November 18th Lecture and Readings Flashcards

Question

what was Rosenhan's goal?

Answer 1

see the impact of labelling

Answer 2

principle of the social inclusion of ppl w disabilities including mental illness

Answer 3

a systematic strategy that seeks to ensure that disenfranchised groups of people, including people with disabilities, have greater participation in decision making that affects their lives.

Answer 4

- community care has been successful for some - issues regarding access to community supports, preventative care and emergency treatment - led to many MH issues living in poverty, being homeless and criminalized - funding shortage - revolving door effect

Answer 5

as we increase reliance on CJS to deal w MI we reduce number of hospital beds and the more beds and resources we have for MI less ppl are incarcerated- hydraulic relationship as one goes up the other goes down

Answer 6

- Reinforce prevention and promotion, community based services for common MH issues and specialized services for those living w severe mental illness - action, prevention and promotion - spending money on things like psychotherapy overall saves money

Answer 7

Canada’s 1910 Immigration Act established “prohibited classes,” which referred to people with mental and physical disabilities. - The 2001 Act’s “excessive demand” section allows refusal of entry to a person who is likely to add to wait lists. - 1929 act categorized ppl w disabilities along w criminals

Answer 8

- Factors associated with increased risk for offending are also associated with increased risk for disabilities. - Ppl living w mental disorders are more likely to be apprehended - police tend to be harsher on these people

Answer 9

- Violence risk assessment involving over 1000 psychiatric patients examining the relationship between 134 potential risk factors and subsequent violence. - The study concluded that, the propensity for violence is the result of the accumulation of risk factors, no one of which is either necessary or sufficient for a person to behave aggressively toward others. People will be violent by virtue of the presence or absence of different sets of risk factors. There is no single path in a person’s life that leads to an act of violence

Answer 10

- Need for more appropriate and adequate MH training for police and correctional officers - more inclusion of ppl w lived experiences of MH are needed in the development of cirricula - need to combat stigma - anti stigma education

Answer 11

- inclusion of multiple experts in the learning process - uniform inclusion of non physical intervention - mobile crisis team- emerg services for MH - est of policing standards

Answer 12

CAMH and Yorkk Uni research showed: - Those living with autism face frequent interaction with police (16% had interaction) - 19% of police interactions included physical restraint - Suggested a need for vulnerable person registries

Answer 13

- Rate of serious MI among persons in custody is up to 6 times higher than the general pop - a system ill equipped to deal w MI - many go w/o adequate treatment - prisoners often end up in segregation - corrections is not geared to deal w those w MI - There is an under-emphasis on the role of mental illness in causing people to enter the CJS - lack of attention paid to mentally ill patients that do not realize they are mentally ill - we criminalize Mi bc stigma, ideal of what else do we do w them?

Answer 14

to est a defense on the ground of insanity it must be proved that at the time of the committing of the act the party accused was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act he was doing or if he did know that he did not know what he was doing was wrong ex: In 1843 Danial McNaughten shot and killed PM's secretary thinking it was PM Sir Robert Pee it was Edward but he could not be punished bc it was his delusions that made him act

Answer 15

not criminally responsible on account of mental disorder - do not know the nature or quality of act - did not know the act was wrong - Sent to psychiatric facility until deemed no longer threat to public and they may be housed there for longer than a prison sentence - No acquitted- may be held as long as they are a threat to the public

Answer 16

cardiologist in QB, he found out his wife (in process of divorce) was in relationship with someone else, drank 1L of washer fluid and doesn’t remember anything after, he stabbed his 3 and 5 year old 47 times, charged of first degree murder, was found NCR bc he was unaware of what he did, he called police on himself and hiding when police came, after going to facility for 18 months he was released in 2012 and it was appealed and then he went to jail (life, 17 years no parole)

Answer 17

suffering from paranoid schizo, and killed Tim McLain, he stabbed him, beheaded him and then tried to eat his body bc schizo told him Tim was the devil - he received an absolute discharge in 2019

Answer 18

- address symptoms of MI - effective treatment outside of an institutional setting requires: 1. a supportive fam network 2. an accepting community 3. adequate community resources 4. a place to live in the community

Answer 19

try to resist stigmatization of MI

Answer 20

- de escalation must be at the heart of all training probs w recruiting, police are not equipped to deal w MH issues - Initiatives taken to mitigate tragic interactions between police and ppl w MI- de-escalation techniques, body cams, training police to not use lethal force or having them not even carry firearms like UK without formal consent, thoughtful assessment before lethal force is used, cop partnered w MH professional

Answer 21

- naturalistic observation and field experiment - also known as the thud experiment - Experiment was conducted to determine the reliability and validity of psychiatric diagnosis- it feigned hallucinations to enter psychiatric hospitals and acted normally afterward- they were diagnosed w psychiatric disorders and were given antipsychotic drugs - Involved the use of healthy associated men and women including the researcher himself who feigned auditory hallucinations in an attempt to gain admission to 12 psychiatric hospitals in 5 states. All were admitted and diagnosed w psychiatric disorders. After admission the ppl acted normal and told staff they were fine and had no longer experienced any additional hallucinations. All were forced to admit having mental illness and had to agree to take antipsychotic drugs as a condition of their release. All but 1 were diagnosed with schizophrenia in remission before their release - In the following weeks out of 250 new patients the staff identified 41 as potential participants w 2 of these receiving sus from at least one psychiatrist and one other staff member - Rosenhan used experiment to test the reliability of psychiatric diagnoses - Study concluded by saying it is clear that we cannot distinguish the same from the insane in psychiatric hospitals and also illustrated the dangers of dehumanization and labelling in psychiatric institutions - It suggests the use of community mental health facilities which concentrated on specific probs and behaviors rather than psychiatric labels might be a solution

