Abstract
An examination of the psychological impact of crime on victims focusing on the long term quantifiable harm. The courts measure the physical and psychological damage caused by crime; however the psychological impact is indirect in relation to the harm caused by the crime. This indirect damage, affects the long-term wellbeing of the victim, potentially affecting their socioeconomic status, and the recurring costs for medical treatment. The paper will quantify these indirect damages to enable the courts and society to more effectively handle restitution for the victim.
Introduction
The impact of victimization affects the victim physically, psychologically, and emotionally. These effects are traumas that can be temporary, permanent, or chronic. By categorizing these traumas and assessing their severity, the courts, social services, healthcare, and society are able to quantify the damage caused and attempt to recoup or control the costs. The physical damage to the victim or to their property are quantifiable damages as their treatments and replacements have direct economic cost; while the psychological and emotional damages are relative in nature and do not have an objective economic measure. “In addition to physical injury and financial loss, victims might experience high levels of emotional distress, increased relationship problems, and significant disruptions and problems at school or work” (Langton & Truman, 2014). These issues stem from the determination that “Some of the financial costs of crime – such as property damage, replacement of stolen or damaged items, medical bills, lost days at work, and therapy expenses – are easy to identify. However emotional pain and suffering… and other intangible costs can be difficult to measure.” (Ellis & Wasserman, 2015). This paper will combine research into the economic cost of psychological issues defined in the short-term and long-term, with research into the psychological effects of crime on victims to ascertain both the individual cost and the societal cost of psychological damage as the result of crime as “Penal law has traditionally concentrated on victims’ physical injuries, ignoring the psychological harm.” (Echeburua & Javier, 2003).
Defining Psychological Harm
The necessity in defining which traumas constitute psychological harm and which constitute temporary reactions to the crime complicates the issue of restitution and assigning cause to the crime in harm that is detected or surfaces at a later date. Echeburua and Javier address both of these issues:
“Psychological harm refers, on the one hand, to the acute psychological damage resulting from a violent crime, and which, in some cases, may subside with the passage of time, with social support, or with appropriate psychological treatment; and, on the other hand, to the emotional consequences that persist in a chronic fashion and interfere negatively with the person’s everyday life” and “It is often difficult to make the connection between psychological harm suffered now and the violent event experienced previously. However the establishment of a casual relationship between the violent crime and the psychological damage is essential for making decisions about criminal and civil responsibility”(Echeburua & Javier, 2003).
These definitions and insights set the foundation for evaluation and rehabilitation of both the victim and the offender. By examining the likelihood and severity of crimes causing psychological trauma, the cost of the crime can be directly quantified along with the physical harm.
Evaluating Trauma
For the trauma experienced by the victim to be quantified it must be evaluated. The physical damage is evaluated by the cost of medical treatment for wounds, the cost of replacement of any property damaged or destroyed, and the direct loss of earnings of the victim during the recovery period and trial. For the non-physical harm “The evaluation of psychological harm (the “quantum doloris”) suffered by victims is important for planning treatment, as well as for typifying the harm in criminal terms, setting the appropriate compensation or determining employment incapacity.” (Echeburua & Javier, 2003). To assist in the evaluation of psychological and emotional harm, the World Health Organization (WHO) initiated a study on the Global Burden of Disease (GBD) to evaluate the economic cost. The “GBD focuses on economic costs of illnesses using a metric known as the Disability-Adjusted Life Year (DALY), a weighted composite that combines expected years of lost life with expected years of decreased functioning due to a particular disease.” (Kessler & Greenberg, 2002). Using these evaluations provides both the statistical chances of victims developing psychological trauma and the means to assign an economic cost to them.
Prevalence of Psychological Harm
Studies by Langton and Truman, and Echeburua and Javier on the probability of psychological trauma resulting from crimes found that victims experienced moderate to severe anxiety and distress in 71% of cases of rape or sexual assault, 70% in cases of robbery, 57% for aggravated assault, and 46% for simple assault (Langton & Truman, 2014). The second study focused on rates of Post Traumatic Stress Disorder (PTSD) in victims of violent crime. The studies found that victims of sexual assault and terrorism were 65-70% likely to develop Post Traumatic Stress Disorder, and 46% of domestic violence victims. From the study’s sample of victims of violent crime 54.5% were diagnosed as clinically PTSD. These findings were examined longitudinally and determined that 61% of victims experienced these psychological issues years after the violent crime (Echeburua & Javier, 2003).
The violent events associated with the Irish Republican Army’s secession effort against the United Kingdom from 1969 to 1997 in Northern Ireland have created a unique situation in which the prevalence of psychological harm is far greater than in any other population, coupled with the effects being confined to the same geographical area. These attributes are examined in detail by a study undertaken to determine the economic impact of the conflict. Focusing on PTSD the study further subdivided the trauma into 12 month and lifetime afflictions. The rate of 12-month PTSD sufferers in the adult population was 5.1% and the estimated lifetime sufferers were 8.8%. 27% of these cases (approximately 18,000 adults) are directly linked to conflict-related traumatic events where it is estimated that 66% of the population have experienced at least one of these events in their lifetime (Ferry, Bolton, Bunting, O'Neill, Murphy, & Devine, 2011). Having defined the issue, identified the impact, and quantified the number and rate of affected individuals it is possible to accurately price the economic cost caused by psychological traumas relating from crime.
