Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Dec 22, 2017; 7(4): 197-206
Published online Dec 22, 2017. doi: 10.5498/wjp.v7.i4.197
Effect of educational intervention on attitudes toward the concept of criminal responsibility
Akihiro Shiina, Tomihisa Niitsu, Aiko Sato, Soichiro Omiya, Takako Nagata, Aika Tomoto, Hiroyuki Watanabe, Yoshito Igarashi, Masaomi Iyo
Akihiro Shiina, Hiroyuki Watanabe, Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
Tomihisa Niitsu, Aiko Sato, Masaomi Iyo, Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 2608670, Japan
Soichiro Omiya, Social Psychiatry and Mental Health, Faculty of Medicine, University of Tsukuba, Ibaraki 3058577, Japan
Takako Nagata, Ministry of Health, Labour and Welfare, Tokyo 1008916, Japan
Aika Tomoto, Yoshito Igarashi, Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
Author contributions: Shiina A planned the study protocol and mainly wrote the manuscript; Niitsu T managed the seminar and aided for the statistical analysis; Sato A contributed to carrying out the seminar; Omiya S, Nagata T and Tomoto A participated in the establishment of the study protocol; Watanabe H had a role as the conductor of the seminar; Igarashi Y administered the study; Iyo M supervised the whole study and was responsible for the funding; all authors read and approved the final manuscript.
Supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare of Japan, for “Iryo-kansatsu-ho iryo ni tazusawaru jinzai no kakuho to chiiki tokusei wo fumaeta senmonka no ikusei [Cultivating of human resources engaged in the MTS Act and expert training based on regional characteristics].”
Institutional review board statement: The Ethics Council of the Graduate School of Medicine, Chiba University (Candidate No. 1881) has approved the whole study protocol in advance of carrying out our study (August 7, 2014).
Informed consent statement: This study is a questionnaire survey to healthy volunteer. Participants were informed about the purpose of the study before the questionnaire was conducted. Replying the questionnaire was completely voluntary. As the questionnaire was anonymously posted, the authors did not collect any personal information of the participants.
Conflict-of-interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: There is no additional data available other than in this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akihiro Shiina, MD, MSc, PhD, Associate Professor, Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuoh-ku, Chiba 2608670, Japan. shiina-akihiro@faculty.chiba-u.jp
Telephone: +81-43-2227171
Received: June 14, 2017
Peer-review started: June 19, 2017
First decision: July 20, 2017
Revised: August 3, 2017
Accepted: September 12, 2017
Article in press: September 12, 2017
Published online: December 22, 2017

To evaluate the effect of educational intervention on individuals’ knowledge of and attitudes toward forensic mental health.


We conducted a questionnaire regarding attitudes toward various ideas about forensic mental health. The respondents attended a 1-h seminar regarding forensic mental health after answering the questionnaire. On completion of the seminar, the respondents answered another questionnaire containing many of the same questions as contained in the pre-seminar questionnaire.


A total of 86 individuals attended the seminar, and 78 responded to the questionnaire. Only 13 (18.8%) participants were supportive of the concept of criminal responsibility initially, and there was a statistically significant increase in those who became more supportive after the seminar, with 22 (33%) being supportive after the seminar (Wilcoxon signed-rank test, P < 0.001). Logistic regression analysis revealed that participants who were skeptical about forensic mental systems and those with fewer opportunities to see media reports regarding psychiatry were likely to become supportive of criminal responsibility after the intervention.


These results suggest that public attitudes toward criminal responsibility and mental health can be influenced via educational interventions.

Keywords: Forensic psychiatry, Criminal responsibility, Psychiatry, Law and Ethics, Public policy, Education in psychiatry, Anti-stigma in psychiatry

Core tip: Many people have an unsympathetic attitude against offenders with mental disorders. However, this seems, to some extent, to be attributable to a lack of precise knowledge about forensic mental health. We prove that public opinion toward criminal responsibility and relevant ideas regarding forensic mental health can be amended via brief educational interventions. Access to accurate information can help to reduce discrimination against offenders with mental disorders.