American Hangman is a movie that shows us what might be possible future repetitive actions when people feel helpless in the face of wrongful determination of crime. Already we see people live-streaming suicide in the face of helplessness to set their life right.

Mental Health of Paul William Gager: An innocent man, he has been ‘killed’ that morning for a crime he did not commit. A poorly communicative/uncommunicative man, living on an isolated estate. “A loner living out in the country”. He has removed all internal walls of his house because of “Claustrophobia”, has an “odd” hobby of metal detection, and has built rabbit hutches/homes of road construction signs! He is also possibly homosexual as he was once arrested for sexual abuse for trying to pick up a 36 yr old man. Odd, yes. Eccentric, possibly. Crazy, maybe – maybe not! Guilty, definitely NOT! The movie shows, how the above information has been interpreted by the media, the police, the judiciary and the society as evidence of a crazy, psychopath and thus been prosecuted and convicted for a murder he did not commit. A psychiatric evaluation was denied by the judge, “for his own protection”!

The question I want to raise is, do you feel there are mental health issues here? I perceive them both in Mr Gager as well as the Police and Judiciary who incriminated him wrongly.

Paul Wiliam Gager is suffering from a fear of closed spaces-Claustrophobia; which is why he knocked out the internal walls of his home. This is an anxiety disorder, treatable with medicines and therapy. I see such patients every day and help them overcome their fear. Whether it is an avoidance of lifts or of travelling in the underground metro or even of the bathroom door being closed; Psychiatrists help such disorders every day. It is treatable, and help is available.

Along with Claustrophobia, is the mention of being a loner, uncommunicative, and being isolated. This is often a result of social anxiety, another co-morbid anxiety disorder leading to withdrawal, avoidance and isolation from society, friends and family. Such persons can be helped by home visits of Mental Health Professionals or even Video chat via Skype or Whatsapp. I do assess people with social anxiety, who are unable to come to my clinic (because of their anxiety) and give sessions of therapy aimed at helping cope with the anxiety, reassuring, answering and clarifying queries and encouraging treatment. But if a person with such anxiety is arrested by the police for a crime he did not commit, I strongly doubt the ability to defend himself or even provide coherent information. A psychiatric evaluation should be a definite part of the pre-trial assessment, which would enable the Psychiatrist to identify both the disorder as well as the inability of such a person to defend himself in court from allegations as atrocious as a murder of a 14 year old girl.

The mental health (or lack thereof) of the public, media, the police and the judiciary are one of the highlights of the movie. ‘Ignorant’ is the word used, but so is ‘corrupt’, ‘blood thirsty’, ‘incompetence’, and ‘corner cutting judiciary’. When a 14 yr old girl is kidnapped and later found murdered, the media goes hyper (as it does), as if that is the only bad thing happening and as if the arrest of the accused would set everything right. The police, pressured to find a criminal, ‘create’ a ‘rock solid’ case against an innocent man, and the Judiciary races to convict and hang him. This thought process is one of the causes of the injustice in this movie. Society as a whole does not balance the possibility of (another) wrong being done in its undue haste to ‘solve’ the crime. Worse still, society with the uninhibited, loud, biased and often illogical discourse by the print and electronic media, are quick to point, blame, and sacrifice any one to satisfy its desire to take revenge-‘An eye for an eye, tooth for tooth’.

For an individual, being unbalanced, being loud, biased and illogical would be enough to be termed mentally unwell or crazy, BUT who will call out the media and our own society the same. Unless we can have logical, rational thinking we cannot aim to be civilized. More importantly, identifying odd and eccentric behaviour and not labelling them as crazy or necessarily criminal will be the first step in striking the balance between the mentally well and unwell.

People can be different, in terms of thinking and behaviour and yet we have to accept them and include and integrate them in society. That does not happen. Most often, in schools, in colleges and in organisations, we push away, almost exclude people who are quiet, introvert, and withdrawn. The positive action would be to include such people, ask them for an opinion, listen to them and thank them for what they have to add. That would be true inclusion.

Keeping mental health professionals away from influencing policy decisions, from allocating resources, and away from the investigative and judicial process is another sign of disempowerment of those with mental health problems. As I have written before in my Blog, the Child Welfare Department of the Govt of Delhi, excludes Doctors esp Psychiatrists from being members of the CWC. This despite the fact that the whole reason for intervention by the State in a child’s life is to enable the complete physical and mental health of the future of the society. Yet they exclude mental health professionals, isn’t that because they view it differently. Sadly, this indirect behaviours of society stigmatises anyone with a mental health problem.

