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Mental Health Services: Legal & Ethical Issues
5th powerpoint
47
Psychology
Not Applicable
12/10/2010

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Cards

Term
Mental health is guided by _______ principles and ___________.
Definition
ethical; state/federal laws
Term
What are the 2 perspectives on Mental Health Law?
Definition

1. Liberal --> rights of mentally ill dominated (1960-1980)

2. Neo-conservatie --> limit rights of patients (1980-onwards)

Term
What are 4 main issues of mental health and the legal system?
Definition

1. Nature of civil vs. criminal commitment

2. Balancing ethical consdierations vs. legal considerations

3. Role of psychologists in legal matters

4. Rights of patient & research subjects

Term
The legal declaration of mental illness.
Definition
civil commitment
Term
When can a person be placed in a hospital for treatment?
Definition
laws & definitions of metnal illness vary by state
Term
What are the 3 general criteria for civil commitment?
Definition

1. Person has a mental illness & needs treatment

2. Person is dangerous to self or others

3. Grave disability (inability to care for self)

Term
What are the 2 types of Government Authorities Over Civil Commitment?
Definition

1. Police power--health, walfare, & safety of society

2. Parens patriae--state acts as a surrogate parent

Term
What are the 4 parts of the initial stages of the civil commitment process?
Definition
  1. Person fails to seek help
  2. Others feel help is needed
  3. Petition is made to a judge on behalf of the person (anyone can do this)
  4. Individual msut be notified of the commitment process (can appeal)
Term
What are the 2 parts of the subsequent stages of the civil commitment process?
Definition

1. Invovle normal legal proceedings (most cases)

2. Judge determines whether or not a person should be committed

Term
The civil commitment process may be skipped if a person is a danger and they can be held for up to ___hrs.
Definition
72
Term
Mental illness is a ______ concept.
Definition
legal
Term
Mental illness is NOT synonymous with a ____________________.
Definition
psychological disorder
Term
Definitions of mental illness vary by _____.
Definition
state
Term
Definitions of mental illness often exclude conditions such as _____________ & ____________________.
Definition
mental illness; substance-related disorders
Term
Assessing the dangerousness of a patient is the role of ________________________.
Definition
mental health professionals
Term
Statistically we are not good at predicting whether or not a person is _________.
Definition
dangerous
Term
When it comes to assessing dangerousness of a patient what 2 types of patients are often treated differently (biased)?
Definition

1. women

2. ethnic minorities

Term
Dangerousness to self or others is central to the __________________.
Definition
commitment proceedings
Term
Early supreme court rulings placed restrictions on ___________________.
Definition
involuntary commitment
Term
What are 3 characteristics of early supreme court rulings on civil commitment?
Definition

1. A non-dangerous person cannot be committed

2. Need for treatment alone is not enough

3. Having a grave disability is insufficient

Term
What are 4 consequences of the early supreme court rulings on civil commitment?
Definition

1. Crminilization of the mentally ill

2. Increase in homelessness

3. Deinstitutionalized (large psychiatric hospitals closed)

4. transinstitutionalization (mentally ill to community care)

Term
After the early supreme court rulings, civil commitment criteria were broadened.  What 2 criteria were added?
Definition

1. For dangerous & non-dangerous persons

2. For persons in need of treatment

Term
After subsequent modifications to the civil commitment criteria, who argued for further reform?
Definition
National Alliance of the Mentally Ill
Term
The nature of criminal commitment includes what 4 things?
Definition
  1. Accused of commiting a crime
  2. Detainment in metnal health facility for evaluation
  3. Focus on fitness to stand trial
  4. Found guilty or not guilty by reason of insanity
Term
A legal statement that states the accused is not guilty because of insanity at the time of the crime
Definition
Insanity Defense Plea
Term
If a person is found "insane" they are sent to ________________.
Definition
a treatment facility rather than prison
Term
Diagnosis of a disorder is not the same as _______.
Definition
insanity
Term
The insanity defense originated here.  The rule says that people are not responsible for their criminal behavior if they do not know what they are doing or do not know what they are doing is wrong.
Definition
M'Naughten Rule
Term
A more inclusive defintion of insanity that included any type of mental disease or defect.
Definition
Durham rule
Term
What definition of insanity is currently used?
Definition
American Law Institute Standard
Term
The American Law Institute Standard includes what 3 things?
Definition
  1. Knowledge of right and wrong
  2. Self-control
  3. Diminished cpacity (peoples ability to understand the nature of their behavior)
  • no criminal intent!
Term
The public misperception and outrage about the insanity defense originated from the case of who?
Definition

John Hinckley Jr. found not guilty by reason of insanity

**In love with Jody Foster

**Wanted to kill JFK to impress her

Term
Outrage at the insanity defense plea caused ___% of states to move to abolish the inanity defense.
Definition
50
Term
The public view the insanity defense as a ____________.
Definition
legal loophole
Term
The insanity defense is used in less than __% of criminal cases.
Definition
1
Term
People who get the insanity defense spend more itme in __________ than in ___________.
Definition
mental hospitals; jail
Term
The movement back to M'Naughten-like standards.
Definition
Insanity Defense Reform Act
Term
The charge or defense that allows for treatment and punishment. 
Definition
Guilty but mentally ill (GBMI)
Term
Using knowledge of behavior change to help those in trouble with the law
Definition
Therapeutic Jurisprudence
Term
Courts that address unique needs of people with specific problems.  Examples include delayed sentencing under the condition that the individual holds a job for 6 months.
Definition

"Problem Solving" Courts

 

**encourages the engagement in better behavior

Term
What are the 2 requirements for competence to stand trial?
Definition
  1. Understanding of legal charges
  2. Ability to assist in one's own defense
Term
What is essential for trial or legal processes?
Definition
competence to stand trial
Term
Burden of proof of competence is on the ________.
Definition
defense
Term
What are the 2 consequences of a determination of incompetence?
Definition
  1. loss of decision-making authority
  2. results in commitment, but with limitations (time limit)
Term
A person with specialized knowledge and expertise, that assists in competency determinations, making reliable DSM diagnoses, advising the court, and assessing malingering
Definition
The Expert Witness: Psychologist
Term
What are the 7 research participant rights?
Definition

1. Right to be informed about the research (informed consent)

2. Right to privacy

3. Right to be treated w/ respect & dignity

4. Right to be protected form physical & mental harm

5. Right to chose/refuse to particpate in research

6. Right to anonymity in report of study findings

7. Right to safeguarding records

Term
What are the 4 rights of the patient?
Definition

1. Right to treatment

-can't be committed involuntarily without treatment

-treatment to reduce symptoms & humane care

2. Right to the Least restrictive alternative

-least confining setting

3. Right to refuse treatment (medication)

-persons cannot be forced to become competent for trial

4. Right to confidentiality vs duty to warn

-Tarasoff and the duty to warn limits on confidentiality

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