DOCSLIB.ORG

Essays in Ethics and Health Policy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Essays in Ethics and Health Policy Essays in Ethics and Health Policy The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Player, Candice Teri-Lowe. 2013. Essays in Ethics and Health Policy. Doctoral dissertation, Harvard University. Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:11051184 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA Essays in Ethics and Health Policy A dissertation presented by Candice Teri-Lowe Player to The Interfaculty Initiative in Health Policy in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the subject of Health Policy Harvard University Cambridge, Massachusetts May 2013 © 2013 Candice Teri-Lowe Player All Rights reserved. Professor Michelle Mello Candice Teri-Lowe Player Dissertation Advisor Essays in Ethics and Health Policy Abstract In 1999 New York enacted Kendra’s Law, in memory of Kendra Webdale, a young woman who was pushed to her death in front of an oncoming train by a man with untreated schizophrenia. Under Kendra’s Law a court can order a person with a mental illness to participate in an “assisted outpatient treatment” (AOT) program. Kendra’s Law includes a number of procedural due process protections including the right to a hearing and the right to counsel. Still critics argue that people with mental illnesses are routinely ordered to participate in the AOT program based on no more than “a bare recital of the statutory criteria.” The first essay in this dissertation, Outpatient Commitment and Procedural Due Process, reports the findings from a study on procedural due process and assisted outpatient treatment hearings under Kendra’s Law. Findings from this study suggest that despite the shift from a medical model of civil commitment to a judicial model in the late 1970s, by and large judges continue to accord great deference to clinical testimony. A second paper, Rethinking Kendra’s Law, addresses the ethical dilemmas that arise when courts impose AOT over the patient’s objection. The third paper of this dissertation, Public Assistance, Drug Testing and the Law, addresses the Fourth Amendment questions that arise when states condition public assistance benefits on passing a suspicionless drug test. To date eight states—including Florida, Georgia and Missouri—condition public assistance benefits on passing a drug test. Proposals to condition public assistance on passing a drug test have also appeared in Congress. However, without a genuine threat to public health or public safety, proposals to condition public assistance on passing a drug test without individualized suspicion of drug use are unreasonable under the Fourth Amendment. Even if the Supreme Court iii were to recognize special needs beyond a genuine threat to public health or public safety, policies that result in withholding public assistance benefits from people who abuse illegal drugs are likely to make many social problems much worse. iv CONTENTS CHAPTER 1. OUTPATIENT COMMITMENT AND PROCEDURAL DUE PROCESS ................... 1 I. PROCEDURAL DUE PROCESS ............................................................................................ 4 A. CASE LAW .................................................................................................................... 4 1. The Right to a Hearing ........................................................................................... 6 2. The Right to Counsel ............................................................................................... 10 3. The Standard of Proof: Clear and Convincing Evidence ............................................ 11 4. The Right to a Neutral Factfinder ........................................................................... 13 B. EMPIRICAL STUDIES ................................................................................................. 15 1. The Right to a Hearing ......................................................................................... 15 2. The Right to Counsel ............................................................................................... 17 3. The Standard of Proof: Clear and Convincing Evidence ............................................ 19 4. The Right to a Neutral Factfinder ........................................................................... 20 C. SUMMARY ................................................................................................................... 23 II. KENDRA’S LAW ................................................................................................................. 24 A. MECHANICS ............................................................................................................... 24 B. DUE PROCESS CHALLENGES ................................................................................... 27 C. PROGRAM IMPLEMENTATION ................................................................................. 31 D. SUMMARY .................................................................................................................. 33 III. METHODS .......................................................................................................................... 34 A. DATA COLLECTION .................................................................................................. 34 1. Courtroom Observation ............................................................................................ 