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PSY 366 - Psychological Disorders - Test 3 > Chapter 16 - Law, Society, and the Mental Health Profession > Flashcards

Chapter 16 - Law, Society, and the Mental Health Profession Flashcards

1
Q

does psychological dysfunction occur in isolation?

A

no, psychological dysfunction affects more than just the individual

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2
Q

what system defines and often regulates the professional responsibilities of clinicians?

A

a complex social system of societal institutions

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3
Q

3 major forces in society

A

the legislation/judicial system, the business/economic arena, and technology

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4
Q

collective term for the legislative and judicial systems

A

the “legal field”

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5
Q

what is the legal field responsible for

A

protecting both the public good and the rights of individuals

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6
Q

two distinct aspects of the relationship between mental health field and legal field

A

mental health professionals play a role in the criminal justice system (“psychology in law”) and legal systems act upon the clinical field (“law in psychology”)

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7
Q

forensic psychology

A

the collective term for the intersections between the mental health field and the legal and judicial systems

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8
Q

the varied activities of forensic psychologists

A

testifying in trials, researching the reliability of eyewitness testimony, or helping police profile the personality of a serial killer on the loose

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9
Q

what do courts need to know before they can arrive at just and appropriate punishments?

A

they need to know if the defendant is responsible for the crimes they commit and capable of defending themselves in court

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10
Q

criminal commitment

A

the process where someone accused of crimes is sent to a mental institution for treatment because they are judged to be mentally unstable

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11
Q

two forms of criminal commitment

A

person was mentally unstable at time of the crime and person is mentally unstable at time of the trial

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12
Q

plea for people who were mentally unstable at the time of the crime(s) and are innocent of wrongdoing

A

not guilty by reason of insanity

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13
Q

someone who was mentally unstable at the time of the crime are released from treatment when

A

they improve enough to be mentally stable

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14
Q

someone who is mentally unstable at the time of the trial is released from treatment when

A

they are competent enough to understand the trial procedures and to defend themselves in court

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15
Q

criticism of judgments of mental instability

A

judgments are loopholes that allow criminals to escape punishment

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16
Q

what kind of term is the term “insanity”

A

a legal term

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17
Q

who can the M’Naghten test be traced back to?

A

to the murder case of Daniel M’Naghten in England in 1843

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18
Q

the M’Naghten test

A

the defendant had to be unable to know right from wrong at the time of the crime

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19
Q

when was the irresistible impulse test first used?

A

in Ohio in 1834

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20
Q

the irresistible impulse test

A

a person who committed a crime during an uncontrollable “fit of passion” was considered insane and not guilty

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21
Q

when was the Durham test made?

A

in 1954 as a result of the case of Durham v. United States

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22
Q

the Durham test

A

people are not criminally responsible if their “unlawful acts was the product of mental disease or mental defect”

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23
Q

issue with the Durham test

A

anyone who fits the criteria of any disorder in the DSM-I would be considered “insane”

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24
Q

when was the American Law Institute test made?

A

in 1955

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25
Q

the American Law Institute test (in class called the American Legal Institute Rule)

A

people are not criminally responsible if, at the time of a crime, they had a mental disorder or defect that prevented them from knowing right from wrong or from being able to control themselves and to follow the law

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26
Q

American Psychiatric Association’s 1983 statement on legal insanity

A

people should be found not guilty by reason of insanity only if they did not know right from wrong at the time of the crime

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27
Q

states that got rid of the insanity plea altogther

A

Idaho, Kansas, Montana, and Utah

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28
Q

percent of people who are found not guilty by reason of insanity who have schizophrenia or another form of psychosis

A

80%

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29
Q

percent of people who successfully plead insanity that are white

A

50%

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30
Q

percent of people who successfully plead insanity that are male

A

86%

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31
Q

mean age of people who successfully plead insanity

A

32 years old

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32
Q

fraction of crimes for which defendants are found not guilty by reason of insanity that are violent crimes

A

2/3

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33
Q

percent of those found not guilty by reason of insanity that are accused of murder

A

15-30%

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34
Q

concerns raised by the insanity defense

A

the fundamental difference between the law and the science of human behavior; the uncertainty of scientific knowledge about abnormal behavior

