Week 7 & 8: Violence Risk Assessment & Suicide Risk Assessment Flashcards
1
Q
What are the key elements for duty to warn & protect?
A
- Specific threat
- Specific victim
- Foreseeable danger
2
Q
Barefoot v. Estelle (1983)
A
- Psychiatrists are allowed to testify about future dangerousness during death penalty sentencing.
- Barefoot appealed (MH professionals’ ability to predict future dangerousness is limited)
- SCOTUS: such testimony is not unconstitutional
3
Q
Thompson v. County of Alameda (1980)
A
There is a specific threat towards a specific victim.
Ruling: The County is not liable for negligence in releasing the prisoner without warning to the community.
4
Q
Parens patriae and police power
A
- A government must protect it’s citizens from each other and themselves.
5
Q
Rouse v. Cameron (1967)
A
- Right to treatment
- Can’t just be confinement, must provide treatment
- Argument sometimes used for release
- “…persons committed to a mental hospital after pleading not guilty by reason of insanity have a constitutional right to treatment while institutionalized.”
6
Q
Rennie v. Klein (1978)
A
- Factors to consider in overiding refusal:
- Patient’s capacity to make treatment decisions
- Patient’s physical threat to staff/other patients
- Whether any less restrictive treatment exists
- Risk of permanent side effects from treatment
- “An involuntarily committed patient who has not been found incompetent, absent an emergency, has a qualified right to refuse psychotropic medication.”
7
Q
O’Connor v. Donaldson (1975)
A
- No dangerousness, no treatment
- “If an individual is not posing a danger to self or others and is capable of living without state supervision, the state has no right to commit the individual to a facility against his or her will.”
8
Q
Addison v. Texas (1979)
A
- Level of proof, clear and convincing; burden of proof is on the petitioner
- “A “clear and convincing” standard of proof is required by the Fourteenth Amendment in a civil proceeding brought under state law to commit an individual involuntarily for an indefinite period to a state mental hospital.”
9
Q
Foucha v. Louisiana (1992)
A
- Does personality disorder count as mental illness?
- “…a criminal defendant found not guilty by reason of insanity may be committed to a psychiatric hospital.”
10
Q
Assessments for Tarasoff and civil commitment require focus on risk state rather than risk status:
A
- Does this present a risk now? (rather than is this a risky person relative to others)
- Need to be able to assess changes over time
11
Q
Risk state: Challenges
A
- Need for research on dynamic predictors and causal factors, not just correlates
- Need for research with assessments at multiple time points
- Schedule of assessment: How quickly does risk change and how often should we assess?
- Multifactorial nature of risk, and complex interplay between risk factors
12
Q
Promising dynamic risk factors:
A
- Focus on dynamic risk allows for:
- More informed decisions about type of treatment and supervision needed.
- Identification of when intervention is necessary to reduce risk
- Identification of appropriate treatment targets
13
Q
What are the types of risk assessment procedures?
A
Clinical, Actuarial, Structured Professional Judgment
14
Q
Define clinical risk assessment procedures.
A
- Evidentiary test of admissibility of expert testimony on violence risk assessment:
- Has the theory been tested?
- Reliance on subjective clinical interpretation of the expert?
- Peer review & publication?
- Potential rate of error?
- General acceptance?
- Non-judicial uses of the theory or technique?
- Post Daubert conclusions: “Testimony by a qualified expert re: a properly conducted clinical violence risk assessment will remain admissible as evidence.”
15
Q
Define actuarial risk assessment procedures.
A
- Use an algorithm/formula to combine risk factors to calculate an overall risk score.
- Clinical Interview.
- Collateral Information (official records)
- Scoring & weighting of predictive characteristics by formula (weighted towards static risk factors)
