Comer, Fundamentals of Abnormal Psychology, 5th edition

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1、1 1Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Slides&Handouts by Karen Clay Rhines,Ph.D.Slides&Handouts by Karen Clay Rhines,Ph.D.Chapter 16 HandoutsLaw,Society,and the Mental Health Profession2Comer,Comer,Fundamentals of Abnormal Ps

2、ychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Law,Society,and the Mental Health ProfessionnPsychological dysfunction of an individual does not Psychological dysfunction of an individual does not occur in isolationoccur in isolationn nIt is influenced sometimes caused by soci

3、etal and social It is influenced sometimes caused by societal and social pressurespressuresn nIt affects the lives of relatives,friends,and acquaintances It affects the lives of relatives,friends,and acquaintances nClinical scientists and practitioners do not conduct their Clinical scientists and pr

4、actitioners do not conduct their work in isolationwork in isolationn nThey are affecting and being affected by other institutions of They are affecting and being affected by other institutions of societysociety3Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Cha

5、pter 16,5e Chapter 16Law,Society,and the Mental Health ProfessionnTwo social institutions have a particularly strong impact Two social institutions have a particularly strong impact on the mental health profession the legislative and on the mental health profession the legislative and judicial syste

6、msjudicial systemsn nThis relationship has two aspects:This relationship has two aspects:n nMental health professionals often play a role in the criminal justice Mental health professionals often play a role in the criminal justice system(“psychology in law”)system(“psychology in law”)n nThe legisla

7、tive and judicial systems are responsible for regulating The legislative and judicial systems are responsible for regulating certain aspects of mental health care(“law in psychology”)certain aspects of mental health care(“law in psychology”)n nThe intersection between the mental health field and the

8、 legal The intersection between the mental health field and the legal and judicial systems are collectively referred to as“forensic and judicial systems are collectively referred to as“forensic psychology”psychology”4Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,

9、5e Chapter 16,5e Chapter 16Psychology in Law:How Do Clinicians Influence the Criminal Justice System?nTo arrive at just and appropriate punishments,the To arrive at just and appropriate punishments,the courts need to assess a defendants _ for courts need to assess a defendants _ for committing a cri

10、me and his or her _ to committing a crime and his or her _ to contribute toward a defense contribute toward a defense n nFor example,people who suffer from“severe mental For example,people who suffer from“severe mental instability”may not be responsible for their actions or be able instability”may n

11、ot be responsible for their actions or be able to defend themselves in courtto defend themselves in courtnThese determinations are guided by the opinions of These determinations are guided by the opinions of mental health professionalsmental health professionals5Comer,Comer,Fundamentals of Abnormal

12、PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Psychology in Law:How Do Clinicians Influence the Criminal Justice System?nWhen people accused of crimes are judged to be When people accused of crimes are judged to be mentally unstable,they are usually sent to a mental mental

13、ly unstable,they are usually sent to a mental institution for treatment institution for treatment n nThis process is called _This process is called _n nSeveral forms:Several forms:n nMentally unstable at the time of the crime=_ Mentally unstable at the time of the crime=_ _ and committed until _ and

14、 committed until improved enough to be releasedimproved enough to be releasedn n_=committed until _=committed until competent to stand trial competent to stand trial 6Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Psychology in Law:How D

15、o Clinicians Influence the Criminal Justice System?nThe determination of mental instability has stirred many argumentsnSome consider the judgments“loopholes”Some consider the judgments“loopholes”nOthers argue that a legal system cannot be just Others argue that a legal system cannot be just unless i

16、t allows for extenuating circumstances,such unless it allows for extenuating circumstances,such as mental instabilityas mental instabilitynThe practice of criminal commitment differs from country to country7Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter

17、 16,5e Chapter 16Criminal Commitment and Insanity During Commission of a Crimen“_”is a legal termnDefendant may have a mental disorder but not Defendant may have a mental disorder but not qualify for a legal definition of insanityqualify for a legal definition of insanitynThe original definition can

18、 be traced to the 1843 The original definition can be traced to the 1843 murder trial of Daniel MNaghten in England:murder trial of Daniel MNaghten in England:n nThe _ stated that experiencing a The _ stated that experiencing a mental disorder at the time of a crime does not by itself mental disorde

19、r at the time of a crime does not by itself mean that the person was insane;the defendant also had mean that the person was insane;the defendant also had to be _to be _8Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Criminal Commitment a

20、nd Insanity During Commission of a CrimenIn the late 19th century,some U.S.courts adopted a In the late 19th century,some U.S.courts adopted a different standard of insanity:different standard of insanity:n n_n nThis test emphasized the inability to control ones actions(“fit of This test emphasized

21、the inability to control ones actions(“fit of passion”defense)passion”defense)nA third test also briefly became popular:A third test also briefly became popular:n n_n nPeople were not criminally responsible if their“unlawful act was the People were not criminally responsible if their“unlawful act wa

22、s the product of mental disease or defect”product of mental disease or defect”9Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Criminal Commitment and Insanity During Commission of a CrimenIn 1955,the American Law Institute developed a te

