Legal and Ethical Issues in Mental Health Services: An Overview, Slides of Abnormal Psychology

Download Legal and Ethical Issues in Mental Health Services: An Overview and more Slides Abnormal Psychology in PDF only on Docsity! Mental Health Services: Legal and Ethical Issues Docsity.com Mental Health and the Legal System: An Overview  Mental Health and the Legal System  Guided by ethical principles and state and federal laws  Shifting Perspectives on Mental Health Law  Liberal era (1960 to 1980) – Rights of persons with mental illness dominated  Neoconservative era (1980 to present) – Emphasized limiting rights of mentally ill  The Issues  The nature of civil vs. criminal commitment  Balancing ethical considerations vs. legal considerations  The role of psychologists in legal matters  Rights of patients and research subjects  Practice standards and the changing face of mental health care Docsity.com The Concept of Mental Illness in Civil Commitment Proceedings  Defining Mental Illness  Is a legal concept, referring to severe thought or behavioral disturbances  Not synonymous with a psychological disorder  Definitions of mental illness vary by state  Mental retardation and substance-related disorders often are excluded  Dangerousness to Self or Others: Central to Commitment Proceedings  Assessing dangerousness: The role of mental health professionals  Knowns and unknowns about violence and mental illness Docsity.com Problems with the Process of Civil Commitment  Early Supreme Court Rulings: Restrictions Over Involuntary Commitment  A nondangerous person cannot be committed  Need for treatment alone is not enough  Having a grave disability is insufficient  Consequences of Supreme Court Rulings  Criminalization of the mentally ill  Increase in homelessness  Deinstitutionalization – Closure of several large psychiatric hospitals  Transinstitutionalization – Movement of mentally ill to community care  More Liberal Changes in Civil Commitment Procedures Followed Docsity.com Subsequent Modification to Civil Commitment Procedures  Civil Commitment Criteria Were Broadened  Involuntary commitment for dangerous and non-dangerous persons  Involuntary commitment for persons in need of treatment  National Alliance of the Mental Ill argued for further reforms Docsity.com Consequences of the Insanity Defense  Public Misperceptions and Outrage  John Hinckley Jr. found not guilty by reason of insanity (NGRI)  50% of states subsequently considered abolishing the insanity defense  Public views – Insanity defense is a legal loophole  Facts About the Insanity Defense  Used in less than 1% of criminal cases  Persons judged NGRI spend more time in mental hospitals than in jail  Changes Regarding the Insanity Defense  Insanity Defense Reform Act – Movement back to M’Naughten-like standards  Guilty but mentally ill (GBMI) – Allows for treatment and punishment Docsity.com Determination of Competence to Stand Trial  Requirements for Competence  Understanding of legal charges  Ability to assist in one’s own defense  Essential for trial or legal processes  Burden of proof is on the defense  Consequences of a Determination of Incompetence  Loss of decision-making authority  Results in commitment, but with limitations Docsity.com Mental Health Professionals as Expert Witnesses  The Expert Witness: Psychologists’ Role  Person with specialized knowledge and expertise  Evaluate imminent dangerousness (to a limited extent)  Assist in making reliable DSM diagnoses  Advise the court regarding psychological assessment and diagnosis  Assess malingering (i.e., faking symptoms)  Assist in competency determinations Docsity.com Clinical Practice Guidelines and Standards  Agency for Health Care Policy and Research  Focus on delivery of efficient and cost-effective mental health services  Dissemination of relevant state-of-the-art information to practitioners  Establish clinical practice guidelines for assessment and treatment  American Psychological Association’s Practice Guidelines  Standards for clinical efficacy research  Standards for clinical effectiveness research Docsity.com Summary of Ethical and Legal Issues in Mental Health Services  Society Views and Laws About Mental Illness Change with Time  Mental Illness Is a Legal Term, Not a Psychological Term  Civil Commitment Is a Legal Processes Involving Involuntary Commitment  Criminal Commitment Involves Criminal Behavior and Mental Illness  Determination of competence, insanity, and criminal culpability  Role of Mental Health Professionals in Legal Matters  Rights of Patients, Research Subjects, and the Future of Mental Health Care Docsity.com Emotion regulation strategies  supression  very inefficient way to deal with emotions, epecially anger  physiological consequences of suppression are similar to expressing anger in an open way (changes in hearth rhythm, high arousal, lack of oxygen to the heart)  denial  good emotion regulation strategy at the beginning, after a trauma  not good in the long-run (leads to chronic stress)  reapraisal  means changing the way we think about an emotionally challenging event  it helps to restructure the problem in a meaningful way, gives the situation a meaning and leads to relieve  the most adaptive way to regulate emotions with the least negative physiological effects  good to combine this strategy with stress management or meditation/relaxation techniques Docsity.com