What is Wrong with Luka Magnotta? Reflections on Forensic Psychiatry

David Laing DawsonBy Dr David Laing Dawson

Does he have schizophrenia or not? And if he does suffer from schizophrenia, is it the cause of his terrible behaviour? (murder, cutting up his victim and mailing the body parts to various people)

Actually, I’m not going to try to answer that question. Our courts decided he was responsible for his actions, whether or not he suffered from a mental illness.

But this case highlights an absurd inequity in our system. Mental hospitals have been closed, psychiatric beds reduced, psychiatric services limited, but for the past 20 years Forensic Psychiatry has been a growth industry. In some instances our old, a little run down, but functional and humane mental hospitals have been simply converted into maximum secure jails for mentally ill offenders. If Dorothea Dix were alive today she would be writing outraged petitions to our legislators.

We have made it harder for the average family with a mentally ill member to access psychiatric service by excluding the family (privacy laws), by reducing the number of psychiatric beds and staff, and by making it far more difficult to get that family member to the hospital and have the hospital keep him long enough to assess, treat, and stabilize. (Mental health laws and modern hospital management practices).

If that average family with a mentally ill member does get to see me on referral from a family doctor, I will spend about one hour figuring things out, “making a diagnosis”, about one half hour explaining, discussing and instituting treatment, about fifteen minutes documenting all this, another ten minutes trying to get a social worker involved, and then have them come back for “follow up” in two weeks. If I think the ill person needs to be in hospital I will spend half a day, on and off, while they wait, trying to find a bed and negotiate an admission. If my first impressions prove correct, and the treatment starts to help, we will have a series of half hour appointments perhaps every second week to once per month over the next couple of years to get treatment and rehabilitation and recovery on solid ground.

That’s it. We do have other mental health services in many of our communities that are better resourced, but for the most part they specialize with strict criteria and long waiting lists.

Now Luke Magnotta. The only real decision being made so expensively was whether he would be spending the rest of his life in a Prison or a Maximum Security Forensic Psychiatric Hospital. He would probably be safer in the Forensic Hospital, require isolation within the Prison, and perhaps be allowed escorted leaves from the Forensic Hospital a decade from now. In either facility he would receive psychiatric medication, perhaps with a little more care and expertise in the secure Forensic Hospital.

And to make this decision we spent a small fortune. I don’t have a figure but I can guess. Courts and lawyers and psychiatrists. Hours and hours of time spent by more than one psychiatrist examining, writing, reporting and testifying. Twenty-five thousand, a hundred thousand dollars of psychiatric time? A million dollars to house, feed, monitor and treat Mr. Magnotta over the next twenty years?

Now I don’t know if Mr. Magnotta has a treatable psychiatric illness, and if consistent treatment over the past five years would have prevented this tragedy. But it would have been a hell of a lot cheaper.

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4 thoughts on “What is Wrong with Luka Magnotta? Reflections on Forensic Psychiatry

  1. The writer paints the clear Picasso-picture of treatment that we have naively created in our mental illness system.

    This system came about because we had no idea what mental illnesses were. So we used the ‘guess and golly’ thinking to explain what was happening to us, using the knowledge available to us in our Stone Age or Medieval world. This is understandable.

    But here we are in an age where we now have the scientific tools to study the brain.
    Yet too many still cling to the same old magical thinking. And we planned our current mental illness system accordingly. No surprise it doesn’t work and often harms.

    We won’t even consider the latest scientific findings that could stamp out the guess/golly nonsense by educating psychiatrists to help build a science-based system that actually works.

    Liked by 1 person

  2. Dr. David Dawson has clearly summed up the issues around the Magnotta law case and has pointed out clearly that closing hospital beds has presented more costs and danger for the public as well as neglecting people who need treatment. Indeed it is not at all clear whether Magnotta would respond to any treatment. It is not clear what Magnotta ails from, but it is clear that he needs to be held somewhere where he cannot inflict such violence on another person ( including other patients) ever again. Thank you for writing the blog regarding the case. Patricia Forsdyke.

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  3. Yes, but what’s wrong with Luka Magnotta? You did pose the question. Did you not, Doctor?

    I was hoping for expert forensic insight that would help me comprehend this behaviour.

    Is the best we can hope for be that he may have been in a delusional state and we have no way of knowing what those delusions are/were?

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  4. Dear Dr. Dawson, I fear you have made an absurd assumption. That being that individuals with mental illness receiving comprehensive treatment are incapable of evil. It is an interesting and partially truthful expose on mental health services in Canada but it resonates with the ridiculous.

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