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Was Raoul Moat mad or just bad?


2:58 pm - July 17th 2010

by Guest    


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contribution by Zarathustra

In the news this week were claims that Moat had requested psychiatric help, the inference being that if he had received it the Northumbria shootings might not have happened. Was Moat mad or bad? And if he was the former, could mental health services have helped him?

I didn’t know Raoul Moat, but as a mental health nurse I’ve learned to be cynical about people who suddenly ask for psychiatric help at a time when they’re facing criminal charges. My cynicism isn’t lessened by the claim that he was offered a psychiatric assessment but didn’t turn up.

Is there any evidence that Moat had a mental illlness?

Moat was a deeply paranoid, emotionally unstable man, prone to “eruptions of anger” he had recently been in prison for assaulting a 9-year old child. Although he had only one previous conviction (for common assault) he had been arrested 12 times.

I can’t find any information on his early upbringing, but from my time in Child and Adolescent Mental Health Services (CAMHS) I’ve seen this kind of dish being baked, and the recipe usually goes something like this.

Select one child from a chaotic family background, preferably one with hefty lashings of poverty, criminality and substance misuse. Prepare the dish by basting with varying permutations of physical abuse, sexual abuse, emotional abuse and neglect.

Expose your prepared dish to social services, ensuring that your social worker is overwhelmed by massive caseloads and strangled with red tape. For best results use an inexperienced, recently-qualified social worker, serving his time in child protection until he can get the hell out of there to a less stressful role where there’s not such horrific consequences of getting it wrong. If the social worker shows signs of getting too close, simply transfer the dish to a new locality where the family isn’t known to social services – you may need to repeat this process several times. Allow to simmer and baste frequently.

Now that your dish is cooking nicely, pop him into foster placements, transferring the dish when foster carers find him too hot to handle. Season with handfuls of CAMHS, Youth Offending Services, educational Welfare Officers and voluntary agencies. Marinade regularly with whatever street drugs happen to be available.

Et voila, you now have an angry, fucked-up kid with chaotic attachments. The dish will settle into an angry, fucked-up adult who will no doubt spend a great deal of time in Her Majesty’s lockups.

There’s a helpful psychiatric diagnosis for the resulting platter – antisocial personality disorder (ASPD).

There’s also the question of what psychiatry could actually do to help someone like Raoul Moat. People with ASPD tend to be service-avoiders, not service- seekers. They don’t generally come to mental health services saying, “Please treat my antisocial personality.” Besides, the evidence base for effective treatments of ASPD is at best limited.

Anger management? Do me a favour. We get regular requests for anger management in CAMHS. Despite what the evidence-base says, in clinical practice I’ve found it to be little more than a CBT sticking-plaster, barely covering a whole slew of much more complex issues than “I can’t control my anger.” And that’s assuming the client wants to control their anger.

Many don’t, because they perceive a lot of advantages to getting angry. Domination of others, alpha male status, the adrenalin thrill of kicking somebody’s head in.

Ultimately I didn’t know Raoul Moat, though I’d hazard a strong guess that his upbringing was a traumatic, abusive one. Even so, I don’t feel that there’s much that psychiatry could have done to “help” him, unless interventions had taken place at a very young age.

And while I can feel a certain amount of sympathy for his doubtless-horrific early life, I’d rather reserve the bulk of my sympathy for Chris Brown, Samantha Stobbard and PC David Rathband.

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Reader comments


1. Rhys Williams

There are thousands of Raoul Moats. Muscle bound, steroid taking bullies who usually work as doorman. They are usually found beating the crap out of drunk teenagers or obtaining E’s for pissed up numpties.

There is evidence anyway that traditional treatments like psychotherapy make psychopaths worse. So quite possibly by refusing him help, they saved lives.

3. little keithy

Don’t know if he was mad or bad. However, I do think there is an element of the social bandit or Robin Hood about how the story has developed. How he was failed and persecuted by authorities and how he is lauded in the north east by thousands. Here is an article about it http://tinyurl.com/2wne96c

Chris Brown?

Raoul Moat killed the guy who smacked Rihanna in the face?

Sounds like a fair cop to me.

(j/k)

5. Dick the Prick

Mad, bad, dangerous to know and beyond all hope of redemption. Ooops, sorry, wrong thread.

@Zebura

“There is evidence anyway that traditional treatments like psychotherapy make psychopaths worse.”

Where is this evidence?

7. Cynical/Realist?

So basically your article spells out how social/mental health services can get it badly wrong and help create conditions for conditions at least similar to Moat’s – and then obsolves all responsibility for saying there’s nothing can be done to help people like that. Which one is it?