Answer 22

- sentenced to life w no chance of parole for 17 yrs originally - sentenced for killing his 2 children - found guilty of 2nd degree murder in stabbing his kids to death - Jury carries out automatic life sentence reflecting the nature of his crimes - Crown asked he serve a minimum of 20 years while the defense argued he should be eligible to apply for parole after 10 yrs - He had no previous convictions and was not considered a risk to society- Crown's request was seen to be exaggerated - At his first trial he was found not criminally responsible for killing his kids and the second trial ultimately ended in his 2nd degree murder conviction - his legal team is appealing the guilty verdict

Answer 23

- Li is a schizophrenic who was psychotic at the time of the event and he acc poses a low risk of reoffending and they say he will be closely monitored that if his mental health declines further it will be quickly detected and actions will be taken to rein in his freedoms - The review board ruled Li could transfer to a psychiatric center at a Winnipeg hospital and will be allowed unsupervised visits to the Manitoba capital as long as he carries a phone - Doc said he did not have hallucinations for over a year - Li received a NCR designation after he killed Tim McLean on a bus - Li said he heard the voice of God instructing him to kill McLean and repeatedly stabbed and mutilated the young man who was on the bus - likelihood of reoffending for these ppl is rare

Answer 24

Ppl held under an NCR are 5x less likely to commit a later crime than ppl who are sent to prison for crimes and are released after they serve their time - Your chances are greater to get struck by lightning than being killed by an NCR person

Answer 25

Ppl under NCR order receive the appropriate medical care and supervision unlike the penal system where ppl serve a set sentence in the NCR system ppl only attain more freedom when their doctors and their review board are convicted that they mentally fit into a threat to the public - Ppl who go through the prison system have a 40% chance of re-offending within 3 yrs of release but for ppl who go through NCR system the rate is 7-9%

Answer 26

Ppl under NCR orders generally commit less serious crimes if they do re-offend such as public disturbances and homicide recidivism is very rare

Answer 27

When ppl under the NCR order run afoul of the law the loosened bounds of the system quickly tighten again

Answer 28

- Ppl who commit serious crime while in the grips of psychosis are often so horrified by their actions that they are highly motivated to follow mandated medical regimen - they often feel bad for their actions and this is then a motivation to change their life - it is hard for ppl w schizophrenia to take their meds daily so this could be a reason for their actions

Answer 29

Sahmi: was not mentally ill but was acting strange following ppl w a knife pl w a knife Police: fired at him and then tasered him O'Brien: O'Brien thought ppl were after him- putting microphone in his teeth Police: O'Brien is walking around w a knife and police tell him to get on the ground and he runs away and he asked why to go on the ground and they did not answer and they shot him within 3 mins of coming into contact w him and he did not pose a real threat Micheal: Micheal leaves hospital in gown and goes to store to get scissors and didn’t want to pay for them and hurt the worker - Micheal suffered seizures from brain injury and he bolts out of door naked through neighborhood banging on car windows, picks up rocks and drops them then police show up and shoot Micheal 2x Police: Micheal waving scissors around confused trying to get in ppls houses and police show up and kill him Boyd: Boyd struggling w bipolar and shot by police- Paul was in successful career, smart- his mom diagnosed with ALS and his bipolar got more regularly, Paul called his dad 3 times that day and did not want to go to hospital Police: eventually shot by police 2 mins after police entered scene, Boyd attacking officer with chain but Boyd was unarmed and crawling when shot was fired- officer who fired believed he was under threat- he was shot 9 times by officer- police were the cause of the violence

Answer 30

What is going on: - Canada keeps no record of police shootings but 72 ppl in crisis are shot and esp non white victims - Toronto and other cities not keeping up w the demand of mental health crisis- should be treating them before crisis - When ppl are obviously vulnerable police kill them - Police are reluctant to back off - Officer safety first- based on police training south of boarder - police put under supervision after so many shootings - Police do this as a fear factor - Police are trained anything to cut your skin is a threat and hand to hand is not an option - Police in a rush to fill positions- they take chances with candidates what they should be doing: - Police should try de-escalation instead of using violence - Over time more ppl ended up in hospital for crisis instead of police killing them - Response to increase of ppl in crisis police now use teams of mental health professional w officer- they divert ppl from the CJS or hospital and talk w mental health official and they put them up with counselling - 21 foot rule required to react and deliver to move out of attackers path- got into officers heads - We need to teach how police are taught- point is for police to back up to buy more time so there is no harm done - Body cams to record interactions w public- 60% of reduction in violence, increase communication skills to talk to individual instead - Cant let emotion or fear take over and remember the person in crisis can be a person you love

Answer 31

- UK a man has a Michetti and give him room to move and handcuffed eventually- he would not of survived in North America - in the UK only small groups handle firearms for training purposes - UK police went in w shields on person seeing things- she got his eye contact and talked to him - Police and UK don’t even have fire arms often times - In UK the issue is ill ppl in system instead of care