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Lecture 11

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Psychology 2030A/B
David Vollick

Chapter 16- Mental Health Services: Legal and Ethical Issues  Final is on chapter 10-16  Civil Commitment  Civil Commitment Laws: Address o Legal declaration of mental illness; not the same a psychological o When person can be places in a hospital or institutions, even against their will o When a person is dangerous to self or others o Has nothing to do with kinds of treatment; can be committed if we think they need treatment in general o When a person can be legally declared to have a mental illness o Have to establish a grave disability; inability to care for self o If legally diagnosed with mental illness and are in need of any treatment, if person if a danger to self or others= grounds to commit someone  All Canadian jurisdictions require the their and some also require the 1al defandtion) 6th  Government Authority over Civil Commitment o Involves trial and overshadow others o Police power: protection of health, welfare, and safety of society o Parens patiae: acts on behalf of a citizen who is not likely to act in his or her own best interest; state acts a surrogate parent; NOT a legal guardian; court becomes surrogate parents  The Civil Commitment Process  Initial Stages o Person fails to seek help, but others feel that help is needed o Assessment by one or two physicians o Petition is made to a judge on behalf of the person; “we deem this individual incapable and are failing in life structure” o The individual must be notified of the civil commitment process  Subsequent Stages o Involve normal legal proceedings in most cases  Determination is made by a judge regarding whether to commit the person  The Concept of Mental Illness in Civil Commitment Process  Defining Mental Illness o Is a legal concept; referring to severe thought or behavioral disturbances; negatively affect health/safety; could be not eating or not dressing for weather o Definition differ by province; Saskatchewan uses “functional Definition”- the effect of illness on thought and behavior  Dangerous to Self or Others: Central to Commitment Proceedings o Assessing dangerousness- the role of mental health professionals; history, alcohol abuse, etc. o Hallucinations, personality disorder raises risk o Not able to make specific predictions about violence and mental illness o 90% of mentally ill have no history of violence; do not harm people  Self Harm (Ogloff)- those who: o Report suicidal thought while in hospital o Show verbal/physical aggression o Have history of self-harm o Had engaged in a suicidal attempt within 2 weeks before being committed o All were more likely to harm themselves in hospital  Problems with the Process of Civil Commitment  Early Supreme Court Ruling: Restrictions On Involuntary Commitment o A non-dangerous person cannot be committed o Need for treatment alone is not enough to be committed o Having a grave disability is insufficient  Consequences of Supreme Court Rulings o Criminalization of the mentally ill o Deinstitutionalization- closed several large psychiatric hospitals and created a network of community health services= increase of homeless mentally ill; no better treatment; the idea was good but no services put in place o Trans-institutionalization- movement of mentally ill to nursing homes, jails and group residences; people at these places were not trained to work with mentally ill  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; not specific  Civil commitment can be overshadowed  Criminal Commitment  Nature of Criminal Commitment o Accused of committing a crime o Detainment in a mental illness health facility for evaluation of fitness to stand trial o Found guilty of not guilty by reason of insanity  I.e. a Schizophrenic who killed someone because voices told him to, he would never go to trial; would not be found guilty  The Insanity Defense  Nature of the Insanity Defense Plea o Legal statement by the accused of not guilty because of insanity at the time of crime; had no idea what they were doing or thought what they were doing was not wrong; does not include intoxication by alcohol or drugs o Defendant goes to treatment facili
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