Screen and intervene

Would the ability to predict which child might grow up to be a criminal be a good thing?

The Steven Spielberg film Minority Report envisages a world where crime can be detected before it happens. Using the powers of the 'precogs' – mutant humans with psychic abilities –  Tom Cruise tackles 'pre-crime' in a futuristic Washington DC where, as a result, murder has been eliminated.

Outside the realms of science fiction the idea of preventing future crimes by accessing the human brain is gaining currency. Scientists are seeking to discover whether our biology means that some of us are more likely to become criminals than others. Is there, for example, a biological basis for types of behaviour associated with criminality such as impulsive aggressiveness or a failure to feel guilt or remorse?

Brain scanSome exponents of technologies from behavioural genetics and brain scanning are already claiming to be able to identify markers which indicate whether someone might be more susceptible to certain antisocial behaviours or psychopathy. 

The prospect is thus raised that these biotechnologies could be used to identify 'risky' individuals before they have committed an offence, with the aim of intervening with psychopharmaceutical or behaviour therapy in order to divert them from a potential life of crime.

Given the costs of crime, early intervention is undoubtedly appealing to some. Research by Professor Martin Knapp from LSE and colleagues at the Institute of Psychiatry, shows that by the age of 28 those who have had conduct problems in childhood cost society up to 10 times more than who have not had these problems. And clearly the costs to the individual, their family and the community at large are also high.

'It's certainly a miserable life for those young people who get into trouble with the law, end up in prison and have no chance of ever getting a job,' says Professor Nikolas Rose Director of LSE's Centre for the study of Bioscience, Biomedicine, Biotechnology and Society (BIOS). But he urges caution about overstating the predictive capacities of these screening techniques.

'All of these assessments are probabilistic. At best, they can tell us that  someone is part of a group with the genetic or neurobiological profile that has a higher probability of engaging in certain types of behaviour given certain social and environmental circumstances,' he says. 'They certainly don't tell us that an individual is going to become a psychopath, or commit a violent crime.'

Rose also stresses that systems of assessment, are never purely technical evaluations.

'These techniques operate within social and cultural contexts,' he explains. 'And our own society is highly risk averse and values precaution, prediction and pre-emption wherever possible. Although prevention sounds like a great idea,  before introducing some of these screening technologies for psychiatric problems or criminality, we must work through how they would play out in actual contexts, where there may well be pressures to over-diagnose and over-intervene.'

This is especially an issue for children and is an area being studied by Dr Ilina Singh in the BIOS Centre. In the United States, for example, there is an ongoing debate over the question of over-diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) which some argue can predict future antisocial behaviour.
 
Professor Rose explains: 'If a child is causing trouble, teachers and parents want to know why, and to get help. The child gets referred to a doctor, the doctor feels pressure to make a diagnosis and find a solution, the school gets some benefit, the child gets special attention, everyone gets an explanation of little Johnnie's bad behaviour –  so there is a concatenation of factors that make it more likely that there is going to be over diagnosis.

Boy in cap'You may say that over prediction doesn't matter and that is true if the consequences of false positives are benign. However, if I'm a kid and this prediction affects my identity and people's responses – my family, my doctor, my teachers, my social workers -  towards me change because they think I have a violent of antisocial predisposition,  then that that matters.  And if I am convicted of a minor crime, and spend more time in prison because I am over-predicted of committing a future violent offence, then that matters.'

The increased preoccupation with 'risk assessment' in mental health and criminal justice systems in almost all western countries – in an attempt to prevent rare but nasty events happening – also means that the net is widened concerning who is labelled as risky and who is not.

'It's difficult for a professional to judge that someone poses no risk – so everyone in contact with these services gets to be considered a bit 'risky' – of low, medium or high risk, but rarely of no risk,' says Professor Rose.

The UK Criminal Justice Act 2003 included public protection measures whereby individuals considered to be a continuing threat can be detained for indefinite periods on an expert judgement of their dangerousness by a psychiatrist. Initially designed as a measure to detain exceptionally dangerous individuals, by 2007 almost 3000 people were being detained in prison under these provisions and this number is expected to increase to over 12,000 by 2012.

Yet despite lurid headlines and political posturing, there is no evidence that we are more at risk of violence from 'psychopaths' today than in earlier times, let alone at risk from those with a psychiatric diagnosis. Indeed people with mental health problems are themselves at increased risk of becoming victims of crime.

While there are undoubtedly people who are dangerous because of their 'personality disorders', the ubiquitous demand for risk assessment seems not to spring from the reality of danger but to the politics of insecurity. As it is very difficult to predict rare events, attempts to identify 'precrime' are likely to lead to the detention of many people who pose no danger to others, but merely lead lives that are troubling different. This is the dream – or nightmare – of identifying and detaining the potentially risky in the name of community safety.

Posted: June 2010

 

Useful links

'Screen and intervene': governing risky brains|, Nikolas Rose History of the human sciences Vol 23 No 1 [opens in new window] Please note, you may have to pay to access this paper if you do not have a subscription to the journal.

 

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