Forensic Psychology – Midterm Study Guide Forensic Psychology SEXUAL OFFENDERS Leroy Hendricks • 5 convictions since the 1955 for sex offenses against children. • His victims were both within his family and outside his family. • His victims were both male and female which is rare. • He was open and honest about hWe also discuss several other topics like dynamic website information is stored in a dynamic catalog, or an area of a website that stores information about products in a database.
If you want to learn more check out the endocrine system's role in puberty involves the interaction of the
If you want to learn more check out swarnava mukhopadhyay
Don't forget about the age old question of melodeclamation
If you want to learn more check out which condition is also known as uremic poisoning
We also discuss several other topics like desition or decision
is inability to control himself. • Before he was released for the 5th time, he admitted that he would only stop offending if he died. Kansas SVP statute • Kansas created a statute that allowed someone like Hendricks to be committed to a mental facility to keep Hendricks off the street. • In response, Hendricks appealed to the supreme court citing double jeopardy and that he was being given restrictions retroactively that didn’t exist when he was charged. • The supreme court responded that the new status is a civil function and as such doesn’t allow him to side step it, no matter how unfair. Current Status • More states have adopted this (20). • This function is very expensive. An estimated $175,000 per year per person in California. • The commitment terms have no definitive end. How the commitment process works • Each sex offender is evaluated shortly before they are released to assess if they should be held. • They are referred from the parole board to the department of mental health. • An evaluator reviews and if he still qualifies is referred to the district attorney to decide if they will file a petition. • Then it would go to court to determine if the person is a Sexually Violent Predator (SVP). California Penal Code §290.46 • Before the sex offender registration act there was no registry so obtaining the details of an area were difficult, a person would have to visit the local police department. • The list of convictions that will require registering as a sex offender: rape, sexual battery, lewd acts with a minor, child pornography, and indecent exposure. • Every state has a registry and they all have a law that says that offenders must register in that state. Welfare & Institutions Code §6600a1. • California used “mental disorder” over the term “mental abnormality” as Kansas does to ensure it is more specific. • The only two issues that arise in these hearings are: is there a mental disorder and will be offend again? Sexual-related Disorders • The first class of sexually related disorders are sexual dysfunctions that are more normal and common just premature ejaculation.Forensic Psychology – Midterm Study Guide Forensic Psychology • Second class is the paraphilia (attraction to strange things): exhibitionism (draw is to shock the other person), fetishism, pedophilia, sexual masochism, sexual sadism, voyeurism, transvestic fetishism. • All paraphilia must persist longer than 6months and cause impairment or distress. Sexual Masochism & Sadism: DSM5 Criteria • Masochism: for at least 6 months, the arousal by being humiliated, beaten, tied up, or made to suffer. Must also cause distress or impairment. • Sadism: for at least 6 months, the arousal from the suffering of another person. This must be distressing, impairing or non-consenting with another person. Sexual Masochism & Sadism • 5-10% of people have engaged in this. This is quite common. • There are clubs available and they are primarily frequented by men but women do participate. Homo and hetero common. • Not about intercourse. • The acts are heavily scripted and planned. • Many participants are switchable. • Occasionally, sadists murder and mutilate but it is very uncommon. Profiles of SVPs (Jumper et al. 2012) • Half of sexually violent predators, pedophiles are the most common. Pedophilic disorder • Pedophilia (attraction to child). • Criteria: persistent for over 6 months, recurrent, intense, and occurring arousing fantasies, urges or behaviors that are with prepubescent child (generally 13 or younger). • They must have acted on the fantasies. This verbiage is vague. • The person is more than 16 years old or more than 5 years older than the child. Characteristics of pedophiles • 50% of them have conduct disorder and are troubled teens. • Most commonly within the family roughly 80%. And usually male 95%. • Violence is usually lacking and cognitive distortions are common. They confuse the situation. • The