23、st In 1955,the American Law Institute developed a test that combined aspects of the MNaghten,irresistible that combined aspects of the MNaghten,irresistible impulse,and Durham tests impulse,and Durham tests n nThe test was adopted,but was criticized for being too The test was adopted,but was critici

24、zed for being too“liberal”“liberal”nIn 1983,the American Psychiatric Association In 1983,the American Psychiatric Association recommended a return to _recommended a return to _n nThis test now is used in all cases tried in federal courts and in This test now is used in all cases tried in federal cou

25、rts and in about half of state courtsabout half of state courts10Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Criminal Commitment and Insanity During Commission of a CrimenUnder this standard,about two-thirds of defendants acquitted by

26、 reason of insanity qualify for a diagnosis of schizophrenianAbout 50%are CaucasianAbout 50%are CaucasiannAbout 86%are maleAbout 86%are malenAbout 65%of cases involve violent crime of some About 65%of cases involve violent crime of some sortsortn nClose to 15%of those acquitted are accused specifica

27、lly Close to 15%of those acquitted are accused specifically of murderof murder11Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 1612Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter

28、16What Concerns Are Raised by the Insanity Defense?nDespite changes in the insanity standard,criticism of Despite changes in the insanity standard,criticism of the defense continuesthe defense continuesn nOne concern is the fundamental difference between the law One concern is the fundamental differ

29、ence between the law and the science of human behaviorand the science of human behaviorn nThe law assumes that individuals have free will and are generally The law assumes that individuals have free will and are generally responsible for their actionsresponsible for their actionsn nA second criticis

30、m points to the uncertainty of scientific A second criticism points to the uncertainty of scientific knowledge about abnormal behaviorknowledge about abnormal behaviorn n_n nIn reality,the number of such cases is small(less than 1%)In reality,the number of such cases is small(less than 1%)13Comer,Co

31、mer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16What Concerns Are Raised by the Insanity Defense?nDuring most of U.S.history,a successful insanity plea amounted to a long-term prison sentencenToday,because of the improvements in drug therapy Toda

32、y,because of the improvements in drug therapy and treatment,offenders are being released earlier and treatment,offenders are being released earlier and earlierand earlier14Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16What Other Verdict

33、s Are Available?nIn recent years,another verdict has been added In recent years,another verdict has been added _n nDefendants receiving this verdict are found mentally ill at the Defendants receiving this verdict are found mentally ill at the time of their crime,but their illness was not fully relat

34、ed to or time of their crime,but their illness was not fully related to or responsible for the crimeresponsible for the crimenSome states allow for another defense _ Some states allow for another defense _ _n nA defendants mental dysfunction is viewed as an extenuating A defendants mental dysfunctio

35、n is viewed as an extenuating circumstance which should be consideredcircumstance which should be considered15Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16What Are Sex-Offender Statutes?nSince 1937,when Michigan passed the first“sex ps

36、ychopath”law,many states have placed sex offenders in a special category:nMentally disordered sex offendersMentally disordered sex offendersn nLike people found NGRI,mentally disordered sex Like people found NGRI,mentally disordered sex offenders are committed to a mental health facilityoffenders ar

37、e committed to a mental health facilityn nIn recent years,a number of states have changed or In recent years,a number of states have changed or abolished these lawsabolished these laws16Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Crim

38、inal Commitment and Incompetence to Stand TrialnRegardless of their state of mind at the time of trial,Regardless of their state of mind at the time of trial,defendants may be judged to be _ defendants may be judged to be _ _ to stand trial_ to stand trialn nThis requirement is meant to ensure that

39、defendants This requirement is meant to ensure that defendants understand the charges they are facing and can work with understand the charges they are facing and can work with their lawyers to present an adequate defensetheir lawyers to present an adequate defensen nThis standard of competence was

40、specified by the U.S.This standard of competence was specified by the U.S.Supreme Court in 1960Supreme Court in 196017Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Criminal Commitment and Incompetence to Stand TrialnIf the court decides

41、 that the defendant is incompetent,If the court decides that the defendant is incompetent,the person is assigned to a mental health facility until the person is assigned to a mental health facility until competent to stand trialcompetent to stand trialn n_nThe majority of criminals currently institu

42、tionalized for The majority of criminals currently institutionalized for psychological treatment are convicted inmates whose psychological treatment are convicted inmates whose psychological problems have led prison officials to psychological problems have led prison officials to decide they need tr

43、eatmentdecide they need treatment18Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Law in Psychology:How Do the Legislative and Judicial Systems Influence Mental Health Care?nJust as the clinical field has influenced the legal system,Just

44、 as the clinical field has influenced the legal system,so has the legal system influenced clinical practiceso has the legal system influenced clinical practicen nCourts have developed the process of _ Courts have developed the process of _ which allows people to be forced into mental health which al

45、lows people to be forced into mental health treatmenttreatmentn nThe legal system,on behalf of the state,has taken on the The legal system,on behalf of the state,has taken on the responsibility of protecting patients rights during treatmentresponsibility of protecting patients rights during treatmen

