1. Law and Ethics in Abnormal Psychology17
Law and Ethics in Abnormal Psychology

2. The Intersection of Psychology and the Law
Some roles of psychologists in the legal system
Psychological evaluation in child protection matters
Evaluation for child custody in divorce proceedings
Civil commitment determination
Protecting client rights
Profiling criminals

3. Additional Roles and Activities of Psychologists in the Legal System
Assessing dangerousness
Filing amicus briefs
Aiding jury selection
Determining sanity or insanity
Providing testimony in malpractice suits
Determining competency to stand trial
Determining repressed, recovered, or false memories

4. Criminal Commitment
Incarceration of an individual for having committed a crime
Criminal law
Some people lack the ability to assist in their own defense or discern the ramifications of their actions because they are mentally disturbed
Although they may be guilty of a crime, their mental state at the time of the offense exempts them from legal responsibility

5. Competency to Stand Trial
Refers to a defendant’s mental state at the time of post-arrest psychiatric evaluation
Requirements to stand trial by federal law
Defendant must have a factual and rational understanding of the proceedings
Defendant must be able to rationally consult with counsel in presenting his or her own defense
Defendant cannot be confined indefinitely solely on the grounds of incompetency

6. Legal Standards that Address the Mental State of the Defendant
Figure 17.1 Legal standards that address the mental state of the defendant

7. Legal Precedents Regarding the Insanity Defense
Legal argument used by defendants
Admit they committed a crime
Plead not guilty because they were not of sound mind at the time the crime was committed
Legal tests of insanity
The “right-wrong” test
The irresistible impulse test

8. M’Naghten Rule (“Right-Wrong Test”)
Person can be acquitted if it can be shown that at the time of the act:
The defendant had such defective reasoning that they did not know what they were doing (nature of the act)
The defendant was unable to comprehend that the act was wrong (quality of the act)
Criticism
Exclusively cognitive test

9. Irresistible Impulse Test
Defendant is not criminally responsible if he or she lacked the will power to control his or her behavior
Criticism
What constitutes irresistible impulse?
Durham standard (the products test)
Accused is not responsible if the unlawful act was the product of mental disease or defect

10. Guidelines from the American Law Institute (ALI) Model Penal Code
Guidelines established in 1962
Mental disease or defect
Impairs capacity to appreciate the criminality of conduct
Or to conform conduct to the requirements of law
Does not include abnormality manifested by repeated criminal or otherwise antisocial conduct

11. The Law of Diminished Capacity
Absence of specific intent to commit offense
As a result of mental impairment
Used primarily to guide sentencing and disposition of defendants
Sometimes introduced in the trial phase

12. Insanity Defense Reform
Insanity Defense Reform Act of 1984
Bases definition of insanity totally on the individual’s ability to understand what he or she did
Some states adopted alternative pleas
Culpable and mentally disabled
Mentally disabled, but neither culpable nor innocent
Guilty, but mentally ill

13. Contemporary Views on the Insanity Defense
Insanity defense mostly used by defendants who have a long history of mental illness
Determination of guilt can be complicated
Factor: severity of the defendant’s illness
Deliberate delays
“Feigning” insanity rarely successful
Past hospitalizations and medical diagnoses usually present

14. Civil Commitment Parens patriae (“father of the country”)
Government’s authority to commit disturbed individuals for their own best interest
Civil commitment
Involuntary confinement of a person judged to be a danger to self or others
Even though the person has not committed a crime
May be viewed as protective confinement

15. Negative Consequences of Civil Commitment
Major interruption in a person’s life
Loss of self-esteem and self concept
Dependency on others
Possible loss or restriction of civil liberties

16. Criteria for Commitment
Criteria vary by state
Clear and imminent danger to self or others
Inability to care for oneself or lack of social network to provide such care
Inability to make responsible decisions about appropriate treatment or hospitalization
Unmanageable state of fright or panic

17. Assessing Dangerousness
Key factors
The rarer something is, the more difficult it is to predict
Violence is a function of both context and a person’s characteristics
The best predictor of dangerousness is past criminal conduct or history of violence or aggression
The definition of dangerousness is unclear

18. Procedures in Civil Commitment
Involuntary confinement rationale
Prevents harm to person or others
Provides appropriate treatment and care
Ensures due process of law
Involuntary commitment is used when the individual refuses hospitalization
Judge appoints two physicians to examine the individual

19. Procedures in Civil Commitment (cont’d.)
Formal hearing takes place
Examiners and others testify about the person’s mental state and potential danger
The judge determines whether the person must enter treatment
Commitment is usually for a defined length of time
Six months to one year
Indefinite subject to periodic review/assessment