proposed distinction was to separate pedophiles from those who seek to hurt the child (child rapist or sadism). • Alcohol is often used in conjunction with the behavior but this seems to be just another coping mechanism with stress and the offenders tend to act out during stressful times. Profiles of SVPs (Jumper et al. 2012) • Additional prominent disorder is paraphilia NOS. Paraphilia Not Otherwise Specified (NOS) • NOS, not otherwise specified. Not enough information to be codified. • Necrophilia, zoophilia, hebephilia (early adolescence that are undergoing puberty).Forensic Psychology – Midterm Study Guide Forensic Psychology • Almost half of sexual predators’ have a NOS diagnosis. The end of Paraphilia NOS... • De jure (means of the law) bu De facto (means in practice). • Two categories cover nos. o When the clinician specifies the disorder (like necrophilia) o Unspecified: when the clinician does not specify. Keep in mind… • Disorder doesn’t always mean the person has engaged in an illegal action. • A pedophile may not have molested a child. • A crime can occur and the perp may not be a pedophile (statutory rape cases 17/13 year olds.) • Sexual sadism and rape are not the same thing. (read the Francis article) Welfare & Institutions Code §6600a1. The case of Tom W. • Was being released from prison in June 2015 after serving 8 years for molesting his 10 year old stepbrother during a family vacation. He was previously convicted for possession of child pornography. He was 36 and lived with his wife. Correlates of Sexual Recidivism (Hanson & Bussiere, 1998) • Things that indicate likelihood of reoffending. • 29k roughly people included in the study. • Within 5 years 13% reoffended. 18.9% for rapists and 12.7% for child molesters. Correlates of Sexual Recidivism (Hanson & Bussiere, 1998) • Age is -.1 so the older they are, the less likely they are to reoffend. • Being related to the victim, the rate of recidivism goes down. • Sexually abused as a child goes down -.01 . Status-99R Coding Form • Easy to use and you don’t have to be a psychologist to administer. • Higher scores men higher risks. The case of Tom W. • He would score as a 3, which is low to moderate. He was released and is on the sex offender registry. Risk Estimates Associated w/ Static-99 • Low-Moderate means up to 15% re-offense rate. Film: Going inside Coalinga. Readings:Forensic Psychology – Midterm Study Guide Forensic Psychology Pedophilia and DSM-5: The Importance of Clearly Defining the Nature of a Pedophilic Disorder Summary: The author criticizes the DSM 5 for possibly contributing to misconceptions about the term pedophilia and pedophilic disorder. The concern is that there is vague language in the DSM 5 that alludes to a person labeled with these disorders having acted on their desires with a child (victimizing a child). The author points out that the true definition is that they have urges and not that they have acted on them outwardly with another person. They state that distinguishing the difference is important. Additionally, they are in favor of including an attraction to prepubescent children in the labels of sexual orientation to distinguish between an attraction to adults vs children. The statistics on individuals who view child pornography vs those who go on to victimize a child shows that less than 1% move to the second action and as such, the diagnosis of pedophilia can be misleading and carry negative effects that may be unwarranted. The article closes with a discussion on how the negative associations of pedophilia may actually deter treatment for those who a\are not and have not acted on their urges but simply want treatment to prevent their urges or move past the. This could have unintended consequences. Sexual Sadism: Avoiding Its Misuse in Sexually Violent Predator Evaluations Summary: There is an issue brought that the difference between a sexual sadist and a person who commits sexual crimes for non dependent-arousal motives is not reliably and clearly enough defined. Also, psychologists are not accurately able to differentiate between the two groups. There are uses of unofficial, makeshift labels that distinguish the two (paraphilia NOS, non consent and paraphilia, NOS, hebephilia). Criticisms of this are that the labels are used to allow the denial of liberties and to create a diagnosis out of a crime. This creates the risk that evaluators will diagnose mental abnormalities in simple rapists. This overuse will cloud the true diagnostic criteria of sexual sadism. Marquis de Sade is the namesake, a 18th century aristocrat, liber- tine, author, and revolutionary. A Place for Pedophiles Documentary takes place in Coalinga State Hospital in California. All patients are previous sex offenders who have served their time and were