Forensic Psychiatry

Question 1

requirements for fitness to stand trial

Answer 1

Understand the nature or object of the proceedings

• Understand the possible consequences of the proceedings
• Ability to communicate with counsel

Question 2

T/F in order to be “fit to stand trial,” the person must be NOT be actively mentally ill

Answer 2

false. being actively mentally ill does not preclude a patient from being fit to stand trial. Mentally handicapped people are often still found to be fit.

Question 3

Definition of “not criminally reponsible”

Answer 3

person is incapable of appreciating the nature and quality of the act or knowing that it was wrong.

Question 4

reasons to not be found criminally repsonsible

Answer 4

Actions controlled by command hallucinations

Elaborate delusion system

Extreme paranoia

Severe psychotic depression

Question 5

mental health act is included under -__ law

Answer 5

civil

Question 6

requirements to form:

Answer 6

1. suffering from a mental disorder AND
2. likely to cause harm to person or other
3. unsuitable for admission to a facility other than as a formal patient.

Question 7

requirements to issue a form 1

Answer 7

• Form 1 Timeline

o Admission: any licensed MD (not a resident) and one person at the facility

• § A single Form 1: last 72hr before admission; 24hr once admitted

§ Two Form 1: lasts 30 days

• o Renewal: 1 psychiatry + 1 at the facility

§ 1st set: another 30d

§ 2nd set: another 30d

§ 3rd set+: 6mo

Question 8

requirements to issue a community treatment order

Answer 8

2 licnesed physician exams, one being a psychiatrist

-

• Within the last 3yr has had at least 2 involuntary admissions with total inpatient days>30d

o Had a CTO in the immediate preceding 3yr period

o Pattern of recurrent or repetitive behavior that can cause harm

• a CTO expires after 6 months, invalidated by hospital admission.

Question 9

if a police officer believes person is suffering mental disorder and may be a danger to himself or others→ immediate facility for physician examination– what form?

Answer 9

form 10

Question 10

intentional vs unintentional tort

Answer 10

Definition: a wrongful act (wilful or negligent) against another person

• Intentional tort: deliberate action that may cause damage (sexual assault, false imprisonment), not covered by malpractice insurance (sexual assault, false imprisonment)
• Unintentional tort: action which have an unreasonable risk of causing (most medical malpractice falls into this category)

Question 11

3 categories of standard of proof

Answer 11

• Beyond a reasonable doubt (95% certain): criminal cases
• Clear and convincing evidence (75-85% certain): high stakes civil cases or civil commitment. This is used when we “form” people with the Mental Health Act

• Preponderance of truth (51% certain): most civil cases

Question 12

When you have a duty to Warn

Answer 12

Risk to a clearly identifiable persons

Risk of serious harm (severe bodily injury, death or serious psychological harm

Must be an element of imminence, creating a sense of urgency

Question 13

criteria for emancipated minor

Answer 13

Criteria: living independently/financially independent; in the military; employed, married; pregnant or has children

Question 14

5 components of dangerousness (MILFS)

Answer 14

M: magnitude of harm

I: imminence of harm

L: likelihood of harm

F: frequency of aggressive behaviour

S: situational factors

Question 15

T/F when someone is in psychosis, they are more likely to commit violent acts

Answer 15

false. more likely to be a victim than a perpetrator.

Command hallucinations: familiar voice, history of compliance, associated with delusions, less violent

• Delusions: feeling threatened or controlled, paranoia/persecution

Question 16

Threats are more likely to lead to violence if:

Threats introduced late in the ___

__ threats

(yes/no) anonymous

Done __ to __

___ relationship

Nothing to lose

Belief that violence is justified

Capacity to carry out threat

Answer 16

Threats introduced late in the grievance

Specific threats

Not anonymous

Done face to face

Intimate relationship

Nothing to lose

Belief that violence is justified

Capacity to carry out threat

Question 17

Psychopathy

Definition: an informal term without a strict definition, consist of components from ___, ___, and ___ PD.

Answer 17

Definition: an informal term without a strict definition, consist of components from antisocial, histrionic, and narcissistic PD.

Question 18

Signs: Glib and superficial, egocentric and grandiose, lack of remorse, lack of empathy, deceitful and manipulative, shallow emotions, impulsive, poor behavior controls, need for excitement, lack of responsibility, early behavior problems, adult antisocial behavior

Answer 18

psychoapathy

Question 19

Antisocial Personality Disorder

Signs: breaking the law repeatedly, deceitful, impulsive, irritability and aggressiveness, disregard for safety of self or others, consistent irresponsibility, lack of remorse, conduct disorder before age ___.

Answer 19

Antisocial Personality Disorder

Signs: breaking the law repeatedly, deceitful, impulsive, irritability and aggressiveness, disregard for safety of self or others, consistent irresponsibility, lack of remorse, conduct disorder before age 15.