Ab Psyhc--Chpt 16- Legal And Ethical Issues

Front 1

People with mental illness who have broken the law or who are alleged to have done so are subject to.....

Back 1

Criminal commitment

Front 2

What is criminal commitment?

Back 2

A procedure that confines a person in a mental hospital either for determination of competency to stand trial or after acquittal by reason of insanity.

Front 3

What was taken into consideration when the concept of men's rea/ "guilty mind", and the rule "No crime without an evil intent" was accepted in English Common law?

Back 3

The concept of Insanity

Front 4

What is insanity?

Back 4

Insanity refers to a disordered mind, and a disordered mind may be regarded as unable to formulate and carry out a criminal purpose.

-A disordered mind cannot be a guilty mind.

Front 5

What type of concept is insanity?

Back 5

A legal concept, not a psychiatric or psychological one.

Front 6

What is insanity defense?

Back 6

The legal term that a defendant should not be held responsible for an illegal act if it is attributable to mental illness or intellectual disability that interferes with rationality or that reasons from some other excusing circumstance, such as not knowing right from wrong.

Front 7

What is insanity defence based on?

Back 7

The accused's mental condition at the time the crime was committed.

Front 8

What percentage of insanity defense has been pleaded in cases?

Back 8

-1%

- Rarely successful when pleaded.

Front 9

What does insanity defense require?

Back 9

It requires the judgment of attorneys, judges, jurors, and mental health professionals.

Front 10

What are the landmark cases and laws regarding the insanity defense?

Back 10

1) Irresistible impulse

2) The M ' Nagahten Rule

3) the American Law Institute Guidelines (1962)

4) Insanity Defense Reform Act (mid 1980s)

5) Guilty but mentally ill

Front 11

What is irresistible impulse (1834)?

Back 11

According to this concept, if a pathological impulse or uncontrollable drive compelled the person to commit the criminal act, and insanity defense is legitimate.

Front 12

What does the M'Naghton Rule (1843) state?

Back 12

The person did not know the nature and quality of the criminal act in which he or she engaged, or, if the person did not know it, the person did not know what he or she was doing was wrong.

Front 13

What does the American Law Institute guidelines (1962) state?

Back 13

1) the person's criminal act is a result of "mental disease or defect" that results in the person's not appreciating the wrongfulnrss of the Act or in the person's inability to behave according to the law (combination of M'Naghten rule and irresistible impulse)

2)"[T]he terms 'mental disease or defect' do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct"

Front 14

What does the Insanity Defense Reform Act (1984) state?

Back 14

1) The person's criminal act is a result of severe mental illness are defect that prevents the person from understanding the nature of his or her crime.

2) The burden of proof is shifted from the prosecution to the defense. The defense has to prove that the person is insane.

3) The person is released from the forensic or prison hospital only after being judged to be no longer dangerous and to have recovered from mental illness. This could be longer than he or she would have been in prison if convicted.

Front 15

What does the Guilty but mentally ill(1975) law state?

Back 15

The person can be found legally guilty of a crime - - thus maximizing the chances of incarceration - - and the person's mental illness plays a role in how he or she is dealt with. Thus, even a seriously ill person can be held morally and legally responsible but can then be committed to a prison hospital or other suitable facility for psychiatric treatment rather than to a regular prison for punishment.

Front 16

What are the two kinds of insanity pleas?

Back 16

1) Not guilty by reason of insanity (NGRI)

2) Guilty but mentally ill (GBMI)

Front 17

What happens in the Not Guilty by Reason of Insanity Plea?

Back 17

1) There is no dispute over whether the person actually committed the crime - - both sides agree that the person committed the crime.

2) The person is not responsible for the crime due to his or her mental illness.

3) The person is committed indefinitely to a forensic hospital.

Front 18

What does the Guilty but Mentally Ill(GBMI) plea allow?

Back 18

1) It allows an accused person to be found legally guilty of a crime - - thus maximizing the chances of incarceration.

2) Mental illness played a role in sentencing.

2a. The person can be committed for treatment until no longer mentally ill.

2aa. The person is sent to prison to serve the remainder of sentence.

3) Most are incarcerated and may or may not receive any psychiatric care.

Front 19

What happens in competency to stand trial?

Back 19

1)The accused must be able to participate in his or her defense.

2) Determination of competency is made before the individual is tried.

2a) Prosecutor, judge, or defense attorney can raise issue

Front 20

When does the 1960 US Supreme Court decision state?

Back 20

1) The test [is] whether [the defendant] has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding

&

2) Whether the person has a rational as well as factual understanding of the proceedings against him.

Front 21

What is another way the courts look at competency?

Back 21

In absentia.

