgänglig som möjlig och dessutom anpassad till de etiska, medicinska och juridiska krav som bör ställas i samband med tvångsomhändertagande av personer med psykisk sjukdom. Utredningen kommer i korthet innebära att tillräknelighet eller ansvarsförmåga åter ska bli ett krav för straffrättsligt ansvar och att allmänna påföljdsregler skall gälla för den som bedöms vara tillräknelig. Överlämnande till rättspsykiatrisk vård kommer att försvinna som särskild påföljd tillsammans med fängelseförbudet.

Genom att överlämnande till rättspsykiatrisk vård som särskild påföljd avskaffas innebär det att den som har behov av psykiatrisk vård skall få detta behov tillgodosett oberoende av straffrättslig reaktion. Vilket straff som utdöms ska inte längre avgöras av vårdbehovet utan av brottets art. Det innebär att även den psykiskt störde ska dömas till fängelse men att denne ska få verkställa straffet i form av psykiatrisk tvångsvård. På detta sätt skiljer man mellan vården och straffet. Vården ska utgå från patientens vårdbehov och när denne inte längre har något vårdbehov kommer personen att återföras till fängelse.

Utredningen har även fått i uppdrag att se över alternativ till hur man kan införa samhällsskyddsåtgärder. För att särskilda skyddsåtgärder skall komma ifråga måste det föreligga påtaglig risk för nya gärningar av allvarligt slag samt att den som döms till fängelse skall ha begått brottet under påverkan av en allvarlig psykisk störning. Frågan om det går att förutse farlighet och återfallsrisk är hårt debatterad, det finns de som hävdar att det inte går att göra riskbedömningar. Särskilda skyddsåtgärder skall vara åtgärder för att förhindra att en gärningsman på nytt begår en gärning av allvarligt slag, det skall vara en fristående reaktion som är knuten till den otillåtna gärningen eller brottet, och således inte vara en del i påföljds-systemet.

Genom att fler psykiskt störda lagöverträdare, både allvarligt psykiskt störda och psykiskt störda, döms till fängelse ökar risken för oroligheter inne på anstalterna. Det är inte bara fler psykiskt störda som kommer att vistas i anstalterna utan också mer allvarligt psykiskt störda. Ett kvalificerat omhändertagande av psykiskt störda lagöverträdare kräver personal med hög kompetens. Möjligheterna att på ett positivt sätt genomföra de förslag som diskuterats står och faller med tillgången på personal med rätt kompetens och inställning när det gäller att arbeta med gruppen psykiskt störda lagöverträdare. Det är ingen lätt grupp att ta hand om och den ställer stora krav på kunskap, engagemang, tålamod och medvetenhet om de etiska problem och avvägningar som är förenade med verksamheten. (Less)
Abstract
The question of how one should look at penalties and sanctions for persons committing crimes under the influence of a serious mental illness is controversial and very complicated. The interest in that people who commit crimes are met with an adequate response to crime is put up against the need to sufficiently take into account the offender's mental condition and need for treatment. The principle that certain people should be given a criminal special treatment because of his mental status has been the case for a long time, both in our country and other countries.

The Swedish law requires for criminal liability not that the accused is accountable, a seriously mentally disturbed offender is not only able to perpetrate crimes, but also... (More)
The question of how one should look at penalties and sanctions for persons committing crimes under the influence of a serious mental illness is controversial and very complicated. The interest in that people who commit crimes are met with an adequate response to crime is put up against the need to sufficiently take into account the offender's mental condition and need for treatment. The principle that certain people should be given a criminal special treatment because of his mental status has been the case for a long time, both in our country and other countries.

The Swedish law requires for criminal liability not that the accused is accountable, a seriously mentally disturbed offender is not only able to perpetrate crimes, but also liable to the penalties for the crime. The main features of the present regulation of sanctions for mentally disordered offenders were made when the criminal code was introduced in 1965. Through a reform in the early 1990s, a new law on psychiatric care for offenders began to apply. The reform meant that the concept of serious mental illness was introduced in the legislation.

Under the current legislation in some cases the penalties appears for mentally disordered offenders as disproportionate to the seriousness of the crime. It can lead to that mentally disordered offenders quickly come out into society after having committed and been convicted of serious crimes or becomes subject to major restrictions on freedom of less serious crimes. This issue is partly overcome by including an amendment of the Criminal Code in 2008. The previous prison ban on persons, who committed crimes while under the influence of a serious mental illness, was replaced with a presumption that sanctions other than imprisonment should be selected. Prison may therefore now be imposed for seriously mentally ill people if there are exceptional reasons.

There is an ongoing inquiry that will make a review of the legislation for mentally disordered offenders. They have the task of making the legislation as pedagogical and accessible as possible and also adapted to the ethical, medical and legal requirements that should be associated with the compulsory treatment of people with mental illness. The report will briefly mean that accountability or responsibility is going to be a requirement for criminal liability and that the general penalty provisions shall apply to those deemed accountable. Submission to the forensic psychiatric care will disappear as a penalty together with the imprisonment ban.

By abolishing the submission to the forensic psychiatric care as a penalty, it means that those who are in need of psychiatric care will have this need met independent of a criminal response. What kind of punishment to be imposed, will no longer depend on the need for care but the nature of the crime. This means that even the mentally disturbed should be sentenced to prison but that they should execute their sentence in the form of compulsory psychiatric treatment. In this way a distinction is made between treatment and punishment. Care should be assumed from the patient's health needs and when that person no longer has any need for treatment, he or she will be returned to prison.