46、tn nThis protection extends to patients who have been involuntarily This protection extends to patients who have been involuntarily committed,as well as to those who have sought treatment voluntarily committed,as well as to those who have sought treatment voluntarily 19Comer,Comer,Fundamentals of Ab

47、normal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Civil CommitmentnGenerally our legal system permits involuntary Generally our legal system permits involuntary commitment of individuals who are considered to be in commitment of individuals who are considered to be in n

48、eed of treatment and dangerous to themselves or need of treatment and dangerous to themselves or othersothersn n_n n_nThe states authority rests on its duties to protect the The states authority rests on its duties to protect the interests of the individual and of societyinterests of the individual

49、and of societyn nPrinciple of parens patriae(“parent of the country”)Principle of parens patriae(“parent of the country”)n nPrinciple of police powerPrinciple of police power20Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16What Are the P

50、rocedures for Civil Commitment?nCivil commitment laws vary from state to statenFamily members often begin the proceedingsFamily members often begin the proceedingsnFew guidelines have been offered by the Supreme Few guidelines have been offered by the Supreme CourtCourtn n1979:_ required:1979:_ requ

51、ired:n nMust be“clear and convincing”proof of illness and of meeting Must be“clear and convincing”proof of illness and of meeting the states criteria for commitmentthe states criteria for commitment21Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e

52、Chapter 16Emergency CommitmentnMany states give clinicians the right to certify certain patients as needing temporary commitment and medicationnRequires the agreement of two physicians and/or Requires the agreement of two physicians and/or mental health professionalsmental health professionalsn nThe

53、se certifications often are referred to as“2PCs”(two These certifications often are referred to as“2PCs”(two physician certificates)physician certificates)nThe length of stay is often limited to three daysThe length of stay is often limited to three days22Comer,Comer,Fundamentals of Abnormal Psychol

54、ogyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Who Is Dangerous?nHistorically,people with mental illnesses were less likely than others to commit violent or dangerous acts because of mass hospitalizationsnSince deinstitutionalization,however,this is no Since deinstitutionalization

55、,however,this is no longer truelonger truen n_23Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Who Is Dangerous?nA judgment of“dangerousness”is often required for involuntary civil commitmentnResearch suggests that,while mental health Re

56、search suggests that,while mental health professionals are very often wrong in making long-professionals are very often wrong in making long-term predictions of violence,short-term predictions term predictions of violence,short-term predictions predictions of imminent violence can be accurate predic

57、tions of imminent violence can be accurate 24Comer,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16What Are the Problems with Civil Commitment?nCivil commitment has been criticized on several Civil commitment has been criticized on several grou

58、nds:grounds:n n_n n_n n_nOn the basis of these and other arguments,some On the basis of these and other arguments,some clinicians argue that involuntary commitment should be clinicians argue that involuntary commitment should be abolishedabolished25Comer,Comer,Fundamentals of Abnormal PsychologyFund

59、amentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Trends in Civil CommitmentnThe flexibility of involuntary commitment laws peaked The flexibility of involuntary commitment laws peaked in 1962in 1962n nThe Supreme Court ruled that imprisoning people who The Supreme Court ruled that imprison

60、ing people who suffered from drug addictions might violate the suffered from drug addictions might violate the Constitutions ban on cruel and unusual punishmentConstitutions ban on cruel and unusual punishmentn nAs the public became aware of these issues,states passed As the public became aware of t

61、hese issues,states passed stricter standards for commitmentstricter standards for commitmentnToday,fewer people are institutionalized through civil Today,fewer people are institutionalized through civil commitment proceedings than in the pastcommitment proceedings than in the past26Comer,Comer,Funda

62、mentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16Protecting Patients RightsnOver the past two decades,court decisions and state and federal laws have greatly expanded the rights of patients with mental disorders,in particular the _ and the _27Comer,Comer,F

63、undamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16How Is the Right to Treatment Protected?nWhen people are committed to mental institutions and do not receive treatment,the institutions become prisons for the unconvictednIn the late 1960s and 1970s,larg

64、e mental institutions In the late 1960s and 1970s,large mental institutions were just thatwere just thatnSome patients and their attorneys began to demand Some patients and their attorneys began to demand that the state honor their right to treatmentthat the state honor their right to treatment28Com

65、er,Comer,Fundamentals of Abnormal PsychologyFundamentals of Abnormal Psychology,5e Chapter 16,5e Chapter 16How Is the Right to Treatment Protected?nSeveral court rulings addressed this issue:Several court rulings addressed this issue:n n1972 A federal court ruled that the state was 1972 A federal co

66、urt ruled that the state was constitutionally obligated to provide“adequate treatment”to constitutionally obligated to provide“adequate treatment”to all people who had been committed involuntarilyall people who had been committed involuntarilyn n1975 The Supreme Court ruled that institutions must 1975 The Supreme Court ruled that institutions must review case files periodically and that the state cannot review case files periodically and that the state cannot continue to institutionalize against