Chapter 19: Mental Disorders and the Law Flashcards
What does Canadian law assume about the individual?
- people can and do think and act in a deliberate and reasoned manner
- recognizes that in some cases mental disorder may cause cognitive or volitional impairment
How is mental disorder defined by the law?
- impairment of psychological functioning that is internal, stable, and involuntary, rather than situational or contextual
- much narrower definition than recognized by mental health professionals and the DSM-V
What are statutes?
- codes of law adopted by a government and supported by a monarch
- govern almost every aspects of daily life
Which types of statutes do mental disorders play a role in?
- civil mental health law
→ varies across provinces and territories - criminal law
→ does not vary
What criteria is required for involuntary hospitalization?
– People must suffer from a severe and treatable mental disorder
– People must be either unwilling or incapable of consenting to hospitalization on a voluntary basis
– People must be at risk of causing harm to self or others due to mental disorder
– Usually the process of voluntary commitment starts with emergency or short-term detention, and often ordered by the physician evaluating the patient
→ Release occurs when improvements are observed due to the passage of time or
because of treatment
What is a temporary substitute decision maker?
- in provincial mental health law, someone authorized to make treatment decision on behalf of a person who is civilly committed and deemed incapable of making such a decision
What is required to appoint someone a temporary substitute decision maker?
1 - appointed decision makers must act in accordance with the best interest’s principle. → make decisions which would best serve the interest of the patient
2 - capable wishes principle
→ the patient’s wishes should be given the greatest weight, especially when these wishes were expressed previously
What are compulsory treatment orders?
- involuntary treatment for people
who are not hospitalized
Who is involuntarily hospitalized?
- 15 to 20% of all hospitalizations for mental disorder in Canada are involuntary
- 14% request a review
How can violence risk be evaluated?
- discretionary approach
→ more informal or intuitive
→ uses clinical judgment - non-discretionary approach
→ actuarial
→ uses strict rules of assessment producing probability estimates of committing violence
What is actus reus?
- prohibited physical act that, combined with mens rea, defines a criminal offence
What is mens rea?
- guilty mind or bad intent that, combined with actus reus, defines a criminal offence
What is NCRMD?
- not criminally responsible on account of mental disorder
- not morally culpable for comitting a prohibited act due to mental disorder at the time the act was confirmed
What is UST?
- unfit to stand trial
- people who are unable to participate actively and effectively during their trial
→ unable to be present, confront accusers, make full answer to the accustion
How are fitness evaluations conducted?
- courts rarely disagree with the opinion of mental health professional regarding the individual’s mental health status
- such opinions are usually based on the severity of the mental disorder
- development of revised Fitness Interview Test (FIT-R) greatly aided competency evaluations
Who are referred for fitness evaluation?
- 15% of defendants
→ >50% NCRMD
→ given indefinite commitment to secure hospitals
What is the history of the M’Naghten Standard?
- 1843, Daniel M’Naghten was acquitted of murdering Edward Drummond, whom M’Naghten had mistaken for British Prime Minister Robert Peel
- British House of Lords asked a panel of judges a series of hypothetical questions about the defence of insanity
- rules proposed have been a standard test for criminal liability in relation to mentally disordered defendants in common law jurisdictions ever since
What is the M’Naughten Standard?
1 - accused must have been suffering from a mental disorder
2 - they must not have known at least one of the two things: the nature and quality of the act and that what they have done was wrong
- “cognitive” test for insanity
What happens if the M’Naughten Standard rules are satisfied?
- accused may be adjudged “not guilty by reason of insanity” or “guilty but insane”
- sentence may be a mandatory or discretionary (but usually indeterminate) period of treatment in a secure hospital facility
→ instead of a punitive disposal
What is the irresistible impulse exemption?
- volitional aspect of insanity
- e.g., “I knew it was wrong, but God told me to do it!”
What is GBMI?
- guilty but mentally ill
- indicates presence of mental illness and mens rea
- is a verdict, unlike NCRMD
What are concerns for the psychologist when assessing sanity?
– The other side is likely to have their own experts (outside of states like Michigan)
– In some jurisdictions, the expert witness cannot provide specific opinions on that specific case and can only answer general questions
– Believing that if a behavior is atypical, it must be pathological (e.g., Jeffrey Dahmer)
– Likely to face a stiff and critical cross‐examination
– The length of time since the offense occurred
– Personal Biases
– Limiting themselves to the boundaries of their license
– Malingering
What is ultimate issue v. ultimate opinion testimony?
- psychologist cannot say definitely whether the defendant is actually guilty or insane
- must be left up to the court to decide
What is malingering?
- individuals who intentionally pretend to have symptoms of mental or physical illness
→ to achieve financial or other gain
→ to avoid criminal conviction or unwanted duty
→ to facilitate escape from captivity or incarceration