referred there. The patients participate in group therapy. The patients are subjected to a penile response test. More people have been released through appeals than through therapy. Some refuse to participate in the therapy program. Most in treatment will never get out. The aim of the hospital is less about rehabilitation and more about confinement. Forensic Psychology – Midterm Study Guide Forensic Psychology INSANITY What’s your intuition: Insane or Not Insane? • Don’t assume that the level of extremity of the behavior is connected with their sanity. Sane people can do horrific things. • The law has a specific definition and it isn’t the behavior but the reason for the behavior. Corpus Delicti • Body of the crime. What does it take for something to be a criminal offense? In American law, there are two components that must be met. 1. Actus rea: the evil act (ie. Killing someone, driving and kills someone, fit of rage and kills someone, and a serial killer type murder.) 2. Mens rea: guilty mind • Two categories of people who cannot formulate mens rea: 1. Children under 7 but sometimes under 14. 2. People who are severely mentally disordered. • If you are convicted of a crime, go to prison, if found not guilty you get to go home. But if you are found not guilty by reason of insanity, you go to a mental hospital. Insanity calculus • Three components: 1. Suffer form a mental illness at the time of the event, not before, not after. Only during the commission of the act. o Mental disorder: psychopathy is not one, intoxication is also not one. 2. The criminal act must be the cause of the act. You cannot say you were insane but your disorder is not possibly the cause. These two connect to the third 3. The link between the disorder and the crime must be linked in a specific way as described by a specific legal test. (each state has different test. only cares about cognitive impairment. They don’t care about volitional impairment. ) M’Naghten Test (cognitive test) • Most commonly used test in the US. Used in California and texas. • This test is cognitive and looks at what the person knows. Not considered if they could control themselves, but only about the awareness of the wrongness of their act. • If you fail either or 2 or both of these items you are insane. 1. Doesn’t know the physical aspects (that a gun is a gun and not a sandwich) and quality (the harm that would result). 2. Doesn’t know it was wrong. This could be moral or criminal. Irresistible Impulse Test (volitional test) • Irresistible and uncontrolled impulse even if they knew it was wrong. • This is a volition, not cognitive.Forensic Psychology – Midterm Study Guide Forensic Psychology • The policeman at the elbow test means that you would still commit this crime even if you were handcuffed to you. This person would have no control over their actions. Kleptomania, they know it is wrong but they do it anyway. They will take things and give them back because they don’t want to do it, they just cannot control the impulse. • This test is very controversial because, how do you tell if it was irresistible or if it is an impulse that was not resisted. • How can you tell? Evidence of premeditation: was there planning involved in this? If they were trying to plan something, they have control to act when they has planned. American Legal Institute (ALI) Test (combo test with variation) • Not responsible if: 1. Lacks the ability to appreciate the criminal wrongfulness. 2. Lack the ability to appreciate his conduct. 3. Lack ability to confirm to the law (volition) Important things to remember about the insanity tests • These vary by jurisdiction o CA uses M’Naghten o US uses (ALI) o Four states don’t have an insanity defense. • All tests refer to the mental state at the time of the act. • Insanity contains three questions. If you ask these and the answer is no at any time, the test stops and the insanity test is thrown out. 1. Was there a mental disorder at the time of the offense? 2. Did the disorder impair the defendant at the time of the offense? 3. Is it the right type of impairment (considering the jurisdiction and the measure there – volition or cognitive) Question: how do you tell if they are faking? They will malinger and will over endorse the symptoms. They way over report symptoms. It is extremely difficult to do not only because people lie but also because you are working retroactively. Cognitive tests: distinguishing the sane from the insane • The easiest way to remember it: o If they did a crazy act for a non crazy reason, that is sane. (kill the president because you don’t like his policy) o If they did a crazy thing because of a crazy reason, that is insane. (you kill the president because he is stealing your thoughts) • How to determine if it is a crazy reason? o