Chapter 10: Mentally Disordered Offenders

Question 1

What is a mental disorder?

Answer 1

• Clinically significant disturbance in an individuals
• Cognition, emotional regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning.

Question 2

How do we diagnose mental disorder?

Answer 2

—> Tool for diagnosing: Diagnostic and Statistical Manual of Mental Disorders (DSM)
—> Five Levels (axes) of diagnoses
1. Clinical Disorders
2. Mental retardation
3. general medical condition
4. psychosocial disturbances
5. Other considerations
—> Mental Health issues may influence criminal behavior

Question 3

When are the three times that mental illness issues show up in criminal justice system?

Answer 3

1. Fitness to stand trial
2. Culpability and criminal responsibility (NCRMD) = not criminally responsible on account of mental disorder
3. Need for assessment and intervention in corrections.

Question 4

What are the 3 reasons someone is unfit to stand trial due to mental disorders?

Answer 4

a) Understand that nature or object of the proceedings
b) Understand the possible consequences of the proceedings
c) Communicate with counsel.

Question 5

What is NCRMD?

Answer 5

• A person has a mental disorder
• He/She is not appreciated what he/she is doing or the consequences of his/her actions…
• NCRMD cannot be convicted may be diverted to mental health system. Mensa Rea (criminal intent)

Question 6

What is MDO’s as a vulnerable population?

Answer 6

–> Effects of deinstitutionalization - diminished access to health care and social support
–> Stigma of mental disorder - misconception of mentally ill as violent and unpredictable; self-stigma
–> Prevalence of mental disorders, among incarcerated offenders - particularly personality disorders

47% substance use abuse
57% antisocial personality disorder

Question 7

Describe police contact with persons with mental illness?

Answer 7

• police are frontline contact, have discretion in handling cases, e.g., informally resolve, take to the hospital for evolution.
• Most do not commit criminal acts, multiple other reasons for interaction with the police. e.g., substance abuse problems, homelessness, poverty.

Question 8

What is the standard training for police to include?

Answer 8

-> understanding of mental illness, role of family
-> How to communicate with mentally ill
-> De- escalation techniques
-> How to assess suicidality, risk, dangerousness
-> Issues related to stigma
-> How to access mental health services
-> Issues related to use of force with mentally ill.

Question 9

What symptoms of mental disorders that increase risk of violence?

Answer 9

• Combination -> psychotic symptoms
  -> substance abuse disorder
  -> history of violence
  -> attitudes supportive of violence
• presence of delusional belief
• command hallucinations to commit violence.

Question 10

What are the protective factors for mental disorders?

Answer 10

• compliance with mediation
• employment
• positive social relations

Question 11

What assessment process for mentally disordered offenders?

Answer 11

• intake assessment of mental health indicators
• assessment of risk of suicide and self-harm
• assessment of risk of future and violent behavior