20. Protection against Involuntary Commitment
Due process procedures important
Ensure commitment does not violate a person’s civil rights
Individual accused of a crime
Considered innocent until proven guilty in a court of law
Criminal justice system will not incarcerate people because they might harm someone
Civil commitment is based on possible future harm

21. Rights of Mental Patients
Addington v. Texas (1979)
Clear and convincing evidence that person is mentally ill and potentially dangerous
Dixon v. Weinberger (1975)
Least restrictive environment
Right to least restrictive alternative to freedom that is appropriate to a person’s condition

22. Right to Treatment
Those involuntarily committed have a right to receive therapy to improve their emotional state
Rouse v. Cameron (1966)
Right to treatment is constitutional right
Failure to provide treatment not justified by lack of resources
O’Connor v. Donaldson (1975)
State cannot constitutionally confine nondangerous person who can care for self

23. Right to Refuse Treatment
Many forms of treatment may have long- term side effects
Forced treatment may nullify potentially beneficial effects
Rennie v. Klein / Rogers v. Okin
People have a constitutional right to refuse treatment (e.g., psychotropic medications) and to be given due process
Least intrusive forms of treatment
Psychotherapy considered least intrusive

24. Deinstitutionalization
Trend toward deinstitutionalization
Influences access to treatment
Shifts care from large institutions to local agencies
Mental hospital population has dropped 75 percent since the 1960s and 1970s
Concept of mainstreaming
State hospitals inadequately staffed and underfunded

25. Criticisms of Deinstitutionalization
States have relinquished responsibility
Mentally ill are not receiving treatment and often live on the streets
Thousands are now homeless
Estimate: 30 to 70 percent of the homeless have a mental disorder
Communities lack preparation and resources to care for mentally ill

26. Moral, Ethical, and Legal Issues Surrounding Suicide
Right to die movement
Medical advances have increasingly lengthened the dying process
Physician faces civil or criminal lawsuit in many states
Particularly if patient lacks advance directive
Suicide considered both a sin and an illegal act
Question: do people have the right to commit suicide?

27. Ethical Guidelines for Mental Health Professionals
Confidentiality
Ethical standard that protects clients from disclosure of information without their consent
Privileged communication
Therapist’s legal obligation to protect a client’s privacy and to prevent the disclosure of confidential communications without a client’s permission

28. Exemptions from Privileged Communication
Civil or criminal commitment or competency to stand trial
Client introduces mental condition as a claim or defense in a civil action
Clients younger than 16 or dependent elderly person
When therapist believes individual has been the victim of a crime
Client presents danger to self or others

29. The Duty to Warn Based on Tarasoff ruling Criticisms
Obligates mental health professionals to break confidentiality when clients pose clear and imminent danger to other person
Must warn intended victim
Criticisms
Therapist placed in role of a double agent
The act of warning could escalate events

30. Duty to Warn Figure 17.3 Duty to warn
Most states have laws that either require or permit mental health professionals to disclose information about clients who may become violent. In some states, the duty to warn about possible danger is mandatory.

31. Family Educational Rights and Privacy Act
Prevents colleges and universities from disclosing personal information about students, even to their parents
Colleges treat students as adults, so telling parents would infantilize students
Students may be less inclined to share information if they knew rights were not confidential
Undergraduates have more mental health needs than ever before

32. Sexual Relationships with Clients
Ethical code
Sexual intimacies with clients prohibited for a minimum of two years after termination of therapy
Importance of separating and creating boundaries between professional and personal lives
Therapists need to be objective

33. Cultural Competence and the Mental Health Profession
Prevailing concepts of mental health and mental disorders are culture-bound
Therapy approaches based on highly individualistic values of middle- to upper-class European Americans
ASA guidelines adopted in 2003
Emphasize importance of culturally-sensitive work with racial and ethnic minorities
Recognize cultural factors in diagnosis

34. Cultural Competence (cont’d.)
Becoming aware of and deal with biases, stereotypes, and assumptions
Becoming aware of the values and worldviews of culturally different clients
Developing appropriate intervention strategies
Considering social, cultural, historical, and environmental factors that influence clients from diverse cultures

35. Review
What are the criteria used to judge insanity, and what is the difference between being insane and being incompetent to stand trial?
Under what conditions can a person be involuntarily committed to a mental institution?
What rights do mental patients have with respect to treatment and care?

36. Review (cont’d.)
Are there situations in which suicide should be an option?
What legal and ethical issues guide treatment practices?