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35
Q

problem which clinicians face when evaluating state of mind of defendant during the crime

A

the event took place weeks, months, or years earlier

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36
Q

percent of defendants who plead insanity

A

less than 1%

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37
Q

percent of defendants who plead insanity and are actually found not guilty for reason of insanity

A

25%

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38
Q

amount of people who are found not guilty by reason of insanity of every 400 defendants

A

1 of every 400 defendants

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39
Q

percentage of insanity pleas that are agreed to by the prosecution

A

75%

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40
Q

causes behind the trend of defendants being released earlier and earlier from mental institutions

A

increasing effectiveness of therapy in institutions, the growing reaction against extended institutionalization, and more emphasis on patients’ rights

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41
Q

Foucha v. Louisiana 1992, what did the supreme court clarify?

A

that the only acceptable basis for determining the release of hospitalized offenders is whether or not they are still “insane”

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42
Q

outpatient commitment

A

the states may insist on community treatment, monitor the patients closely, and rehospitalize them if neccessary

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43
Q

what other verdicts besides not guilty by reason of insanity are available?

A

guilty but mentally ill, guilty with diminished capacity

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44
Q

guilty but mentally ill

A

defendants who receive this verdict are found to have had a mental illness at the time of their crime, but the illness was not fully related to or responsible for the crime

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45
Q

guilty with diminished capacity

A

a defendant’s mental dysfunction is viewed as an extenuating circumstance that the court should take into consideration in determining the precise crime of which the person is guilty

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46
Q

why do many legal experts have argued against the diminished capacity defense

A

because of possible miscarriages of justice

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47
Q

when did Michigan passed the first sexual psychopath law

A

1937

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48
Q

purpose of sexual psychopath laws

A

some of those who are repeatedly found guilty of sex crimes have a mental disorder, so the state categorizes them as “mentally disordered sex offenders”

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49
Q

where are mentally disordered sex offenders sent to?

A

a mental health facility

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50
Q

“sexually violent predator” or “sexually dangerous person” laws

A

sex offenders removed from prison before their release and committed involuntarily to a mental hospital for treatment if a court judges them likely to engage in further “predatory acts of sexual violence” as a result of “mental abnormality” or “personality disorder”

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51
Q

supreme court case that upheld the constitutionality of the sexually violent predator laws

A

1997 case of Kansas v. Hendricks

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52
Q

why can a person be judged mentally incompetent to stand trial?

A

to ensure that the defendant understands the charges they are facing and can work with their lawyers to prepare and conduct an adequate defense

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53
Q

Supreme Court upholds the minimum of the defendant being competent in this case

A

Dusky v. United States in 1960

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54
Q

number of competency evaluations conducted in the United States every year

A

50,000-60,000

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55
Q

percent of defendants who are evaluated for competency that are found incompetent to stand trial

A

20-25%

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56
Q

supreme court ruling that addressed indefinite commitment

A

Johnson v. Indiana in 1972

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57
Q

until the early 1970s, most states required that mentally incompetent defendants be committed to what kind of place

A

maximum security institution for the “criminally insane”

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58
Q

jail diversion

A

the disturbed person is “diverted” from jail to the community for mental health care

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59
Q

civil commitment

A

certain people are forced into mental health treatment

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60
Q

people who are subjected to civil commitment

A

people who are unaware of their psychological problems or those who are not interested in going through therapy

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61
Q

where are people who are committed involuntarily sent to?

A

mental facilities

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62
Q

in what circumstance would the US legal system permit involuntary (civil) commitment?

A

when the individual being committed is in need of treatment and dangerous to themselves or others

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63
Q

in what ways might someone be dangerous to themselves?

A

if they are suicidal or if they act recklessly

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64
Q

in what ways might someone be dangerous to others?

A

if the individual seeks to harm others or if they unintentionally place others at risk

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65
Q

is a hearing necessary when committing a minor?

A

no, a hearing is not necessary as long as a qualified mental health professional considers commitment necessary

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66
Q

process of being involuntarily committed as an adult

A

the court orders a mental examination and allow the person to contest the commitment in court, often represented by a lawyer

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67
Q

before an individual is involuntarily committed, what does the supreme court say there must be?

