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239 - final > L13: legal issues > Flashcards

L13: legal issues Flashcards

1
Q

cjs + mental health system overlap

A

legal system excercises influence over mental health.

- impacts disciplines, ethical principles and laws.

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2
Q

what is civil commitment?

A

person can be declared to have mental illness + forcefully placed in hospital.
– once in hospital, each province has diff way to handle.

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3
Q

three conditions met to have civil commitment

A
  1. mental illness as defined by mental health act
  2. deemed dangerous to self or others.
  3. in need of treatment.
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4
Q

3 criteria that physicians looks at when civilly committing someone?

A
  1. suffering a mental disorder
  2. likely to cause harm to self/others OR suffering mental/physical deterioration OR serious physical impairment
  3. unsuitable for admission as formal patient (unwilling)
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5
Q

2 types of authority that the govt has justified its right to act against the wishes of the individual

A
  1. police power authority: police take against will to protect public health, welfare + safety.
  2. under parens patriae: state applies power when citizen is unlikely to act in best interst. act as surrogate parent.
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6
Q

when does civil commitment begin?

A

when voluntary help isnt sought, but others feel treatment is necessary.

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7
Q

what happens once civil commitment begins

A

Psych assessment of mental illness (defined legally =/= psych disorder): agreement by a few.

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8
Q

two components of criminal commitment?

A

criminal act = actus reus

guilty mind = mens rea

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9
Q

2 reasons why ppl are detained in psych facility when accused of committing crime?

A
  1. detained until assessed to be “fit to stand trial”

2. if found ncrmd (insanity).

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10
Q

M’Naghten case?

A

psychotic episode led him to kill secretary.

  • courts declared insanity bc defect reason, disease of mind = didnt understand the nature of the act.
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11
Q

not guilty by reason of insanity

A

old criminal term.

  • in psych hospital due to mental disorder improved sufficiently.
  • one guy said “ not fair to have indeterminate detention” = won + changed rule
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12
Q

difference btw ncr and not guilty

A

ncr = deed was done, person did deed. lacked mens rea

not guilty = lack proof of actus reus. not legally liable

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13
Q

burden of proof in ncr?

A

on defendant.

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14
Q

how is mental disorder defined in ccc?

A

disease of mind.

- but not all “disease of mind” => ncrmd.

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15
Q

to be ncrmd need?

A

mental disorder
incapable of appreciating quality/nature
*exceptions : self-induced intoxication

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16
Q

three dispositions (“sentences”) avail for ncrmd.

A
  1. absolute discharge: free + clear.
  2. conditional discharge: release into community with conditions
  3. detention: in custody
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17
Q

prevalence of ncr

  • adult?
  • youth?
  • quebec?
A

A: 7.5-9/10,000
Y: 1.4-4/10,000
quebec has 3% more than other provinces

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18
Q

what is alberta ncr project?

A

prof reserach on ncr data in province

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19
Q

of those ncr in alberta, what is most common psych diagnosis?

A

psychotic.

- many co-morbid disorders

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20
Q

average age of ppl ncr in alberta?

A

35 yoa

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21
Q

how many youth were ncr?

A

14/551 = 2.5%

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22
Q

what offence is most likely considered ncr?

A

direct violenct (no homicide, sex assault)

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23
Q

% of prior criminal experience in those that are ncr?

A

54% had none
44% had one
18% had 5+
7.1% had 10+

24
Q

most common level of education in ncr cases?

A

below grade 12

25
Q

most common race for ncr?

A

white. but statistics look vvv similar to demographic of province.
- no over-representation

26
Q

marital status for ncr?

A

mostly single, none are actually connected with someone

- rare to have healthy marriage

27
Q

time to absolute discharge IF they receive it?

A
  • more time in custody than if were to plead guilty = not easier.
  • doesn’t have to be absolute discharge ever.
28
Q

define recidivism?

A

return to target behaviour

29
Q

sexual recidivism of ncr?

A

4/528

- at least 4 yeaers after.

30
Q

major violent recidivism of ncr?

A

2 years = 0.8%

20 years = 4%

31
Q

violent recidivism of ncr?

A

5 years = 2%
35 years = 11.4%
in gen pop, takes 3-6 months to have 10% recidivism rate.

32
Q

ncr + public alarm

A

moral panic

- sensationalized. not as frequent as thought, but ncrmd spend more time in detection than non-ncr

33
Q

what is fitness to stand trial?

A

fitness to stand requires person understand charges against them + able to assist with their own defence

34
Q

3 issues addressed to determine fitness

A
  1. accused assist in defence (communicate w counsel)
  2. understand roles of various court room players
  3. know what they are charged with
35
Q

what happens if person is deemed unfit?

A
  • lose authority to make decision + faces commitment.

review board may conditionally discharge, retain in hospital, order treatment to restore fitness

36
Q

3 ways to assess dangerousness?

A
  1. clinical opinion
  2. actuarial approach
  3. structured professional judgement
37
Q

clinical opinion in assessing dangerousness

A

consider info in each case + make judgement to dangerousness

  • problem: useless in predicting dangerousness
38
Q

actuarial approach to assessing dangerousness

A
  • take known risk factors from literature review + create equation to numerically predict likelihood of violence.
  • precise estimates (+)
  • dunno what to do about risk (-)
39
Q

structured professional judgement in assessing dangerousness

A

review literature + ID factors that predict violence.
- have clinicians base opinions on these factors.
(+): can predict dangerousness using crim record
(-): not perfect

40
Q

why do mental health professionals tend to over-predict dangerousness

A

overpredict > underpredict that way no consequences to releasing dangerous ppl.

41
Q

societal impacts of over-prediction on society?

A

civil + economic impact.

- more ppl in custody, more tax money goes there.

42
Q

controversy of dangerousness from?

A
  • patient in new york was civilly committed, said it was unjust
  • 900 ppl released = rate of violence in the popln was super low.
43
Q

what is post hoc problem

A
  • recognizing pattern after-the-fact.
  • hindsight bias
    • recognize violent tendencies after violence occurs.
44
Q

what is problem in leaping from general to specific?

A

generalized perceptions of violent tendencies do not predict specific acts.

45
Q

what are some problems in defining dangerousness?

A

lack agreement of what dangerous behaviours include

- drug dealing?

46
Q

what are base-rate problems?

A

hard time making predictions about events that occur infrequently.

47
Q

psychologists + treatment ethics?

A

when provide treatment to individuals with mental disorder, psychologists bound by canadian code of ethics for psychologists.

48
Q

what does ccep cover?

A

boundary issues
patient rights
professional issues + legal liability

49
Q

what are boundary issues?

A

minimize harm

  • practice within limits of competence
  • avoid dual-role
50
Q

what are patient rights

A

fundamental right of those in mental health facilities = right to treatment, right to say no to treatment

51
Q

wyatt v stickney case?

A

american. set standard for staff:patient ratio

52
Q

ccr+f protect rights of ppl with mental illness how?

A
  • right to treatment in least restrictive enviro

- right to refuse treatment

53
Q

why is right to refuse treatment controversial?

A

concern of mental health/society + individual choice/freedom of will

54
Q

duty to warn vs duty to protect:

A

warn: warn id-ed person that danger could befall them
protect: dont need to tell explicity, just act to protect them

55
Q

tarasoff case

A
  • duty to warn came up.
    patient talked about killing T. psychologist went to police, + superior = they took patient in + released him. patient later killed T. ruled that psychologist had duty to warn T – switched to duty to protect.
  • if roles reversed, complete confidentiality > duty to warn.

239 - final (5 decks)

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