What seems to me to be the case with Moat is that the man was very serious trouble just waiting for the cork to blow. The responsibility for his crimes rests with him. But that doesn’t stop the medical and prison services looking at their actions too.

@7.

So basically your article spells out how social/mental health services can get it badly wrong and help create conditions for conditions at least similar to Moat’s

No, dysfunctional and social family conditions generally “help create conditions for conditions at least similar to Moat’s”.

People like Moat can be helped by social and mental health services – but only when they’re children. As I said, in the original post, “don’t feel that there’s much that psychiatry could have done to “help” him, unless interventions had taken place at a very young age.

Abuse can be stopped during childhood and post-abuse therapy can be provided, but that is not the same thing as expecting psychiatry to change the personality of a 37 year old man from a violent psychopath to that of a law-abiding citizen.

9. Flowerpower

Moate’s brother Angus has a degree in Politics from Nottingham University and works for HM Customs and Revenue.

He had exactly the same family upbringing as Moate: dippy hippy mum; absent dad.

At the risk of stirring the nature vs nuture thing again – the two lads had different dads.

10. Shatterface

‘Ultimately I didn’t know Raoul Moat, though I’d hazard a strong guess that his upbringing was a traumatic, abusive one.’

I’m guessing he had too much caffeine. Or he lost some music reinstalling iTunes. Or he heard ‘My Family’ was coming back.

I’m yet to read any actual *informed* comment on Moat. I don’t need anyone to ‘guess’ on my behalf.

He was a bit mental. But the whole thing could have been prevented had he been on radar with the social services.

Sounds like the same debate as the one about Peter Sutcliffe: ‘mad’, ‘bad’ or (as Joan Smith argued in her book Misogynies) ‘male’. Take your pick, according to preference.

There’s an interview in today’s Guardian with Moat’s brother which gives a bit more info about their upbringing.

It seems Mum was mentally ill – the interview describes some psychosis. Angus Moat alleges Mum was also emotionally abusive and didn’t show maternal warmth.

As Flowerpower says above, Angus Moat seems to have come out better-adjusted than Raoul – from the Guardian interview, that might be because apparently their step-Dad was physically abusive to Raoul but not to Angus. Even so, Angus describes struggling with his own demons. He refers to having been given nicknames like “Angry Angus” and “Anguish”, and has used antidepressants and psychotherapy.

What I dislike about the news reports is the suggestion that if Raoul had seen a shrink, then he would’t have committed the murders. Even with the best mental health services in the world (and Lord knows we haven’t got that), it simply isn’t realistic to expect psychiatry to be a giant social-engineering project that sorts out all the fucked-up aspects of the world. The brutal truth is sometimes fucked-up people do fucked-up things, and it can’t always be predicted if/when they’ll do them.

Besides, Raoul Moat was offered a psychiatric assessment, and he didn’t turn up.

[deleted]

Couldn’t agree more, zarathustra, speaking as a now retired CPN. There has come into being a wholesale tendency to medicalise problems of life, psychiatrise them, in fact. This is augmented by a general shift over the past couple of decades in the general view of human beings as vulnerable, fragile creatures. And in tandem with this has come a growing expectation from the public that there is an answer to every problem, and if he professionals haven’t found it their not trying hard enough.
I have always remembered one particular case. I assessed a young man at the GP’s request, the GP saying he could detect no signs of mental illness, but hinted that this bloke’s mother was vulnerable. I found no signs of formal mental illness at all and informed the GP. A few days later his mother turned up at the centre asking to see the person who had seen her son. She had a massive black eye. Did she ask for help? No. “He’s got to have help” she pleaded. My suggestion that it was she who needed help fell on deaf ears. Then you get the families demanding that Johnny getsthe “right kind of help” or the right medication.
And as for “anger management”, our local secure unit gave it up because half the referrals never turned up, and the other half came once.
The idea that anyone can be changed for the better given the right remedy is widespread, and completely fallacious.

It doesn’t surprise me that Flowerpower would take the opportunity to use this case to forward his ‘nature’ argument, but, unless siblings are identical, they are all subject to different environments, as Zarathustra illustrates with Moat’s brother, and this is the case when siblings have the same mother and father.
But back to Moat and his actions, even if he had a mental health problem, this would not, in itself, account for his actions any more than the fact that he had broken his leg when he was a child. Attempting to establish cause will be central to this investigation, no doubt the social services and mental health services will somehow be blamed for not keeping their crystal balls to hand.

17. Flowerpower

steveb

unless siblings are identical, they are all subject to different environments

I don’t think you’ve quite grasped this genetics thing, have you?

18. Roberto M

You haveall forgotten Fiona Pilkington who murdered her daughter and killed herself. She had also been asking for help for a very long time.
It is not Moat, itis not Fiona or manymore like them – itils the failure of the sysmte (Police Council Servces etc.)