The inquiry has also been commissioned to review options for how to introduce civil actions. For special protective measures to be considered there must be a substantial risk for new offenses of serious nature and the person who is sentenced to prison must have committed the crime while under the influence of a serious mental illness. The question whether it is possible to predict dangerousness and recidivism is heavily debated, there are those who argue that it is impossible to carry out risk assessments. Special protective measures shall be measures to prevent an offender from recommitting an act of a serious nature, it must be an independent reaction that is linked to the unlawful act or offense, and thus not be part of the sanction.

As more mentally disordered offenders, both seriously mentally ill and mentally retarded, is sentenced to prison the risk increases of unrest inside the prisons. It is not only more psychologically disturbed which will reside in prisons but also more severely mentally retarded. Qualified treatments of mentally disordered offenders require highly qualified personnel. The ability to positively implement the proposals under discussion stands and falls with the availability of personnel with the right skills and attitude in working with the mentally disordered offenders. It is not an easy group to take care of and it demands considerable knowledge, commitment, patience and awareness of the ethical issues and tradeoffs associated with the operation. (Less)
Please use this url to cite or link to this publication:
author
Eriksson, Emilie LU
supervisor
organization
alternative title
Who should take care of the madman? An essay about the penalties for mentally disordered offenders
course
JURM01 20111
year
type
H3 - Professional qualifications (4 Years - )
subject
keywords
straffrätt, criminal law, psykiskt störda lagöverträdare
language
Swedish
id
1975575
date added to LUP
2011-06-09 11:07:29
date last changed
2011-06-09 11:07:29
@misc{1975575,
  abstract     = {The question of how one should look at penalties and sanctions for persons committing crimes under the influence of a serious mental illness is controversial and very complicated. The interest in that people who commit crimes are met with an adequate response to crime is put up against the need to sufficiently take into account the offender's mental condition and need for treatment. The principle that certain people should be given a criminal special treatment because of his mental status has been the case for a long time, both in our country and other countries.

The Swedish law requires for criminal liability not that the accused is accountable, a seriously mentally disturbed offender is not only able to perpetrate crimes, but also liable to the penalties for the crime. The main features of the present regulation of sanctions for mentally disordered offenders were made when the criminal code was introduced in 1965. Through a reform in the early 1990s, a new law on psychiatric care for offenders began to apply. The reform meant that the concept of serious mental illness was introduced in the legislation.

Under the current legislation in some cases the penalties appears for mentally disordered offenders as disproportionate to the seriousness of the crime. It can lead to that mentally disordered offenders quickly come out into society after having committed and been convicted of serious crimes or becomes subject to major restrictions on freedom of less serious crimes. This issue is partly overcome by including an amendment of the Criminal Code in 2008. The previous prison ban on persons, who committed crimes while under the influence of a serious mental illness, was replaced with a presumption that sanctions other than imprisonment should be selected. Prison may therefore now be imposed for seriously mentally ill people if there are exceptional reasons.

There is an ongoing inquiry that will make a review of the legislation for mentally disordered offenders. They have the task of making the legislation as pedagogical and accessible as possible and also adapted to the ethical, medical and legal requirements that should be associated with the compulsory treatment of people with mental illness. The report will briefly mean that accountability or responsibility is going to be a requirement for criminal liability and that the general penalty provisions shall apply to those deemed accountable. Submission to the forensic psychiatric care will disappear as a penalty together with the imprisonment ban. 

By abolishing the submission to the forensic psychiatric care as a penalty, it means that those who are in need of psychiatric care will have this need met independent of a criminal response. What kind of punishment to be imposed, will no longer depend on the need for care but the nature of the crime. This means that even the mentally disturbed should be sentenced to prison but that they should execute their sentence in the form of compulsory psychiatric treatment. In this way a distinction is made between treatment and punishment. Care should be assumed from the patient's health needs and when that person no longer has any need for treatment, he or she will be returned to prison.

The inquiry has also been commissioned to review options for how to introduce civil actions. For special protective measures to be considered there must be a substantial risk for new offenses of serious nature and the person who is sentenced to prison must have committed the crime while under the influence of a serious mental illness. The question whether it is possible to predict dangerousness and recidivism is heavily debated, there are those who argue that it is impossible to carry out risk assessments. Special protective measures shall be measures to prevent an offender from recommitting an act of a serious nature, it must be an independent reaction that is linked to the unlawful act or offense, and thus not be part of the sanction.

As more mentally disordered offenders, both seriously mentally ill and mentally retarded, is sentenced to prison the risk increases of unrest inside the prisons. It is not only more psychologically disturbed which will reside in prisons but also more severely mentally retarded. Qualified treatments of mentally disordered offenders require highly qualified personnel. The ability to positively implement the proposals under discussion stands and falls with the availability of personnel with the right skills and attitude in working with the mentally disordered offenders. It is not an easy group to take care of and it demands considerable knowledge, commitment, patience and awareness of the ethical issues and tradeoffs associated with the operation.},
  author       = {Eriksson, Emilie},
  keyword      = {straffrätt,criminal law,psykiskt störda lagöverträdare},
  language     = {swe},
  note         = {Student Paper},
  title        = {Vem ska ta hand om galningen? Ett arbete om påföljder för psykiskt störda lagöverträdare},
  year         = {2011},
}