Economic Cost
The World Health Organization’s study on the Global Burden of Disease “estimates suggest that mental disorders, as a group, are the most costly diseases in the world and that major depression, in particular, is the single most costly disease among people in the middle years of life in terms of overall DALYs” (Kessler & Greenberg, 2002). This finding includes the cost of treatment and the loss of productivity resulting from the individual’s inability to function due to the trauma. These studies on the cost of issues focus on the cost of treatment, or the loss of function; however it is important to determine the cost benefit analysis and if the cost of treatment is worth the increase in productivity.
In the Northern Ireland study it was determined that the direct cost of the trauma was £33 million, while the indirect cost was £139.8 million in 2008. These direct costs are associated with doctor and hospital visits, and medication; the indirect costs are from loss of productivity or reduced productivity at work due to “PTSD and other acute stress reactions” (Ferry, Bolton, Bunting, O'Neill, Murphy, & Devine, 2011). An analysis of financial costs in 1996 in the United States found that crime is “estimated to cost $105 billion annually in medical costs, lost earnings, and public program costs related to victim assistance. Including pain, suffering, and the reduced quality of life increases the cost of crime to victims to an estimated $450 billion annually. Violent crime accounts for $426 billion of this total” (Ellis & Wasserman, 2015). These studies show that the indirect costs associated with psychological trauma outweigh the direct costs on average four to one; £33 million and $105 billion direct costs with £139.8 million and $426 billion indirect costs respectively. Based on these statistics “Would the increased direct costs of treatment be offset by decreased indirect costs in such things as sickness absence, poor work performance, and accidents?” (Kessler & Greenberg, 2002).
The estimation of cost resulting from psychological trauma is determined by the loss of work productivity from the psychological trauma and comparing that trauma with physical trauma resulting in an equal loss of work productivity. The comparison uses the cost of treatment for the physical trauma and assigns the psychological trauma that cost to quantify the psychological trauma. An alternative cost estimation measure is to examine the jury rewards for pain and suffering during trials. Cohen contrasts this method with the previous ones by stating, “these studies are unable to estimate the value of specific types of injuries, and there is no reason to believe that the average work-related injury is identical to the average crime-related injury.” (Cohen, 1988). Cohen also establishes in his critique of this method of accounting that “Although drawing inferences from jury decisions is not an ideal method of determining the monetary value of pain and suffering, jury awards tend to be both predictable and stable.” (Cohen, 1988). This stability and predictability provides a solid basis for determining economic costs however; as such the jury awards can be used to verify the accuracy of other methods of accounting. When written in 1988 this report used an example of “$80 per hour for psychiatric care, they imply the average patient suffering from a traumatic neurosis requires 52 visits and that a patient suffering from a severely disabling injury requires 310 visits.” (Cohen, 1988). By basing these estimates on medical costs, and extrapolating work injury costs, the total economic impact of a psychological trauma due to crime can be estimated to be $24,750 in medical and lost wages, and $97,556 in pain and suffering (Cohen, 1988). An estimate of the annual cost of anxiety disorders in the United States eight years later determined that the most likely cost was $47 billion a year (Kessler & Greenberg, 2002). Both these macro and micro level examinations of cost along with the prior research comparing the long-term psychological damage against the direct physical costs clearly show the economic impact and prevalence of psychological trauma caused by crime.
Conclusion
The severity and statistical likelihood of psychological trauma stemming from crime coupled with the estimated indirect economic costs portrays a stark issue for society. The traditional cost of crime estimations which only take into account the monetary outlay of the criminal justice system such as police and court employee salaries and equipment, added to the repair and replacement costs of physical damage are not enough to fully grasp the impact on the economy caused by crime. A complete picture of the costs of crime can be obtained by taking into account the psychological harm and the associated costs (largest medical issue according to the research conducted by the WHO) and adding these costs to the better understood direct costs. With this complete picture, policymakers and society will be able to structure both the criminal justice system and the medical treatment system to be able to handle the economic impact of billions of dollars in associated costs. Finally, the outlay for treatment while expensive will allow victims to more easily reintegrate their lives and remain a net producer for society “Specifically, what difference does the existence of a particular chronic condition make to the individual’s lifetime profile of productivity?” (Kessler & Greenberg, 2002). With the indirect cost of long-term psychological harm being four times that of the direct cost of medical treatment; an increased outlay in treatment coupled with additional resources for early diagnosis may dramatically reduce the economic cost of crime both by reducing the rate of loss of productivity, and by decreasing the recovery time of the victims.
References
- Cohen, M. A. (1988). Pain, Suffering, and Jury Awards: A Study of the Cost of Crime to Victims. Law & Society Review , 537-556.
- Echeburua, E., & Javier, P. (2003). Evaluation of Psychological Harm in the Victims of Violent Crime. Psychology in Spain , 10-18.
- Ellis, C. A., & Wasserman, E. (2015, April 11). Impact of Crime on Victims. http://www.ccvs.state.vt.us/sites/default/files/resources/VVAA%20Ch%206%20Impact%20of%20Crime.pdf
- Ferry, F., Bolton, D., Bunting, B., O'Neill, S., Murphy, S., & Devine, B. (2011). The Economic Impact of Post Traumatic Stress Disorder in Northern Ireland. Enniskillen: Initiative For Conflict-Related Trauma.
- Kessler, R. C., & Greenberg, P. E. (2002). The Economic Burden of Anxiety and Stress Disorders. In K. L. Davis, D. Charney, J. T. Coyle, & C. Nemeroff, Neuropsychopharmacology: The Fifth Generation of Progress (pp. 981-992). Philadelphia, Pennsylvania: Lippincott, Williams, & Wilkins.
- Langton, L., & Truman, J. (2014). Socio-emotional Impact of Violent Crime. Washington D.C.: U.S. DOJ Bureau of Justice Statistics.