Mental Health of the main character Henry David Cole: The movie shows us how an individual, the main protagonist, feels wronged, exasperated, frustrated and disappointed by the wrongful conviction of a man for a murder that he did not commit.

What do you do when an innocent man is killed by the government for a crime that he did not commit, when you know that man was innocent because you yourself had committed the crime(!), when during your interaction with investigative police you leave them clues to tell them where the crime took place, who did the crime and yet the police under the glare of media frenzy and the hurriedness to punish somebody catches hold of an innocent, gullible, dis-empowered man and proves that he did the crime. Would you feel helpless or would you feel angry or disappointed? If you do feel helpless, then your emotional health is preserved, your ability to feel when wrong is done is present. On the other hand, if you were a psychopathic serial killer who did not have any feelings for society, humanity, children or your victim then you would feel happy. You will celebrate, you would plan more crimes because you have been allowed to go free, because you have been empowered by the police to commit more crimes and that despite investigation they would prosecute somebody else and hang that man to death for a crime he did not commit.

That is the basic difference between a psychotic killer or a psychopathic serial killer versus a person who commits a crime knowing that it is wrong, frustrated that he could not stop himself from doing the crime, wanting to be punished for it so that he may not do it again and yet feeling helpless that the state, the big papa, the justice that society should have done, does not allow him to stop doing what he knows is wrong and yet does.

He is so angry at the wrongful conviction of an innocent man that he decides to abduct the judge who presided over the court which pronounced Paul Gager guilty of a crime he hadn’t committed. The truth is that Cole himself is the man who had abducted and murdered Claudia Jeeter, and thus he ‘knows’ that Gager is/was innocent.

The movie is about the trial by social media of the judge, and Cole goes on to prove the judge Guilty.

To movie reviewers, Henry Cole appears to be a crazy, raving mad, or a psychopath. Let me prove them wrong. Cole’s ability to plan the abduction and the virtual trial on social media of the retired Judge, is proof that he is not stupid or intellectually impaired. More importantly, Cole does not feel happy that he hasn’t been caught, instead he feels its an absurdity that despite a 2 year manhunt, and despite him giving clues to the police he was never arrested. He feels guilty not only about his crime but also remorseful that an innocent man has been killed. So he conducts this trial on social media to prove that he was the criminal who should have been punished, and ‘for justice’: ‘A man is guilty of taking the life of another man. If convicted, that guilty man must be put to death’. That doesn’t sound crazy, does it!? (Spoiler Alert: Further, he does not kill the judge but ‘allows’ the police to execute the Judge! Justice served)

Feeling guilty and remorseful is not what Psychopaths feel, as by definition they don’t have the capacity to feel good human emotions.

Cole describes his emotions of regret when he “takes the 14 yr old girl’ He describes how it was a ‘horrible thing to do . . . . . whole life up until then just shattered . . . . . into a million pieces . . .’ He expected himself to be caught, tried and punished but was horrified when Ganger was instead not only arrested but convicted and hanged!

As a Psychiatrist, I detect the unfortunate, unreasonable, unstoppable URGE and IMPULSE that characterise so many heinous crimes but which are looked upon differently by our present society. In Cole’s words: ‘slowly he realized that he wanted to possess that purity, hold it in his hand like a snowflake, protect it from being sullied” It wasn’t sexual, it wasn’t a serial crime, it wasn’t for pleasure, it was a spur of the moment crime.

Yes, Cole needs an assessment, a Forensic Psychiatric assessment and following that he would have been treated for reducing, coping, and challenging such urges and impulses; treatment similar to what a gambler, a shoplifter, a compulsive buyer, a sexually compulsive, a pyromanic (fire setter) or an internet addict gets. We do not label them as psychopaths, even though the consequence of some of the above impulse control disorders can be devastating for society and definitely for families.

The brain circuits of such persons are unfortunately dysfunctional making ‘reward seeking behaviours’ or ‘harm avoidance behaviours’ as the focus or priority of the thoughts and emotions, rather than being regulated by the rational/thinking part of the brain. This disorderly flow of information in the brain, worsens without treatment and hence early detection and speedy treatment is essential to prevent major damage from occurring.

Watch the film for two reasons:

1. Trial by social media will soon be more frequent, just as suicide on social media is now a reality.

2. For understanding what goes through the mind of a person who has impulse control disorder.