Psych 361 week 14

-        Forensic psychology: application of clinical psychology principles to law, legal system issues

o   Forensic psychologists (and psychiatrists):

§  Assess mental competency and criminal responsibility (insanity); need for hospitalization

§  Cases of child custody, guardianship, execution of wills

§  Develop psychological profiles of criminals

§  Study jury decision-making, guide attorneys on questioning witnesses and present arguments

o   Scope of forensic psychology

§  Commitment to (and release from) psychiatric hospitals

§  Child custody issues

§  Determination of the need for a guardian due to incapacity

§  Criminal responsibility and competency to stand trial (insanity defense)

§  Predicting violence

§  Criminal profiling

§  Psychological damages suffered as the result of another’s negligence

§  Law enforcement psychology

§  Determination of disability for Social Security claims

§  Workers’ comp claims

§  Eyewitness testimony and identification

§  Jury selection

§  Interviewing youth to understand incidents of maltreatment

§  Advice to attorneys regarding factors that may affect juror’s behavior

§  Offender treatment programs

-        Testifying in civil cases

o   Factors considered by courts when making child custody rulings

§  The love, affection, and other emotional ties existing between the competing parties and the child

§  The capacity and disposition of competing parties to give the child love, affection, and guidance, and continuation of educating and raising the child in a religion or creed, if any

§  The capacity and disposition of competing parties to provide the child with food, clothing, medical care, or other remedial care recognized and permitted under the laws of the specific state in lieu of medical care or other material needs

§  The length of time the child has lived in a stable satisfactory environment and desirability of maintaining continuity

§  The permanence, as a family unit, of the existing or proposed custodial home

§  Etc.

-        Criminal versus civil commitment

o   Criminal – NGRI “acquittal” (not guilty by reason of insanity) difference between descriptive and ascriptive responsibility

o   Civil – person judged to be danger to self and/or others, non-criminal. Preventative detention?

-        Competency to stand trial vs. insanity defense – two separate issues

o   Competency – is the accused able to assist in his or her own defense? “…sufficient present ability to consult with their attorney with a reasonable degree of understanding and whether they have a rational and well as a factual understanding of proceedings…” (Dusky v. United States, US Supreme Court, 1960). This issue necessarily precedes issues of insanity defense, comes before a criminal trial and may even prevent one. Note that it is the person’s current psychological state that is at issue, not whether he or she was sane at the time of the crime, which is the domain of the insanity defense

o   Insanity defense – shall the accused be held legally responsible for a crime that he or she committed? (note: very rarely used, it turns out, and seldom successful. But widely publicized and, like competency determination, raises civil liberties issues)

-        Mental hospital vs. prison

o   Is NGRI necessarily in the accused’s best interests? Maybe not – indeterminate vs. determinate incarceration

o   Better to convict even insane patients and then treat in prison or prison hospital? Better not to seek an NGRI verdict since incarceration is indeterminate – till one is “cured”? (guilty but mentally ill)

-        Civil commitment issues: rights to treatment, to refuse treatment, and to be treated in the least restrictive setting—can they be reconciled?

o   Can the right to be treated in the least restrictive fashion be reconciled with both the right to treatment and the right to refuse treatment? Three different principles here and they can conflict

o   Paul and Lentz proposal (1977), minimal vs. optimal goals

§  Minimal (like self-care, not being violent) vs. optimal goals (like vocational skills, high school diploma)

§  Achievement of minimal goals will allow patients to move into a less restrictive setting, which is desirable, a move towards non-institutional

§  Patients can be justifiably forced to participate in particular treatments if empirical evidence supports it to achieve minimal goals, but not optimal goals

o   Advanced directive: created by people who are legally competent and able to make decisions and specify how they want to be treated in the event that, sometime in the future, they need psychological or medical therapy but are at that future time mentally unfit to make decisions bearing on their therapy

§  Document may state what procedures the person consents to or refuses for implementation in the future

§  Document may name another person to make such decisions

§  Advanced directives may enable people who are psychologically troubled but still competent to have more power over their future health care (when they might not be adjudged competent). But can perspectives change when one is facing death?

-        Thomas S. Szasz and the case against forensic psychiatry and psychology

o   He was best known as a social critic of the moral and scientific foundations of psychiatry, as what he saw as the social control aims of medicine in modern society

o   “by codifying acts of violence as expressions of mental illness, we neatly rid ourselves of the task of dealing with criminal offenses as more or less rational goal-directed acts, no different in principle from other forms of conduct (Szasz)”.

o   Mental illness as an explanation for criminal behavior when people acted in a way that was threatening to society, especially people of low social rank attacking people of high social rank. Also other cases (Kennedys, Verwoerd, King, Lennon, Reagan, Pope Paul II, Soviet Union and Russia, Cuba)

o   Szasz offers the provocative notion that “the issue of insanity may have been raised in these trials in order to obscure the social problems which the crimes intended to dramatize”

o   Szasz is concerned with individual freedom and responsibility for one’s actions. Right to deviate and/but be responsible

o   Alan Dershowitz (The Abuse Excuse, 1994): lawbreakers are trying hard to avoid responsibility for their criminal acts by invoking one or another hardship in their past history as a reason for their unlawful actions, e.g., “Adopted Child Syndrome”

o   Szasz held that legal responsibility should be extended to all, even to those whose actions are so far beyond the limits of convention that some explain their behavior in terms of mental illness and then given “treatment” that can be humiliating, punitive, and ineffective (except in a strictly custodial sense)

o   Evaluation of Szasz’s position

§  Civil committed patients’ liberties are receiving greater protection. Huge influence by Szasz and the ACLU as influenced by Szasz over the past 50 years. Szasz’s influence so great that he is often unrecognized and cited for the changes in criminal and civil commitment that protect individual civil rights. For example, it is much harder to be civilly committed these days

§  But Szasz has been criticized by those who believe that psychiatry and psychology should have an important role in deciding how to deal with people whose acts, whether criminal or not, seem attributable to mental illness. Our concern for the liberties of one individual has always been tempered with our concern for the rights of others

-        Thomas Szasz on coercive suicide prevention

o   Impractical and immoral

§  Except very delimited, like with “impulsive” suicide attempts

§  Except with children and adolescents (but not “mentally ill”?)

§  Suggested a psychiatric will (could include coercive suicide prevention) but can people know in advance what they will want in the distant future?