Did he know what he was doing? If it was directionless, that would suggest they didn’t know what they are doing. (most people don’t fail this because even the most psychotic people usually have a bit of a hold on the physical reality). o Did he know it was wrong? They try to hide their act, which shows it was wrong.Forensic Psychology – Midterm Study Guide Forensic Psychology Volitional tests: distinguishing the sane from the insane • The ability to make choices: was the behavior goal oriented? Was there a desired outcome? Did the person choose to be at a certain place at a certain time as opposed to just going right away. • Was there premeditation? Did they think about how they will get away? Did they think about how to hide evidence? • Regard for apprehension: did they do things to try to avoid being caught? Did they do things like buy gloves before they committed a crime? Relevant Classes of Mental Disorders • Psychotic disorders (detachment from reality like schizophrenia) o Cognitive-Could impair your ability to understand the wrongness. o Volition-Could impair your ability to have a choice. MUST do something. • Trauma or stressor-related disorder (ptsd) o Re-experiencing traumatic events or hyper arousal could create a reactive response. • Mood disorders (bipolar) paraphilias (pedopilia) o Might appreciate the wrongness of the act but not be able to resist. The case of Mr. Davidson (1st degree murder) Henderson? • alcohol: we don’t know if the alcohol has anything to do with this act. But lets assume it didn’t. • was their a cognitive impairments? (California). He went home to get the gun so we know he understood the nature and quality of what he was doing because he knew the gun would kill his boss. • Did he believe his boss was one of the devils at the time of the crime? We don’t know. The case of Mr. Hedges (kidnapping to facilitate a felony and attempted sexual battery) (ALI STATE) • Mental disorder? Yes bipolar two. No psychosis. • Does it cause mental impairment? (ALI) cognitive criminality or moral = no. Volition = no he did it in front of witnesses but he did put her in the truce and took her to another location. Andrea Yates trial Movie (M’Naughten used in Texas, cognitive: was it wrong and is she aware of what she is doing?) • People said she was a good mother and did everything for them. • She drowned all 5 of her children while in postpartum psychosis. • She believed that Satan was within her and that if she killed them, they would go with god. • At time of the marriage she was not religious but came from a catholic family. • Over the years she became more religious. • She became more and more critical and more ridged. She was more concerned with sin. • She became more subservient and stopped expressing her needs. • She attempted suicide and spent 6 days in the hospital, then shortly after she was found with a knife pressed to her neck. • She was then almost catatonic and diagnosed with psychosis.Forensic Psychology – Midterm Study Guide Forensic Psychology • She had impulses to kill but didn’t explain who. • They moved into a 3 bedroom home. Andrea decided to resume her responsibilities and said she was on vacation long enough when really she was being treated for mental illness. • She began to focus on the sins of the children. • Her father died and her condition declined. She stopped eating, drinking or sleeping. She walked aimlessly and scratched at her head continuously. • She was checked into hospital. • She then was home and was running water “incase she needs it” and was checked in hospital again. • She called 911 after drowning the children and said she needed police. • She was asked if she understands what she did and she said “yes I do” without any emotion. • She was immediately questioned at the police station. • She said she ran cold bath water so she could kill her children. • She said the children were not developing correctly. • She said the children fought her but she overpowered them. • Andrea cited postpartum psychosis and bipolar disorder. • The prosecution stated that the organization needed to kill all 5 children showed premeditation. The locked doors and the lack of shower mat. • She told the psych that she was such a bad mother that her children would go to hell if she didn’t kill them. • She said she knew it would seem wrong but morally it was right. • She was found guilty. • She will be eligible for parole when she is 77 years old. Discussion • Prosecution said she knew it was wrong. But Dr. Deets said she didn’t understand the moral wrongness of her behavior. • Did she have a mental disorder? Yes • Did she have a cognitive problem? Yes, she knew she was putting her kids under water and that they would die so she doesn’t fail prong two. • So, did she know it was