CH-16-Mental Health Services – Legal & Ethical Notes

Vocabulary flashcards covering major legal, ethical, and clinical concepts from the lecture on mental health law.

Court‐ordered involuntary placement of a person with mental illness in a psychiatric facility when statutory criteria (e.g., danger, grave disability) are met.

Civil Commitment

Government authority to protect public safety, health, and welfare by restraining individuals who pose a threat to society.

Police Power

State’s authority to act as guardian for those unable to care for themselves, permitting involuntary treatment for their own good.

Parens Patriae

Court mandate requiring a person with severe mental illness to accept community‐based treatment as a condition for remaining in the community.

Assisted Outpatient Treatment (AOT)

A statutory concept—often severe disturbances in thinking or mood that threaten health/safety—distinct from DSM clinical diagnoses.

Mental Illness (Legal Definition)

Likelihood that an individual will cause serious harm to self or others; key criterion in civil commitment decisions.

Dangerousness

Condition in which a person is unable to provide basic needs (food, shelter, medical care) due to mental illness.

Grave Disability

1960s–70s movement to close large state hospitals and treat patients in community settings.

Deinstitutionalization

Shift of individuals with severe mental illness from hospitals to other institutions such as jails, nursing homes, or shelters.

Transinstitutionalization

Confinement of individuals in a mental facility because they are unfit to stand trial or found not guilty by reason of insanity.

Criminal Commitment

Legal plea asserting lack of criminal responsibility owing to mental illness at the time of the offense.

Insanity Defense

Standard holding defendants not responsible if, due to mental disease, they did not know the nature or wrongfulness of their act.

M’Naghten Rule

Obsolete test stating an accused is not criminally responsible if the unlawful act was the product of mental disease or defect.

Durham Rule

Insanity standard excusing defendants lacking substantial capacity either to appreciate wrongfulness or to conform conduct to law.

American Law Institute (ALI) Test

Doctrine reducing culpability when mental illness impairs the defendant’s ability to form criminal intent (mens rea).

Diminished Capacity

Verdict that absolves legal guilt and commits the defendant to a psychiatric facility until no longer dangerous or ill.

Not Guilty by Reason of Insanity (NGRI)

Verdict imposing a criminal sentence while acknowledging the defendant’s mental illness; treatment may occur before or during incarceration.

Guilty but Mentally Ill (GBMI)

Ability of a defendant to understand legal proceedings and consult rationally with counsel.

Competence to Stand Trial

Supreme Court case ruling that defendants incompetent to stand trial cannot be held indefinitely; must be treated, tried, or released.

Jackson v. Indiana (1972)

Responsibility placed on the defendant to demonstrate incompetence to stand trial (Medina v. California, 1992).

Burden of Proof for Incompetence

Legal obligation of therapists to breach confidentiality and protect identifiable third parties threatened by a client.

Duty to Warn (Tarasoff Rule)

Landmark case establishing clinicians’ duty to warn potential victims of foreseeable violence.

Tarasoff v. Regents (1976)

Qualified professional who offers specialized opinion testimony to aid the court (e.g., on diagnosis, risk, competence).

Expert Witness

Deliberate faking or exaggeration of symptoms for external gain, often evaluated with psychological tests like the MMPI.

Malingering

Legal philosophy that uses knowledge of behavior change to craft problem‐solving courts (e.g., drug, mental health courts).

Therapeutic Jurisprudence

Legal principle that persons involuntarily hospitalized are entitled to active efforts toward therapeutic goals (e.g., Wyatt v. Stickney).

Right to Treatment

Requirement to provide care in the setting that imposes the fewest constraints consistent with safety and treatment needs.

Least Restrictive Alternative

Patient’s legal ability to decline recommended therapies, especially psychotropic medication, unless overruled by court procedures.

Right to Refuse Treatment

Due‐process hearing allowing involuntary medication in prisons or hospitals if an individual is dangerous and treatment is in their interest.

Harper Hearing

Supreme Court decision limiting forced antipsychotic medication solely to render a defendant competent for trial.

Riggins v. Nevada (1992)

Participant’s voluntary agreement to treatment or research after receiving full disclosure of risks and benefits.

Informed Consent

Clinical decision making that integrates best research evidence with clinical expertise and patient preferences.

Evidence‐Based Practice (EBP)

Systematic recommendations outlining effective interventions for specific disorders, based on evidence review.

Clinical Practice Guidelines

Guideline dimension assessing whether an intervention produces beneficial outcomes under controlled research conditions (internal validity).

Clinical Efficacy Axis

Guideline dimension evaluating feasibility, generalizability, and cost-benefit of interventions in real‐world settings (external validity).

Clinical Utility Axis

Specialized tribunals (e.g., drug, domestic violence, mental health courts) that integrate treatment mandates with judicial oversight.

Problem‐Solving Courts

Statutes permitting civil commitment of sexually violent offenders after prison if still deemed dangerous (e.g., Kansas v. Hendricks, 1997).

Sexual Predator (SVP) Laws

Case establishing minimum standards for staffing and environment in mental institutions and mandating active treatment.

Wyatt v. Stickney (1972)

Supreme Court ruling affirming residents’ rights to reasonable safety and freedom from undue restraint, leaving treatment decisions to professionals.

Youngberg v. Romeo (1982)

Federal law creating state agencies to investigate abuse/neglect and advocate for rights of people with mental illness.

Protection & Advocacy for Mentally Ill Individuals Act (1986)