34 2. Participant Interviews .............................................................................................. 34 B. DATA ANALYSIS ........................................................................................................ 35 IV. RESULTS............................................................................................................................... 36 A. AOT HEARINGS ....................................................................................................... 36 1. Uncontested Hearings .............................................................................................. 36 2. Contested Hearings .................................................................................................. 37 a. Evidence ........................................................................................................... 40 b. Defense Counsel Activity .................................................................................. 42 c. Disposition ....................................................................................................... 42 B. INTERVIEWS ............................................................................................................... 43 1. Attorneys ................................................................................................................ 44 a. Impediments to Effective Advocacy ................................................................... 44 i. History of Treatment Noncompliance ........................................................ 44 ii. Expert Testimony .................................................................................... 45 iii. Judicial Attitudes Toward the Mentally Ill ............................................... 46 iv. Medicalization of Deviance .................................................................... 47 b. Attorney Role: Zealous Advocacy or Best Interests?.......................................... 47 2. Judges .................................................................................................................... 48 a. Deciding AOT Hearings ................................................................................. 48 i. Expert Testimony ................................................................................ 49 ii. Harm to Others ................................................................................... 50 v iii. The Revolving Door of Hospital Admissions ......................................... 50 vi. Liberty Interests ................................................................................... 51 b. Clear and Convincing Evidence ........................................................................ 52 c. Attorney Role: Zealous Advocacy or Best Interests? .......................................... 52 V. DISCUSSION ........................................................................................................................ 53 CHAPTER 2. RETHINKING KENDRA’S LAW: THE ETHICS OF ASSISTED OUTPATIENT TREATMENT ...................................................................................................................................... 59 I. DEINSTITUTIONALIZATION: PITFALLS AND PROMISES ............................................. 63 II. KENDRA’S LAW ................................................................................................................ 69 III. HARM TO OTHERS ........................................................................................................... 71 A. VIOLENCE AND MENTAL ILLNESS ........................................................................ 73 1. Community Surveys ................................................................................................. 73 2. Psychosis and Violence ............................................................................................
Load more

Recommended publications
  • Volk V. Demeerleer Study
    Volk v. DeMeerleer Study Commissioned by: Washington State Legislature House Judiciary Committee December 1, 2017 UW School of Law Center for Law, Science and Global Health Volk v. DeMeerleer Study Research Team Tanya E. Karwaki, JD, LLM, PhD Research Associate, Center for Law, Science and Global Health Jaclyn Greenberg, JD, LLM (candidate) Annemarie Weiss, LLM Gavin Keene, JD (candidate) Faculty Supervisors Patricia C. Kuszler, MD, JD Charles I. Stone Professor of Law Faculty Director, Center for Law, Science, and Global Health Terry J. Price, MSW, JD Executive Director, Center for Law, Science, and Global Health VOLK V. DEMEERLEER STUDY TABLE OF CONTENTS I. Executive Summary ............................................................................................................................... 3 II. Comprehensive Review of the “Duty to Warn” and the “Duty to Protect” ............................................ 5 A. Background: The Tarasoff Case and the Duties to Endangered Third Parties ............................... 5 B. Review of Case Law and Legislative Provisions Across the United States ..................................... 7 1. Terminology with Respect to the “Duty to Protect” and the “Duty to Warn” ......................... 7 2. Summary of the National 50-State (plus District of Columbia) Legislative and Case Survey .. 8 a) Description of the Duty to Third Parties ............................................................................. 8 b) Who Has a Duty to Third Parties in the Context of Mental Health Care .........................