The courts do not want a person to be brought in trial in absentia ("not present")

Hint 21

In absentia is an English Common law that refers to the person's mental state, not his or her physical appearance.

Front 22

What is synthetic sanity?

Back 22

1) If medication can produce rationality, trial can be held

1a) Even if discontinuation of the drug would again render the defendant incompetent.

Front 23

When can force medication be used?

Back 23

Forced medication can be used to restore competency only in very limited circumstances.

Front 24

What is the US Supreme Court stance for executing individuals with mental disorders?

Back 24

1) It is unconstitutional to execute individuals who are insane or had an intellectual development disorder.

1a) execution what constitutes cruel and unusual punishment.

Hint 24

However, definition of mental retardation varies from state to state.

Front 25

What is "Parens patriae"(Power of State?

Back 25

The duty of government to limit freedom for peoples protection.

Front 26

What does "Parens Patriae" allow?

Back 26

It allows an individual to be committed to a psychiatric hospital against his wishes if:

1) The person is mentally ill

2) Danger to self or others

2a) Commitment should end when person is no longer dangerous

Front 27

How can a formal commitment be obtained?

Back 27

It is by court order. Usually the police, a relative, or a friend can request it.

Front 28

How is informal emergency commitment obtained?

Back 28

Initially no court involvement is needed. If a hospital administrative board believes that a voluntary patient requesting discharge is too mentally ill and dangerous to be released, it is able to detain the patient with a temporary, informal commitment order.

Front 29

What is the most common informal commitment procedure?

Back 29

2PC or two physicians certificate.

Front 30

What happens with a 2PC?

Back 30

2 physicians can sign a certificate that allows a person to be incarcerated for some period of time, ranging from 24 hours to as long as 20 days. Detainment beyond this period requires formal judicial commitment.

Front 31

Which commitment affects more people?

Back 31

Civil commitment effects for more people than criminal commitment.

Front 32

What percentage of violent crimes are linked to mentally ill?

Back 32

3%

Front 33

If violent, who are the ones usually targeted by the mentally ill?

Back 33

1) The target is usually family or friends, not strangers.

2) stranger homicide by people with mental illness is extremely rare.

Hint 33

When substance abuse is not a factor, mentally ill are no more likely to commit violent crimes than the average person.

Front 34

What are factors that influence accuracy of violence prediction:

Back 34

1) Repeated violent act in the past

2) Individual returns to the same environment in which passes violent acts were committed and individual's personality has not changed

3) Person is on the brink of committing a violent act

4) Medication non-compliance

Front 35

In the Supreme Court decision, Addington v Texas, what does it state?

Back 35

The state must produce clear and convincing evidence that a person is mentally ill and dangerous before he or she can be involuntarily committed to a psychiatric hospital.

Hint 35

In 1980, the Ninth Circuit Court of Appeals ruled that danger must be imminent.

Front 36

When is the least restrictive alternative provided?

Back 36

When treating people with mental disorders and protecting them from harming themselves and others.

Front 37

What does the right to treatment require?

Back 37

It requires the state to provide treatment after civil commitment.

Front 38

When can a person with mental illness not refuse treatment?

Back 38

Unless the person is a danger to self or others.

Front 39

What happened in the deinstitutionalization?

Back 39

1) In the 1960s, many states release patients from state psychiatric hospitals; community treatment was preferred

2) Many cities lack sufficient community mental health facilities

Front 40

What happens in

transinstitutionalization?

Back 40

1) Many mentally ill end up in nursing homes, hospitals and prisons.

1a) Justice Department survey found that 16.2% of prison population is mentally ill.

Front 41

Who are those being called on to do the work of mental health professions?

Back 41

Police officers. New laws provide funding for special training.

Front 42

What are some research restraints for research in mental illness?

Back 42

1) Ethical restraints to avoid unnecessary harm, risk, humiliation, and invasion of privacy to participants.

1a) Institutional review board (IRB) approval necessary.

1aa) Researchers must receive training in research ethics.

2) Researchers must ensure that mentally ill participants understand risk of research before participating.

2a) Informed Consent

2aa) Sufficient information must be provided to allow an individual to make an informed decision to participate.

2b) Freedom to withdraw at any time for any reason.

Front 43

What must be provided in therapy when treating those with mental illness?

Back 43

1)Confidentiality

2) Priveleged communication

2a) Patient "holds the privelege"

Front 44

How can Confidentiality and Priveleged communication be broken?

Back 44

1) Patient has filed a malpractice suit against the therapist

2) Patient is under age 16 and a crime or abuse victim

3) Patient is trying to avoid arrest for a crime committed or planned

4) Patient is a danger to self or others

4a) Tarasoff decision