wrong? Criminally, yes because she called the police. But did she know it was wrong morally? The jury found it was aware of the moral wrongness by saying it was a sin. • But there was another trial because of a mistake by Dr. Deets because he thought Andrea was a tv show that is similar to her case but the show never aired. • The second trial found that she was not guilty by reason of insanity. • If it were an irresistible impulse test, she would have failed because there was lots of planning. • Texas uses the M’Naghten test • Think about how she fares under that test (both prongs) Readings: Forensic Evaluation of Insanity: Assessing Valid Symptom Report in Defendants with Major Mental DisorderForensic Psychology – Midterm Study Guide Forensic Psychology In an insanity assessment: The case report shows how several methods of psychological assessment are used in concert to provide a more accurate representation of true symptoms of mental disorder when working with individuals with major mental disorders and to weed out feigned symptoms. Some individuals will exaggerate symptoms or even make up a whole hos of symptoms so a good method of getting to the truth is to interview 3rd parties who are not interested in the outcome. This should be combined with a self report, observed symptoms, psychological testing, the defendant’s report on their own testing, how genuine the symptoms appear. Additionally, malingering and a real disorder may both exist at the same time. The article outlines a case where Mr. X was malingering in top of real psychiatric disorder. The moral was that using multiple sources outlined the weakness in his malingering. A mental disorder at the time of the commission of the act as question is not enough to determine insanity but instead a causal relationship between the mental disorder and the act. COMPITENCIES State of CA v. Nathaniel Burris (2012) • The toll plaza killer. • He believed his girlfriend was having an affair with a coworker. He drove up at night and shot them both in their tollbooths. • He represented himself. • There are two issues here: o Was he competent to stand trial? o Is he competent to act as his own attorney? Type of Competencies • Competency: do you understand? Not that you understand the words but the ramification of things. • Types of competency: o To confess o Plead guilty o Stand trial o Waive right to an attorney o To refuse medication or treatment if you are incarcerated o To be executed- there is no purpose in executing someone who doesn’t understand that and a punishment that serves no purpose is cruel and unusual. Why competency matters • Is it fair if you were convicted of a crime but you didn’t know there was a trial or a crime? No, that is trail in absentia. 1. Sixth amendment: the right to confront witnesses, compulsory process, assistance of counsel. Competency matters because you are guaranteed these rights and you are guaranteed that because we have the adversarial process. It should be a fair competition.Forensic Psychology – Midterm Study Guide Forensic Psychology 2. Society has an interest in a dignified process: the trial process would be considered to be repugnant if severely mentally ill people were falling victim to the legal system with no awareness. If people stop respecting the law, they will stop following the law. Competency to Stand Trial (CST) • This means any side of the trial can go to the judge and ask for a competency evaluation. While the competency content cannot be used in court for either side as case support but they can use that is said to alter their case. • 1 in 15 defendants will be evaluated for CST. 4 of 5 are found CST. • The “ultimate issue” issue: is what the fact finder is trying to determine. In competency trials expert witnesses almost always weighs in and the judge almost always goes with that recommendation. Restoration to Competency • What if restoration is impossible. o Jackson vs. Indiana (1972) robbed two different women and gained $9. He was deaf and mute and had the IQ of a preschool child and thus couldn’t realty understand the proceedings. The problem is that he could not be restored to a high IQ. The Supreme Court ruled that you cannot be held if you cannot be restored. o Length of treatment cannot be longer than the potential prison sentence that would be ordered. ▪ Most cases the limit is 3 years ▪ The charges have to be dropped or dismissed without prejudice, of a petition for civil commitment. o Restoration time is not equal to time served. If a criminal spends 2 years in hospital to be able to stand trial and then is convicted, they are given 2 years, they then have to spend those 2 years in prison. Competency to Stand Trial • Dusky vs. United States (1960) • Have to be able to consult with their attorney and have a rational understanding of the proceedings before him. 5 points of Dusky 1. 