A

“clear and convincing” proof that the person is mentally ill and has met the state’s criteria for involuntary commitment

68
Q

what makes proof “clear and convincing” in the context of civil commitment?

A

if the proof provides 75% certainty that the criteria of commitment has been met

69
Q

in the past, what was necessary before initiating emergency commitment?

A

certification by two physicians

70
Q

what must clinicians declare to initiate emergency commitment?

A

that the state of mind of the patient makes them dangerous to themselves or others

71
Q

what are the certifications from physicians for emergency commitment referred to as?

A

two-physician certificates, or 2 PCs

72
Q

limit of emergency commitment stay

A

3 days

73
Q

percent of people with mental disorders that are not dangerous or violent

A

90%

74
Q

percent of violent acts that are committed by people with mental disorders

A

5%

75
Q

what makes someone with a mental disorder somewhat more likely to perform violent behaviors

A

if their mental disorder is untreated

76
Q

disorders with the strongest relationship to violence

A

severe substance use disorder, impulse control disorder, antisocial personality disorder, and psychotic disorders

77
Q

what is often required before involuntary civil commitment is carried through?

A

the determination of dangerousness of the individual

78
Q

are long-term predictions of violence or short-term predictions of violence more accurate?

A

short-term predictions of violence are more accurate than long-term predictions of violence

79
Q

in long-term predictions of violence, is the likelihood that the individual will be violent overerstimated or underestimated?

A

overestimated

80
Q

what are the problems with civil commitment?

A

it is difficult to assess a person’s dangerousness; the legal definitions of “mental illness” and “dangerousness” are vague; the actual therapeutic value of civil commitment is questionable

81
Q

ruling of Robinson v. California 1962

A

imprisoning people who suffered from substance use disorders might violate the constitution’s ban on cruel and unusual punishment, and involuntary civil commitment was recommended as a more reasonable action

82
Q

the two rights of patients that the legal system aims to protect

A

the right to treatment and the right to refuse treatment

83
Q

ruling of Wyatt v. Stickney

A

the state was constitutionally obligated to provide “adequate treatment” to all people who had been committed involuntarily

84
Q

the “adequate treatment” that Wyatt v. Stickney ruled ought to be provided to those who were committed involuntarily

A

more therapists, more social interactions and physical exercise, better living conditions, more privacy, and a more proper use of physical restraint and medication

85
Q

Supreme Court ruling for the O’Connor v. Donaldson 1975

A

mental institutions had to review patient cases periodically; state cannot continue to institutionalize people involuntarily if they aren’t dangerous and are capable of surviving on their own or with help from family or friends

86
Q

Protection and Advocacy for Mentally Ill Individuals Act in 1986

A

set up protection and advocacy systems in all states and U.S. territories; gave to public advocates who worked for patients the power to investigate possible abuse and neglect and to correct those problems legally

87
Q

what do most of the right-to-refuse-treatment rulings center on?

A

biological treatments

88
Q

what do some states also acknowledge in their right-to-refuse-treatment laws?

A

the right to refuse electroconvulsive therapy (ECT) and psychotropic medications

89
Q

in what case could a patient’s refusal to take medications be overturned?

A

if the patient’s refusal is considered incompetent, dangerous, or irrational

90
Q

three other rights that patients have

A

patients who work in mental institutions get a minimum wage; patients have a right to aftercare and to an appropriate community residence; people with psychological disorders should receive treatment in the least restrictive facility available

91
Q

the four other ways the legal field and the mental health field interact with each other

A

malpractice suits, professional boundaries, jury consultation, and psychological research of legal topics

92
Q

malpractice suits

A

claims made against clinicians in response to inappropriate, irresponsible, or negligent behavior of the clinician

93
Q

examples of malpracitce

A

sexual activity with a patient, failure to obtain full consent for a treatment, negligent drug therapy, omission of drug therapy that would speed improvement, improper termination of treatment, and wrongful commitment

94
Q

professional boundaries

A

the legal field has helped change the boundaries that distinguish one clinical profession from another

95
Q

1991, the Department of Defense makes this change to the difference between the practices of psychiatrists and of psychologists

A

they gave the authority to psychologists to prescribe drugs, something previously denied to psychologists

96
Q

American Psychological Association’s recommendation regarding giving psychologists the power to prescribe medications

A

extensive educational and training programs in prescription services in order to receive certification to prescribe medications

97
Q

jury consultation

A

clinicians advise lawyers about which potential jurors are likely to favor their side and which strategies are likely to win juror’s support during trials

98
Q

clinicians involved in jury consultation

A

jury specialists

99
Q

on what do jury specialists make their suggestions?

