Chapter 18
Mental Health and the Law
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Competency to Stand Trial
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People who do not have an understanding of what is
happening to them in a courtroom and who cannot
participate in their own defense are said to be
incompetent to stand trial.
Defense attorneys suspect impaired competence in their
clients in up to 10 percent of cases.
Psychologists have developed tests of cognitive abilities
important to following legal proceedings, and can identify
people who perform poorly on these tests.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Critical Judgments That Mental-Health
Professionals Are Asked to Make About
People Accused of Crimes
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Whether they are competent to stand trial
Whether they were sane at the time the
crimes were committed.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Insanity Defense
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Insanity is actually a legal term rather than a
psychological or medical term, and it has been
defined in various ways.
All definitions of insanity reflect the fundamental
doctrine that people cannot be held fully responsible
for their acts if they were so mentally incapacitated at
the time of the acts that they could not conform to the
rules of society.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Insanity Defense, continued
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While the lay public often thinks of the insanity
defense as a means by which guilty people “get off,”
the insanity defense is used much less often than
the public tends to think.
Fewer than 1 in 100 defendants in felony cases file
insanity pleas, and of these only 26% result in
acquittal.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Comparison of Public Perceptions of
the Insanity Defense
Persons "not guilty by
reason of insanity" set free
Persons "not guilty by
reason of insanity" sent to
mental hospitals"
Insantiy pleas resulting in
"not guilty by reason of
insanity"
Felony indictments for which
an insanity plea is made
Reality
Public Perception
Chapter 18
0
20
40
60
80
100
Percentage
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Insanity Defense Rules
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M’Naghten Rule
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At the time of the crime, the individual was
so affected by a disease of the mind that
he or she did not know the nature of the
act he or she was committing or did not
know it was wrong.
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Irresistible
Impulse Rule
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At the time of the crime the individual was
driven by an irresistible impulse to perform
the act or had a diminished capacity to
resist performing the act.
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Durham Rule
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The crime was a product of a mental
disease or defect.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Insanity Defense Rules
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ALI Rule
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At the time of the crime, as a result of mental
disease or defect, the person lacked substantial
capacity either to appreciate the criminality
(wrongfulness) of the act or to conform his or
her conduct to the law.
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APA Definition
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At the time of the crime, as a result of mental
disease or mental retardation, the person was
unable to appreciate the wrongfulness of his or
her conduct.
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Guilty but
Mentally Ill
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Defendants convicted are incarcerated for the
normal terms designated fro their crimes, with
the expectation that they will also receive
treatment for their mental illness.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Civil Commitment
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Before 1969, in the U.S., the need for treatment
was sufficient cause to hospitalize people against
their will. Such involuntary hospitalization is called
civil commitment.
Since 1969, the need for treatment alone is no
longer sufficient legal cause for civil commitment in
most states.
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Criteria for Involuntary Commitment
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Chapter 18
Grave Disability
Dangerousness to Self*
Dangerousness to others*
*In many states the danger posed must be imminent.
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Involuntary Commitment and Civil
Rights
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Chapter 18
People who have been committed to a mental institution
often feel that they have given up all their civil rights.
But numerous court cases over the years have established
that these people retain most of the civil rights, and have
certain additional rights due to their committed status:
–
Right to treatment
–
Right to refuse treatment
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Clinicians’ Duties to Clients and Society
To provide competent and
appropriate treatment for
client’s problems
Not to become involved in
multiple relationships with clients
To protect client
confidentiality
To protect persons who might be
in danger because of their clients
To report suspected abuse of
elderly persons or children
To provide ethical service to
culturally diverse populations
Chapter 18
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.