2 pronged competency test (must have both to be able to stand trial): a. capacity to understand the process b. ability to help their attorney with their defense 2. have to have the “present” ability. You could have been lacking that during the commission of the offense. 3. “capacity” and but no necessarily the willingness 4. “reasonable” degree of understanding. That could be dependent on the complexity of the crime. 5. “rational” what happens if convicted and “factual” the likelihood of possible outcomes. Competency to Stand Trial Forensic Psychology – Midterm Study Guide Forensic Psychology • Dusky vs. United States (1960) • what is the role of mental disorder in this? There is no requirement that the individual has to have a mental disorder to be incompetent to stand trial. (note: insanity must have a mental disorder) Assessment techniques • Screening instruments: • Unstructured interview 1. Screening Instruments • The Competency Screening Test • Be able to rationally finish sentences to show understanding. • Problems: high false positives (determining incompetency when not appropriate). Biased for illiterates. 2. Unstructured interviews • Are the most common method. • There is no preset of questions and they just go into the interview and focus on whether the person can be trained. You can explain what the judge, jury, prosecution or defense does and you then see if they understand what you are saying to them. • Reliability: unlike the dangerousness reliability, these evaluations are pretty reliable. • Judges tend to agree with the majority (2 out of 3 opinions) • Judges tend to err on the side of caution. Feigning • Is the person refusing to participate or are they unable? That is the main question. • 15-20 roughly are faking their incompetency. • Ways to detect that people are lying: o Psychosis: people with delusions usually don’t tell people about all their weird beliefs and voices. If someone tells you all about their strange beliefs, they may be lying. o There is a test to find feigning- psych reads questions to the individual, and if the subject scores less than chance, they are likely faking. People who don’t understand will likely still score around 50%. Even children will score at chance levels. o Inventory of legal knowledge (ILK) has very high accuracy: about 90-95% Pro se • Means for one’s self or on one’s own behalf. Pro se • Faretta v. California, 422 U.S. 806 (1975): • Individuals do have the right to represent themselves in criminal proceedings. • Godinez v. Moran, 509 U.S. 389 (1993): • If you are able to stand trial you are able to represent yourself.Forensic Psychology – Midterm Study Guide Forensic Psychology • But these don’t address ability to represent yourself. Indiana v. Edwards 554 U.S. 164 (2008) • The supreme court said: that a defendant can be forced to have an attorney even if he doesn’t want one. • Dusky doesn’t mean you can represent yourself. • The supreme court said the dusky standard doesn’t apply but let the states determine what the standard is. Reading: The Shift of Psychiatric Inpatient Care From Hospitals to Jails and Prisons State mental facilities used to house many of the mentally ill but with the closure of those hospitals, many mentally ill persons end up in the criminal justice system. It is common for them to be substance abusers, combative and assaultive. These qualities are commonly used as decision making factors in criminal incarceration. There are mental health programs within the criminal justice system but they are severely under funded and not effective. 24 hour management of many of the most mentally ill is needed to serve them properly. In California there are state mental hospital-like facilities, which are high, quality and cost effective. However, there is a small populations of extremely resistant patients who refuse help and could only be effectively treated via a state hospital. State hospitals would removed this burden from the justice system and would prevent from them being labeled as criminal. Psychiatric Emergency Service Use and Homelessness, Mental Disorder, and Violence 30% of those who utilize psychiatric emergency services are homeless and they are also more likely to utilize the services multiple times. Homelessness is also responsible for the high rates of mental illness in conjunction with substance abuse. Of these people, violence is a large issue. This combination of isues makes for a complicated method of service. They have complicated symptoms to tackle. The need for these individuals is a complex cooperation of multiple services to effectively treat their mental illness. They also need housing, medication management, case management that is assertive, community and