Legal and Ethical Issues - California State University
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Transcript Legal and Ethical Issues - California State University
Legal Concerns
Defining “Mental Illness”
Mental Illness is a Legal Concept
Varies by State
Not the Same as Psychological Disorder
Responsible for Actions?
How do you determine this?
Legal Concerns
Insanity Defense
Less than 1% of all cases
Even
fewer succeed
Often spend more time locked in hospital than would
be in prison
Not
same as having a disorder
Knowledge of right vs. wrong, Self-control, &
Diminished capacity
“Twinkie Defense”
Guilty But Mentally Ill
Legal Concerns
Competent to Stand Trial
Understand Charges
Assist in Own Defense
Civil Commitment
Should People Be Committed to a Psychiatric
Institution Against Their Will?
Criteria for Civil Commitment
Person has a Mental Illness
Needs Treatment
Is Dangerous (self or others)
Is Unable to Care for Self (gravely disabled)
Known as “5150” in California
Problems with determining risk and disability
Right to Refuse Treatment?
Clients’ Rights
To Refuse Treatment
To Obtain Treatment
To Confidentiality
Therapeutic Effect
Limits
Imminent Harm to Self or Others
Duty to Warn (Tarasoff)
Suspicion of Child Abuse
“Least Restrictive Environment”
Deinstitutionalization
Made Possible Largely Due to Medications for Severe
Disorders
Intended Shift of Treatment to Community Mental
Health Centers
Largely a Failure
Least restrictive environment gone awry?
Criminalization of the mentally ill
“Greyhound Therapy”
Homelessness
Other care facilities
Nursing and group homes
Antipsychotic Drugs and Inpatient Treatment
Current Trends
Managed Mental Health Care
Fewer Hospitalizations
Briefer Treatments
Fewer psychiatrists, and now psychologists,
providing psychotherapy
Greater use of medications
Movement Toward Practice Guidelines
Manualized treatments
EVTs, ESTs, and narrowing treatments
Treatment is in many cases very good, but some
areas not very good
Social Aspects of Mental Illness
Social Stigma
Choice of wording
The Myth of Mental Illness
Szasz
Mental illness is an invention not a discovery
Power of Mental Health Professions
Abuse of power, even if unintentional
“On Being Sane in Insane Places” - Rosenhan
Be Aware and Willing to NOT Pathologize People
Summary, Reflections, & the Big Picture
So, what does all this mean?
Not just this chapter, but the whole set of chapters?
What are some of the central themes of this
semester?
What are some of the most valuable principles
and/or ideas you’ve learned?
What about this semester do you think will help you
the most in your career/profession?
How will you continue your learning and growth in
this area?