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Notes -
Druggie's are one thing that is rather complicated, but for the mentally ill, especially at the level of severe mania and psychosis....they aren't making informed and considered choices, the disease gets in the way.
If someone lives a healthy, normal life, then gets frontal lobe damage and becomes an asshole....that's not their fault. We might lock them up to prevent them from threatening others, but the substrate is damaged and they can't make decisions required to stay out of trouble.
if your brain is telling you that you are NORMAL and HEALTHY and that medical people and government people are out to get you, then you can't make the right decisions. That's what a delusion is.
In very careful and controlled circumstances we can work around it, but it's depressingly rare. Many people feel great and are normal with meds (and want to continue), but then they get sick and metabolize a dose differently and then the whole thing starts again.
Do not underestimate the way severe mental illness impairs your ability to make the right choices, hell some of the medications have side effects like "compulsive gambling."
There comes a point where "is it their fault" doesn't matter. If someone is regularly violently criminal, it doesn't matter if it's because of a brain injury or they're just a sociopathic asshole, what matters is that they be stopped from victimizing other people. Whether or not they are morally culpable is a secondary concern over the need to incapacitate them for the benefit of their would-be victims.
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