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Criminal Justice and the Mentally Ill
Transcript of Criminal Justice and the Mentally Ill
and the Mentally Ill Samantha Stanhope, Kate Myers, Jon Brooks Mental illness is a legal concept typically meaning severe emotional or thought disturbances that negatively affect the individual's health and safety
Each state has it's own definition Defining Mental Illness . . "Mental illness" means a psychiatric disorder, alcohol dependence, or drug dependence, but does not include intellectual disability or other developmental disabilities. Tennessee's Definition . - History of Institutionalization London's Bedlam Hospital-began in the 1200's and operated as an asylum for inpatient care of those with mental illness Prior to American asylums, people with mental illness were directed to prisons and shelters for the poor -Between 1817 and 1824, four privately funded asylum were established in the northeaster states of CT, NY, MA, and PA http://www.youtube.com/watch?v=k_ sYn8DnlH4 Ann- http://www.youtube.com/watch?feature=player_detailpage&v=1nVEN1Reeaw#t=363s Legal Evolutions in Mental Institutionalization Right to treatment
-Rouse vs. Cameron (1966)
-Wyatt vs. Stickney Right to treatment in the least restrictive settings
-Lake vs. Cameron (1966) Right to refuse treatment
-state and hospital policy
-Tennessee Annotated Code
-emergency situations Deinstitutionalization in the 1950's & '60's New medications challenged the necessity of institutionalization for the care of patients with mental illness. -Thorazine was invented and proved to be effective in treating psychosis
-In 1960 the US created Medicare and Medicaid
-In 1963, President John F. Kennedy signed the Community Mental Health Centers Act Bryce Institution: for patients who needed to be taken out of society. Wyatt Vs. Stickney (1970) Continued.... Involuntary commitment
-Addington vs. Texas (1979)
-Raises the burden of proof
-Due process in civil commitment
-least restrictive alternative doctrine
- Tn AC 33-5-403 Not guilty by reason of insanity
-a compromise between society and the law
-reflects society's belief of not punishing individuals who are mentally incapable of controlling their conduct 1843: McNaughton Rule- at the time of committing the act, the accused was laboring under such a defect of reason from a disease of the mind as not to know the nature and quality of the act he was doing, or he was unaware his actions were wrong. -Mid 1950's: Durham Rule of irresistible impulse- an accused is not criminally responsible if his unlawful act was the product of mental disease or mental defect 1972: Model Penal Code- turns responsibility to a jury 1984: The Federal Rule Comprehensive Crime Control Act
-Return to the standard of knowing right from wrong Incompetent to stand trial
-A qualified expert to examine the defendant at any stage of a felony criminal proceeding
-TN AC 33-7-401 (look at 33-6-502) Economic concerns
- Where are those with mental illnesses treated?
Adults with persistent mental illnesses are found being treated in the public sector either using state or local health dollars or Medicaid, if they qualify. Economic Concerns Coverage:
Serious mental illnesses
-Medicare if they have a work history and are retired
-Medicaid if they qualify for TANF
Less severe mental disorders and mental health problems
-may be treated in a general medical setting, workplace, or school
-private insurance companies cover those who are employed and whose mental disorders are not persistently disabling Continued... Currently, Medicare has no annual limit on outpatient mental health services, but a 50% copayment for psychotherapy remains.
-Note: the role of definitions and mental health policies are intertwined
-many policies place dependence upon definitions that are being expanded in order for treatment to be made available to individuals with mental illnesses Ethical Dilemmas and Considerations Stigma- attitudes and beliefs that lead people to reject, avoid, or fear those they perceive as being different. Factors that directly affect stigma -Personal attachment to mental illness
-Group-based social identity of the mentally ill community Ethical Dilemma Autonomy
-Right to treatment
-Right to informed consent
-Right to refuse treatment
Autonomy vs. Incompetence Patient confidentiality
-Hippa Legal considerations Tort Law
-Protects patients and nurses Statistics - More than 50% of Americans will suffer from a mental illness at some point in their lives - By 2020 depression will be the number one mental disorder suffered by women -A nationwide study found that 74% of respondents agreed with the statement, "virtually anyone can become mentally ill" Nurse's Role -Advocacy
-Standards & Scope of Practice
Jamie- http://www.youtube.com/watch?feature=player_detailpage&v=1nVEN1Reeaw#t=878s The number of psychiatric inpatients declined from 550,000 in 1950 to 30,000 by the 1990's Jared Lee Loughner case Types of Stigma associated with Mental Illness? Determination made by court system: if found incompetent a court-appointed legal guardian is chosen and is then responsible for giving or refusing consent Rights regarding restraint and seclusion What does Medicare and Medicaid cover? A good example of an institution is Willowbrook