A

on surveys, interviews, analyses of juror’s backgrounds and attitudes, and laboratory simulations of upcoming trials

100
Q

the focus of the psychological research of legal topics

A

eyewitness testimony and patterns of criminality

101
Q

eyewitness testimony

A

not very reliable and can be made less accurate by misinformation; the confidence of witnesses is not indicative of the accuracy of their testimony

102
Q

patterns of criminality

A

the study of criminal behavior patterns in order to make profiles of criminals that help identify a criminal

103
Q

positives of criminal profiling

A

researches have indeed found that perpetrators of particular kinds of crimes (serial murder or serial rape) frequently share a number of traits and background features

104
Q

the issue with psychological profiling

A

while particular traits are often present in criminals, they are not always present in criminals; applying profile information can be wrong and misleading

105
Q

the best way to use psychological profiling

A

to keep in mind the limitations of profiling

106
Q

how do clinicians regulate themselves?

A

by continually developing and revising ethical guidelines for their work and behavior

107
Q

how many guidelines are in the American Psychological Association code of ethics?

A

7 guidelines

108
Q

are psychologists allowed to give advice wherever they want?

A

yes, as long as they do so responsibly, professionally, and base their advice on appropriate psychological literature and practices

109
Q

what kind of advice has been difficult to regulate?

A

internet-based professional advice

110
Q

APA guideline regarding proper research practice

A

psychologists may not conduct fraudulent research, plagiarize the work of others, or publish false data

111
Q

with whom should psychologists acknowledge their limitations

A

with patients who are disables or whose gender, gender identity, ethnicity, language, socioeconomic status, or sexual orientation differs from that of the therapist

112
Q

what must psychologists who make evaluations and testify in court do?

A

base their assessments on sufficient information and substantiate their findings appropriately

113
Q

what must clinicians never participate or assist in?

A

acts of torture

114
Q

until how long after treatment ends is it allowed that a therapist and a former client be in an intimate relationship?

A

2 years after the end of treatment

115
Q

can psychologists accept as clients people they once had a sexual relationship with?

A

no, a psychologist cannot take in a former sexual partner as a client

116
Q

percent of therapists today that have a sexual relationship with a client

A

4-5%

117
Q

percent of therapists that report having been sexually attracted to a client

A

more than 80%

118
Q

what principle must psychologists follow?

A

the principle of confidentiality

119
Q

why is confidentiality important in therapy?

A

so that the client may have peace of mind and to make sure that therapy is as effective as possible

120
Q

two situations in which confidentially can be broken

A

if therapist reports to a supervisor or if someone is in danger

121
Q

case that lead to the rule that confidentially can be broken if someone is in danger

A

1976 case of Tarasoff v. Regents of the University of California

122
Q

phrase that explains the limits of confidentiality

A

“the protective privilege ends where the public peril begins”

123
Q

percent of workers who find their jobs very stressful and a cause of mental health issues

A

40% of workers

124
Q

percentage of stressed-out workers that report excessive workload causes their stress

A

46% of stressed-out workers

125
Q

percentage of stressed-out workers that report people and personnel issues cause their stress

A

28% of stressed-out workers

126
Q

percentage of stressed-out workers that report difficulties balancing work with home life cause their stress

A

20% of stressed-out workers

127
Q

percentage of stressed-out workers that report lack of job security as the cause of their stress

A

6% of stressed-out workers

128
Q

percent of work absences that can be tied to stress of related mental health issues

A

60% of absences

129
Q

stress in work can contribute to these problems at work

A

poor productivity, more accidents, employee mistakes, employee departures, insurance costs, and worker compensation expenses

130
Q

two common approaches that employers use to address employee stress

A

employee assistance programs and stress reduction programs

131
Q

employee assistance programs

A

mental health services made available by a place of business, and are run either by mental health professionals who work directly for a company of by outside mental health agencies

132
Q

stress reduction and problem-solving programs

A

workshops or group sessions in which mental health professionals teach employees techniques for coping, solving problems, and handling and reducing stress

133
Q

what technique of stress reduction is provided by 1/4 of all employers?