income support, etc to be effective. These measures may increase public safety and overall betterment of the lives of the patients. INDIANA, Petitioner, v. Ahmad EDWARDS. A defendant who shot a shoes store clerk was assessed for competence at multiple times and was found a variety of competencies. He was allowed to self represent when the APA filed a amicus brief to discuss that the limited competency of the client and clients in this state is not sufficient to self represent and would not uphold the constitutional right to a fair trial. The Dusky standards do not sufficiently measure this form of competency. As such, it was decided that the judges in the trails have the ability to judge on the ability to determine the ability of a defendant to self-represent. CIVIL COMMITMENT Mr. Boggs and Mr. Price • The police and the law are supposed to protect us from dangerous individuals? Forensic Psychology – Midterm Study Guide Forensic Psychology • Can criminal law prevent violence fro occurring? No, it is reactive. Something has to happen and then it can react. • Civil law can prevent violence and harm before it occurs. It can intervene before something happens. The person must be dangerous due to a mental illness. • Mr. Boggs can be locked up before Mr. Price. Definitions Civil Commitment- The legal procedure that permits a person to be certified as mentally ill and to be institutionalized (put in a psychiatric facility) against his or her will (not on their own volition). • All 50 states have civil commitment laws. • Must remember that this is different because these individuals may not have ever done anything harmful or illegal in the past. Two justifications (or types): • Parents Patriae (parent of the nation) means that you are granting the government the ability to act as a guardian over a person. Like paternalism which is being a parent. -active danger (they are a danger to themselves or others) -passive danger (sometimes called grave disability, they cannot care for themselves appropriately) Example is a mentally ill person who may freeze to death in the winter due to not finding shelter or using clothes or blankets to stay warm. • Police Power – Because of mental illness, this person is dangerous to others. They are mentally ill and likely to do something. If they did commit a crime, they could not be help responsible because they are insane. Because of this, the state can lock them up preemptively. O’Connor v. Donaldson (1975) • He spent 15 years in a psychiatric facility in Florida. His father took him to the hospital because he believed his neighbor would hurt him. He didn’t want to be in the hospital and wanted to go home but was schizophrenic. He was mentally ill but was not dangerous (he was 32 years in the hospital). He was help involuntarily once he wanted to leave. His case went to the Supreme Court and they found that mental illness isn’t enough to hold someone against their will. They had to be dangerous. This now applies to all states but each state can give the definitions to “mental illness” and other terms. • Many of the states added an additional clause: Lease Restrictive - they can civilly commit if it is the least restrictive. Some say that being civilly committed in-patient is less restrictive because you can refuse medications if you are inpatient. You cannot if you are outpatient. Differences between Criminal & Civil Commitment • Civil law: concerned with the future. It takes only a reasonable concern to lock them up. There is not max time and can be renewed indefinitely. • Criminal law: concerned with the past. Given Due Process rights (right to attorney, right to a trial by jury, govt must prove beyond a reasonable doubt). You get a definitive term (sentence). Brief History of “Civil’ Commitment • There was civil commitment in ancient times. • But back in the colonial times there was no civil commitment. They were just sent to jail.Forensic Psychology – Midterm Study Guide Forensic Psychology • In the mid 1800’s, psychiatric hospitals began to be built but you could not voluntarily go there. You had to be sent there against your will and could never get out. • Lanterman-Petris-Short (LPS) Act • Passed in 1969. • At most they can only be help for 17 days (usually) and they will receive treatment. There is no punishment intended because they haven’t committed a crime. Five Basic WIC (welfare and institutions code – civil law) Commitments 1. 5150: a 72 hour hold for a brief time to be evaluated. 2. 5250: a 14 day hold after the 72 hours to allow treatment. 3. 5260: additional 14 day hold 4. 5270.15: additional 30 day hold 5. 