Relevant for bioethicists, policymakers as well as diversity, inclusivity and otherisation researchers but also animal rights activists, political philosophers and others, even anyone who wonders about what's behind stalking, perhaps because you want to lower the chance that you become stalked and hacked if you're an independent professional, small-business owner, self-employed or a freelancer.
The current approach, namely that stalking is a regular police matter, does not work. In my opinion, assessing and investigating stalking should become the domain of specialized task forces containing specialized psychologists, psychiatrists and IT specialists. They’d be much more efficient and effective.
Police now waste a lot of time and resources on “stupid shit” that is not actually stalking. It leads to police fatigue, the assumption that any new reported incidence of stalking is bound to be more time-wasting “stupid shit”. (Many police officers prefer to investigate issues like money-laundering.)
Police do not have the required psychology and psychiatry knowledge. It is fair to say that the stalking knowledge of the average police officer is similar to that of the average homeless meth addict. Police officers are not able to distinguish between cases that are merely “stupid shit” and cases that contain a serious threat to someone’s safety.
Currently, going to the police is often the worst thing to do when you are being stalked in a worrisome manner. It enrages the stalker but also confirms that he is in control and untouchable.
Police do not have the required IT knowledge. It is a persistent myth that stalkers always only use their own public name in digital stalking and never use advanced IT knowledge. And, unfortunately, police take any kind of printed digital matter at face value. (I could easily fake printed evidence that anyone – even, say, Barack Obama or Donald Trump – sent me an e-mail stating that he is going to kill me. If I use the name of any random local individual and print that faked e-mail to me, police are likely to accept it as evidence. Police prefer printed matters as they can be scanned into the computer system whereas any kind of other evidence “would likely get lost”.)
Police clearly failed Shana Grice who was fined for wasting police time when she reported stalking, then was killed by her stalker.
Police may actually have precipitated the murder of Molly McLaren but, in any case, could and should have foreseen the attack on her, hence should have acted to prevent it, in theory. The murder of Bijan Ebrahimi could have been prevented too.
This is not the fault of the police. It is the result of police being unequipped to deal with stalking cases.
Shana Grice’s, Bijan Ebrahimi’s and Molly McLaren’s are examples of sad cases that make it into the limelight. Most don’t, yet happen anyway.
On the other hand, cases of stalking can also involve people with, for example, certain intellectual deficiencies whose behaviour puzzles other people so much that they don’t know how to deal with it and feel stalked. Police do not know how to deal with that either. Criminalizing such people (with learning difficulties or intellectual disabilities) serves no purpose whatsoever, and only does harm. It is a matter of educating the public. (I once spotted a poster about this at my local police station, from a foundation or charity.)
As a psychiatrist, I find that one of the hardest parts of my job is telling parents and their children that they are not to blame for their illness.
Children with emotional and behavioral problems continue to suffer considerable stigma. Many in the medical community refer to them as “diagnostic and therapeutic orphans.” Unfortunately, for many, access to high-quality mental health care remains elusive.
An accurate diagnosis is the best way to tell whether or not someone will respond well to treatment, though that can be far more complicated than it sounds.
I have written three textbooks about using medication in children and adolescents with emotional and behavioral problems. I know that this is never a decision to take lightly.
But there’s reason for hope. While not medically able to diagnose any psychiatric condition, dramatic advances in brain imaging, genetics and other technologies are helping us objectively identify mental illness.
Separating out normal behavior from problematic behavior can be challenging. Emotional and behavior problems can also vary with age. For example, depression in pre-adolescent children occurs equally in boys and girls. During adolescence, however, depression rates increase much more dramatically in girls than in boys.
It can be very hard for people to accept that they – or their family member – are not to blame for their mental illness. That’s partly because there are no current objective markers of psychiatric illness, making it difficult to pin down. Imagine diagnosing and treating cancer based on history alone. Inconceivable! But that is exactly what mental health professionals do every day. This can make it harder for parents and their children to accept that they don’t have control over the situation.
Most important of all is making sure your child is assessed by a licensed mental health professional experienced in diagnosing and treating children. This is particularly important when medications that affect the child’s brain are being considered.
Seeing the problem
Thanks to recent developments in genetics, neuroimaging and the science of mental health, it’s becoming easier to characterize patients. New technologies may also make it easier to predict who is more likely to respond to a particular treatment or experience side effects from medication.
Our laboratory has used brain MRI studies to help unlock the underlying anatomy, chemistry and physiology underlying OCD. This repetitive, ritualistic illness – while sometimes used among laypeople to describe someone who is uptight – is actually a serious and often devastating behavioral illness that can paralyze children and their families.
Through sophisticated, high-field brain imaging techniques – such as fMRI and magnetic resonance spectroscopy – that have become available recently, we can actually measure the child brain to see malfunctioning areas.
We have found, for example, that children 8 to 19 years old with OCD never get the “all clear signal” from a part of the brain called the anterior cingulate cortex. This signal is essential to feeling safe and secure. That’s why, for example, people with OCD may continue checking that the door is locked or repeatedly wash their hands. They have striking brain abnormalities that appear to normalize with effective treatment.
We have also begun a pilot study with a pair of identical twins. One has OCD and the other does not. We found brain abnormalities in the affected twin, but not in the unaffected twin. Further study is clearly warranted, but the results fit the pattern we have found in larger studies of children with OCD before and after treatment as compared to children without OCD.
Meanwhile, the field of psychiatry continues to grow. For example, new techniques may soon be able to identify children at increased genetic risk for psychiatric illnesses such as bipolar disorder and schizophrenia.
New, more sophisticated brain imaging and genetics technology actually allows doctors and scientists to see what is going on in a child’s brain and genes. For example, by using MRI, our laboratory discovered that the brain chemical glutamate, which serves as the brain’s “light switch,” plays a critical role in childhood OCD.
What a scan means
When I show families their child’s MRI brain scans, they often tell me they are relieved and reassured to “be able to see it.”
Children with mental illness continue to face enormous stigma. Often when they are hospitalized, families are frightened that others may find out. They may hesitate to let schools, employers or coaches know about a child’s mental illness. They often fear that other parents will not want to let their children spend too much time with a child who has been labeled mentally ill. Terms like “psycho” or “going mental” remain part of our everyday language.
The example I like to give is epilepsy. Epilepsy once had all the stigma that mental illness today has. In the Middle Ages, one was considered to be possessed by the devil. Then, more advanced thinking said that people with epilepsy were crazy. Who else would shake all over their body or urinate and defecate on themselves but a crazy person? Many patients with epilepsy were locked in lunatic asylums.
Then in 1924, psychiatrist Hans Berger discovered something called the electroencephalogram (EEG). This showed that epilepsy was caused by electrical abnormalities in the brain. The specific location of these abnormalities dictated not only the diagnosis but the appropriate treatment.
That is the goal of modern biological psychiatry: to unlock the mysteries of the brain’s chemistry, physiology and structure. This can help better diagnose and precisely treat childhood onset mental illness. Knowledge heals, informs and defeats ignorance and stigma every time.