A

mindfulness training

134
Q

how many workers agree that they need help learning how to manage stress?

A

nearly half of workers

135
Q

acuts reus

A

guilty act; that the defendant committed the crime

136
Q

mens rea

A

guilty mind; that the defendant did the crime intentionally

137
Q

implication of an insanity defense

A

the defendant did not have mens rea when they committed the crime

138
Q

Insanity Defense Reform Act (1984)

A

at the time of the crime, as a result of a “mental disease” or intellectual disability, the person did not know their behavior was wrong

139
Q

who has the burden of proof under the Insanity Defense Reform Act?

A

the defense

140
Q

who has the burden of proof under the Irresistible Impulse Rule?

A

the defense

141
Q

who has the burden of proof under the M’Naughten Rule?

A

the prosecution

142
Q

who has the burden of proof under the Durham Rule?

A

the prosecution

143
Q

who has the burden of proof under the American Legal Institute Rule?

A

the prosecution

144
Q

percentage of cases where defense attorneys suspect their clients have impaired competence

A

10% of cases

145
Q

three possible outcomes after competence evaluation

A

competent to stand trial; incompetent and restorable; incompetent and not restorable

146
Q

4 philosophies of incarceration

A

rehabilitation, deterrence, incapacitation, and retribution

147
Q

rehabilitation

A

teach people not to do crime again and to be more prosocial

148
Q

deterrence

A

punish criminal to show why civilians shouldn’t commit crimes

149
Q

incapacitation

A

society is made safer by locking up criminals

150
Q

retribution

A

an eye for an eye; the criminal hurt us, so we will hurt the criminal

151
Q

example of how a broad economic decision by the government may influence the clinical treatment of people with mental disorders

A

deinstitutionalization was motivated by the government’s desire to reduce to costs

152
Q

government funding for mental health services in 1963 compared to today

A

1 billion USD in 1963 compared to 179 billion USD today

153
Q

percent of mental health services covered by government funding

A

64% of mental health services

154
Q

managed care programs

A

the insurance company determines which therapists clients may choose from, the cost of sessions, and the number of sessions for which a client may be reimbursed

155
Q

peer review systems

A

clinicians who work for the insurance company periodically review a client’s treatment program and recommend that insurance benefits be either continued or stopped

156
Q

what do insurance companies require from clinicians in peer review systems

A

reports or session notes from the therapist, often including intimate personal information about the patient

157
Q

one of the issues with managed care programs

A

the priorities of managed care programs lead to therapy being cut off prematurely, and they may promote short-term treatments over long-term improvement

158
Q

issue with insurance coverage of mental disorders in general

A

reimbursements for mental disorders are, on average, lower than those for physical disorders

159
Q

2014 act that expanded the reach of the 2008 parity law

A

The Affordable Care Act (“Obamacare”)

160
Q

what provides new triggers for abnormal behavior?

A

the digital world

161
Q

what has brought a new exhibitionistic feature to certain kinds of abnormal behavior?

A

the Internet

162
Q

clinicians’ fear regarding social media

A

it will lead shy or socially anxious people to withdraw from valuable face-to-face relationships

163
Q

telemental health

A

the use of remote technologies such as long-distance videoconferencing to provide real-time therapy sessions without the therapist being physically present

164
Q

percentage of therapists who have reported going to therapy at least once

A

84%

165
Q

the issues most often credited as the reason a therapist goes to therapy

A

relationship problems, depression, and anxiety

166
Q

how many therapists have said that anxiety, depression, and/or relationship problems have affected the quality of their work?

A

more than half of therapists

PSY 366 - Psychological Disorders - Test 3 (8 decks)

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