5300: additional 180 day hold 72 Hour Hold (WIC 5150 hold language) • Emergency admission. • It is an observations period. You cannot be medicated, you are to be observed. • You cannot contest the hold and you cannot petition to leave. • Note: in a criminal hold, you have to be brought before the judge within 48 hours, not the case here. • Probable Cause: a decision by a lay person. • Who is authorized: a peace officer People vs. Trilett (1983) • Police were called, woman walks down stairs and has blood on her hands. She tried to slit her wrists. • She was taken to the hospital for 5250 hold. • They found drugs in her purse. • She went to court to state that the police office was not qualified to say she had a mental disorder. He didn’t have probable cause to hold her. • The court said” intoxication and tearfulness as well as self-harm would lead someone to believe that she was disordered and a danger to herself. • Probable cause is a lay decision and a peace officer can make it. Mental Disorder Criteria • Not disorders to allow civil commitment: (in California, any personality disorder) mental retardation, antisocial behavior, alcohol and drug use. DTO Criteria Definition • We know risk assessment is difficult. In a psychiatric emergency, you likely don’t have access to their case file or medical record. All you have is an interview with the person and they may or may not be honest as they don’t want to be there. • It must cause bodily harm (not emotional harm) and the harm must be due to the mental illness. The root is mental illness like the insanity defense but the harm hasn’t happened yet.Forensic Psychology – Midterm Study Guide Forensic Psychology • This is focused on harm to one’s self (suicide or self mutilation) DTS Criteria Definition • It must cause bodily harm (not emotional harm) and the harm must be due to the mental illness. The root is mental illness like the insanity defense but the harm hasn’t happened yet. • This is focused on harm to one’s self (suicide or self mutilation) Assessing DTS (assessing danger to self, this is what is looked for) must be active danger • Suicide is so uncommon it cannot be predicted so we just look for signs of likelihood that they will do it. (4:1) • Age: risk increased with age in males but for women there is a risk range of 35-65. • Race: Caucasian (2:1) • Marital status. • Of those who commit suicide: o 40-60% of all cases have a major depressive disorder. o 20% alcohol dependence. o 10% schizophrenia GD Criteria Definition • Other than choice or lack of money, someone is unable to provide food, shelter, or clothing. This factor must pose a danger. Remember Donaldson (1970s). Bellevue: Inside Out • Before people are committed they are taken to the psychiatric emergency room. • They give many people Ativan. • There are group activities. • There is seclusion. • Once further hold is entered, medications are given. 5250 (14 day hold if they are still in need of treatment) • The psychiatric staff must show probably cause for the extended hold. • Because this is an extended time, the courts have created more safeguards in these holds. In some cases you can have a jury trial if you are being held (very rare). You can have an attorney and call witnesses. More safeguards like a criminal proceeding. • Problems: o Not adversarial (two sides are not in competition): although the government is being adversarial in their attempt to take away your liberty. But even the person’s attorney who is supposed to advocate on the patients behalf, the attorney will do as they think is best for the client instead of just doing what the individual wants. This negates the adversarial structure/process. So some of the safeguards are not truly upheld. o Rubber stamping: 95-100% of the time the judge will go along with what the doctor recommends. Riese V. St. Mary’s Hospital and Medical Center (1989) • Your rights as a patient once you are committed under 5250. • California case.Forensic Psychology – Midterm Study Guide Forensic Psychology • Riese was schizophrenic, 1985 she checked herself into the hospital. Then she was involuntarily committed when she wanted to leave. • She then wanted to refuse treatment. Is she incompetent to refuse treatment? LPS Act doesn’t explicitly grant this right. • The appellate court held that you cannot be medicated against your will just because you have been civilly committed. • Riese Petition: if the hospital wants to medicate someone against their will, they have to file a Riese Petition to go before a judge to try if the person is competent to refuse meds. Competency under Riese • Not about a good or bad decision but instead competency to make that poor decision. 1. Is the patient aware of their situation? 2. Do they understand the risks, benefits and the available alternatives to the meds? 3. Is there a clear link between the delusions or hallucinations and the refusal of meds. 4. Must be proven by clear and convincing evidence.