Topics
1) Common difficult questions
2) Ethics code
3) 4 benefits for forensic psychiatry
4) Civil Commitment Laws
5) Conditions have to be met for commitment
6) Legal system use Mental Illness
7) Criminal Commitment
8) Insanity Defence
9) Theory of Criminal Intent
10) American Law Institute criteria conclude that someone is not responsible for a crime
11) Competency to stand Trial
12) Concept of Diminished Capacity
13) Duty to Warn
14) Tarasoff case
15) Expert witnesses
16) Guardian ad Litem
17) Right to treatment
18) Subjects to treatment must agree to
19) Clinical practice guidelines
20) Confidentiality and Duty to Warn
21) Multiple Relationships
22) Example of Multiple Relationships
Names and years
1) Hobbs (48) - Hobbits
2) Florenz (06) - Florenzo
3) Simon & Shuman (09) - Simon says Schumacher
4) Spiegel & Koocher (88) - Spielberg & Cooker
5) Fisher (09) - Fisher
6) APA (05) - Apo
That Hobbit Florenzo was playing Simon says w/ Schumacher and invited film director Spielberg and his personal Cooker to act as a Fisher and fish Apo’s apple from his mouth.
What are common questions asked about psychological disorders and Legal issues?
- If a person is deemed to have psychosis were to be of fatal danger to the public, would they be accountable for a crime?
- If someone were to tell their clinician of the intent to harm someone else, should the clinician inform the police, or adhere to their duty of confidentiality?
What did professionals do to face difficult situations?
•American Psychological Association (APA) developed an Ethics Code in 1947
•Revised every year so to:
A) Encourage the highest endeavours of psychologists
B) Ensure public welfare
C) Promote sound relationships between with allied professions
D) Promote professional standing of the Discipline
(Hobbs, 1948)
What are the 4 benefits for forensic psychiatry?
- Evolution in understanding & appreciation b/ mental illness and criminality
- Evolution of legal tests to define legal insanity
- New methodologies for mental conditions providing alternatives to custodial care
- Changes in attitudes and perceptions of mental illness among the public (Florenz, 06)
What are Civil Commitment Laws?
- Conditions under which a person may be certified legally to have a mental illness and therefore to be placed in a hospital
- Sometimes in conflict with the person’s desires
- When involuntarily placed in psychiatric hospital, clients have the right to treatment, liberty and safety, right to refuse, the right to least restrictive environments (e.g. patients cannot be locked in solitary confinement)
What Conditions have to be met for commitment?
- Person has a mental illness and needs treatment
- The person is dangerous to himself or to the public
- Person is unable to care for himself
How does the Legal system use Mental Illness?
- Not synonymous to psychological disorder.
- Each state has its own definition of mental illness, usually meant to include people with severe disturbances that negatively affect their safety or health
•Having a mental illness does not seem to increase the likelihood of dangerousness. Although having symptoms of hallucinations and delusions does seem to indicate more risk for behaving violently.
Criminal Commitment
Process by which people are held for 1 of 2 reasons:
- They have been accused of committing a crim and are detained in a mental health facility until they can be determined fit or unfit to participate in legal proceeding against them
- they are been found not guilty of a crime by reason of insanity
Insanity Defence
Defined by:
• M’Naghten rule (people are not responsible for criminal behaviour if they don’t know what they are doing, or don’t know that it is wrong).
•ALI (American Law Institute) included concept of DIMINISHED CAPACITY (people’s inability to understand the nature if their behaviour and therefore their criminal intent can be diminished by their mental illness)
Theory of Criminal Intent
Aka Mens Rea (“guilty mind”) is important legally because to convict someone of a crime, there must be proof of the physical act and the mental state of the person committing the act (Simon & Shuman, 09)
How American Law Institute criteria conclude that someone is not responsible for a crime
If because of mental illness, they lacked either:
•Cognitive ability to recognize the inappropriateness of their behaviour or
•Ability to control their behaviour
Competency to stand Trial
Prediction made by the mental health expert of the defendant about their cognitive and emotional stability during the period of the trial
Concept of Diminished Capacity
People’s ability to understand the nature of their behaviour and therefore their criminal intent could be lessened by their mental illness
Duty to Warn
Responsibility of the therapist to warn potential victim that a client may attempt to hurt or kill them.
•Does not apply if the client does not explicitly specify a designated person or persons (i.e. cannot discuss information if patient vaguely intents to harm a non-specific somebody).
Tarasoff case
The girl was killed by her boyfriend, the psychologist’s patient, when the psychologist could have warned the victim and thus avoid the casualty.
Expert witnesses
Individuals who have specialized knowledge and who assist judges in making decisions, especially about such issues as competence and malingering.
Guardian ad Litem
Psychologists, if appointed by the court, can represent or make decisions on behalf of the accused if the person is legally incapable to do so.
Right to treatment
- One of the fundamental rights of patients in mental health facilities. It is their right to ongoing effort to both define and strive toward treatment goals.
- Psychologists have to have the competence to access and conceptualize the mental disorder, and then provide intervention for the client.
- By contrast, great deal of controversy exists over whether all patients are capable of making a decision to refuse treatment. Especially in case of antipsychotic medications that may improve patient’s symptoms, but bring with them severe side effects.
Subjects to treatment must agree to
Must be fully informed of the risks and benefits and formally give their consent to indicate they have been fully informed.
Clinical practice guidelines
Can provide major role in providing information about types of interventions that are likely to be effective for a specific disorder, thereby setting the stage for EVIDENCE-BASED PRACTICE.
•Critical to Evidence-based Practice are measure of:
a) Clinical efficacy (internal validity)
b) Clinical utility (external validity)
In other words, the former is a measure of whether the treatment is effective in a variety of settings and can be implemented in those settings.
Confidentiality and Duty to Warn
General standard of professional conduct that obliges a professional not to discuss information about a client with anyone (Spiegel & Koocher, 98) except under certain circumstances agreed by both source and subject.
•A pychologist is legally required to duty of warn (discussed previously), report in purpose of mandate (to protect a minor from potential abuse).
Multiple Relationships
- Important that clinical psychologists exercise reasonable judgement and precautions to ensure that their work does not reflect personal biases or prejudices that can lead to injustices (Fisher, 09)
- Psychologist could play role of Multiple Relationships (e.g. not only patient’s clinician, but also, a colleague in another setting.) This could lead to vulenrable situation, where clinician might exploit position of professional, to get personal gains.
- This is why there are boundaries dictated by APA to prevent this.
Example of Multiple Relationships
For example, APA (05) code prohibits psychiatrists to have sexual relationships with a client prior to 5 years after the termination of the treatment.