I don’t think Raoul’s background fits mentalnurse’s classic underclass scenario. But, as study after study shows, fatherless children, even after controlling for the lower income of single parents, do worse on pretty much every measure of human achievement.

As A.H. Halsey puts it in his foreword to “Families Without Fatherhood” :

“The children of parents who do not follow the traditional norm (i.e. taking on personal, active and long-term responsibility for the social upbringing of the children they generate) are thereby disadvantaged in many major aspects of their chances of living a successful life. On the evidence available such children tend to die earlier, to have more mental illness, to do less well at school, to exist at a lower level of nutrition, comfort and conviviality, to suffer more unemployment, to be more prone to deviance and crime, and finally to repeat the cycle of unstable parenting from which they themselves have suffered.”

There’s nothing we can do about it, though. As Sunny so perceptively pointed out a month or so back, people who have children and don’t get married wouldn’t be any more likely to stay together if they DID marry each other. His conclusion is that people who don’t marry are just the kind of people with low commitment to the relationship, who are more likely to split (aka desert the kids), married or not !

With all due respect Roberto, I don’t think Fiona Pilkington and Raoul Moat are comparable cases.

Fiona Pilkington repeatedly asked for help (from the police rather than mental health services) due to the gangs who were abusing her, and killed herself and her daughter when it became all too much.

By comparison Raoul Moat only suggested he needed he needed psychiatric help on one occasion (as far as we know) and that was at a time when he was sitting in front of a bunch of social workers and police facing criminal charges. As I said in the original post, spend enough time in mental health and you quickly learn to be suspicious of people who suddenly declare, “Oh no, I need help with my mental health problem” when they’re in trouble with the cops. Besides, he was promptly offered a psych appointment and he didn’t attend it.

Incidentally, mental health services wouldn’t have been able to help Fiona Pilkington either unless the police had got their act together first. It’s widely-acknowledged that psychotherapy for ongoing abuse is completely useless. The first priority is to stop the abuse, and THEN you offer therapy.

Nature vs. nurture – that lovely debate. From my perspective, it’s always a bit of both – with the added note that your ‘nature’ often informs the kind of environment you end up in. Even simple things like birth order can have massive effects on the kind of company you keep.

I do often wonder why I didn’t turn out like my two brothers; the best answer I’ve managed to come up with is that, since I was bullied more, I ended up with a simmering hatred of ‘that kind of person’, which gave me the energy to get an education and escape to more stable middle-class climes. I certainly don’t have a ‘social responsibility’ gene that they lack, or something equally fantastical.

“As I said in the original post, spend enough time in mental health and you quickly learn to be suspicious of people who suddenly declare, “Oh no, I need help with my mental health problem” when they’re in trouble with the cops”.

And blokes (it usually is blokes) who get referred for a mental health assessment just before they’re due up in court, particularly when they say “I think I need counselling. My mate’s having it”.

17
Ah. you must mean the gene that compels me to contradict bigots on LC, got you.

the guy was a cnut and a useless coward..fcuk him.

I have a couple of questions for Zarathustra:

1) does the alleged fact that his mother was mentally ill, he himself had attempted to commit suicide once, and his brother had also suffered from some sort of breakdown before (I get all of this from the brother’s Guardian interview) perhaps suggest that he did indeed have an inclination towards mental illness? Isn’t mental illness hereditary and don’t suicidal tendencies suggest that kind of inclination?

2) does the fact that he first asked for help and then didn’t keep his appointment, suggest that he was not really in need of help, but rather was exaggerating his mental state in the face of criminal charges? (so when he was offered help he didn’t bother to turn up)
or could it equally suggest that he was in two minds whether he needed help? (so he cried for help on one occasion, and was then in denial of needing it on another)


Reactions: Twitter, blogs
  1. Liberal Conspiracy

    Was Raoul Moat mad or just bad? http://bit.ly/9sgee4

  2. David O'Keefe

    RT @libcon: Was Raoul Moat mad or just bad? http://bit.ly/9sgee4

  3. Lola Snow

    Reading: "Was Raoul Moat mad or just bad? | Liberal Conspiracy" ( http://bit.ly/dyDoOU )

  4. Mark Ferguson

    Interesting post on Raoul Moat re: mental health http://bit.ly/9HOxRg

  5. This Week in Mentalists: Raoul Moat Will Blow You Away Edition « Mental Nurse

    […] considerable debate taking place on the Raoul Moat post (a revised version of which is now up on Red Hot Liberal-on-Liberal Action), I’d just like to say that we will not be hosting any of the Raoul Moat jokes that are […]





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