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Lecture 12

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Psychology 2030A/B
David Vollick

Abnormal  Psychology  Chapter  16:   Mental  Health  Services:  Legal  and  Ethical  Issues  (pp.  558-­‐578)     Civil  Commitment  (pp.  560-­‐565)   • Civil  Commitment  Laws   o Address  legal  declaration  of  mental  illness   o Address  when  a  person  can  be  placed  in  a  hospital  or  institution  for   treatment   • General  Criteria  for  Civil  Commitment   o Demonstrate  that  a  person  has  a  mental  illness  and  needs  treatment   o Show  that  the  person  is  dangerous  to  self  or  others   o Establish  a  grave  disability  –  inability  to  care  for  self    All  Canadian  jurisdictions  require  the  second  and  some  but  not   all  require  the  first  and  third  criteria   • Governmental  Authority  Over  Civil  Commitment   o Police  Power  –  protection  of  the  health,  welfare,  and  safety  of  society   o Parents  Patriae  –  acts  on  behalf  of  a  citizen  who  is  not  likely  to  act  in   his  or  her  own  best  interest  –  State  acts  as  a  surrogate  parent     The  Civil  Commitment  Process  (pp.560-­‐565)   • Initial  Stages   o Person  fails  to  seek  kelp,  but  others  feel  that  help  is  needed   o Assessment  by  one  or  two  physicians   o Petition  is  made  to  a  judge  on  the  behalf  of  the  person   o Individual  in  question  must  be  notified  of  the  civil  commitment   process   • Subsequent  Stages   o Involve  normal  legal  proceedings  in  most  cases   o Determination  is  made  by  a  judge  regarding  whether  to  commit  the   person     The  concept  of  Mental  Illness  in  Civil  Commitment  Proceedings  (pp.  560-­‐565)   • Defining  Mental  Illness   o Is  a  legal  concept,  referring  to  severe  thought  or  behavioural   disturbances  –  negatively  affect  health/safety   o Not  synonymous  with  a  psychological  disorder   o Definitions  of  mental  illness  vary  by  province  –  Saskatchewan  uses   “Functional  Definition”  =  the  effect  of  illness  on  thoughts  and   behaviour   • Dangerousness  to  Self  or  Others:  Central  to  Commitment  Proceedings   o Assessing  dangerousness:  The  role  of  mental  health  professionals  –   history,  alcohol  abuse   o Hallucinations,  delusions,  personality  disorder  raise  risk   o Not  able  to  make  specific  predictions  about  violence  and  mental   illness   o 90%  of  mentally  ill  have  no  history  of  violence   • Self-­‐Harm  –  those  who:   o Report  suicidal  thoughts  while  in  hospital   o Show  verbal/physical  aggression   o Have  a  history  of  self-­‐harm   o Had  engaged  in  a  suicide  attempt  within  two  weeks  before  being   committed   o All  were  more  likely  to  harm  themselves  in  hospital   • Early  Supreme  Court  Rulings:  Restrictions  on  Involuntary  Commitment   o A  non  dangerous  person  cannot  be  committed   o Need  for  treatment  alone  is  not  enough   o Having  a  grave  disability  is  insufficient   • Consequences  of  Supreme  Court  Rulings   o Criminalization  of  the  mentally  ill   o Deinstitutionalization  –  downsize/close  several  large  psychiatric   hospitals  and  create  a  network  of  community  health  services   o Transinstitutionalizaion  –  movement  of  mentally  ill  to  nursing  homes,   jails,  and  group  residences     Subsequent  Modification  to  Civil  Commitment  Procedures   • Civil  Commitment  Criteria  were  Broadened   o Involuntary  commitment  for  dangerous  and  non-­‐dangerous  persons   o Involuntary  commitment  for  persons  in  need  of  treatment     Criminal  Commitment  (pp.565)   • Nature  of  Criminal  Commitment   o Accused  of  committing  a  crime   o Detainment  in  a  mental  health  facility  for  evaluation  of  fitness  to  stand   trial   o Found  guilty  or  not  guilty  by  reason  of  insanity     The  Insanity  Defense  (pp.  565-­‐566)   • Nature  of  the  Insanity  Defense  Plea   o Legal  statement  by  the  accused  of  not  guilty  because  of  insanity  at  the   time  of  the  crime   o Defendant  goes  to  a  treatment  facility  rather  than  a  prison   o Diagnosis  of  a  disorder  is  not  the  same  as  insanity   o Battered  wife  syndrome:  a  valid  form  of  the  self-­‐defense  because  an   accused  may  reasonably  believe  that  her  life  is  in  danger  even  though   it  may  not  be  imminent   • Definitions  of  Insanity   o M’Naughten  rule  –  Insanity  defense  originated  with  this  ruling  –  not   know  what  they’re  doing,  or  that  its  wrong   o Durham  rule  –  more  inclusive,  involving  mental  disease  or  defect  –   has  been  disc
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