    [Show full text]
  • The Liability of Alaska Mental Health Providers for Mandated Treatment
    111103 WILDE.DOC 12/29/03 2:01 PM THE LIABILITY OF ALASKA MENTAL HEALTH PROVIDERS FOR MANDATED TREATMENT MARSHALL L. WILDE* This Article analyzes the liability of mental health professionals for services rendered to patients who are ordered by a court to undergo mental health treatment. After a brief review of relevant legal authority, this Article examines mandated treatment under the framework of quasi-judicial immunity and continues by discussing the specific duties of mental health professionals to patients under- going mandated treatment. The Article also comments on the unique issues that arise from treatment of patients under federal benefit programs. The Article concludes by arguing that mental health professionals do not enjoy a blanket exemption from mal- practice liability and by suggesting a cautious course of action for such professionals. I. INTRODUCTION Court-ordered treatment programs for substance abuse and mental illness have become a popular tool to achieve the goals of the criminal justice system: to punish, rehabilitate, and deter crimi- nal behavior. In Alaska, mental health providers serve an essential role in determining the disposition of offenders, minors, and in- competents, and have traditionally enjoyed immunity for their du- ties in these roles.1 Outside the protection of immunity, mental Copyright © 2003 by Marshall L. Wilde. This Article is also available on the Internet at http://www.law.duke.edu/journals/20ALRWilde. * Major, Judge Advocate General’s Department, United States Air Force Re- serve, 433rd Airlift Wing, Lackland Air Force Base, Texas; L.L.M., University of Houston Law Center, 2003; J.D., University of Oregon School of Law.
    [Show full text]
  • Mental Health Law & Policy Journal
    MENTAL HEALTH LAW & POLICY JOURNAL VOLUME 1 SUMMER 2012 NUMBER 2 ESSAY THE PARADOX IN MADNESS: VULNERABILITY CONFRONTS THE LAW Marie Failinger, J.D. ARTICLES REFUSING TO RECOGNIZE THE RIGHT TO REFUSE MEDICAL TREATMENT, OR ENSURING PUBLIC SAFETY: AN ANALYSIS OF NEW YORK’S ASSISTED OUTPATIENT TREATMENT LAW Andrew Zacher, J.D., M.S. ONLINE INVESTIGATIONS AND THE AMERICANS WITH DISABILITIES ACT: THE RESURGENCE OF OVERBROAD AND INEFFECTUAL MENTAL HEALTH INQUIRIES IN CHARACTER AND FITNESS EVALUATIONS Bernice M. Bird, M.S. MENTAL HEALTH LAW & POLICY JOURNAL VOLUME 1 WINTER 2012 NUMBER 1 JAMES OLSEN, PH.D. Editor-in-Chief NEELY THOMAS Managing Editor JONATHAN MOSLEY AUSTIN RAINEY Executive Editor Business Editor KAREN HENSON LYNDSEY PARE Articles Editor PETER DAWSON Articles Editor Articles Editor KELLY BUCKHOLDT, M.S. Articles Editor ALLISON RENFRO KERRY KRAUCH Online Editor Administrative Editor SENIOR ASSOCIATE MEMBERS STEVEN BARNES NICOLE BURTON REBECCA HINDS PATRICIA BLOUNT KACY COBLE JOHN-MICHAEL RYALL HANNAH BURCHAM CHARLES FLEET JANA SNYDER ASSOCIATE MEMBERS SARAH ATKINSON BLAKE LESKO COURTNEY PEASANT, M.S. JESSEE BUNDY CHRISTOPHER MARTIN AMANDA RACH NATALIE BURSI RANDAL MARTIN CATHERINE REICH, M.S. JAMES DALE JENNIFER MAYHAM JONATHAN RING TAMARA DAVIS WILLIAM MCCALLUM JESSICA SULLIVAN SHALONDRA GRANDBERRY, M.B.A. JILL MICAI ROBERT SWANN DANIEL LENANGAR RACHEL TILLERY FACULTY ADVISOR LARS GUSTAFSSON, J.D., LL.M. DEAN KEVIN SMITH, J.D., PH.D BOARD OF ADVISORS DONALD BERSOFF, J.D., PH.D. Drexel University ANNETTE CHRISTY, PH.D. University of South Florida DAVID DEMATTEO, J.D., PH.D. Drexel University TREVOR HADLEY, PH.D. University of Pennsylvania THOMAS HAFEMEISTER, J.D., PH.D.
    [Show full text]
  • Psychoanalytic
    Ethics for Clinicians p. 1 Most people print off a copy of the post test and circle the answers as they read through the materials. Then, you can log in, go to "My Account" and under "Courses I Need to Take" click on the blue "Enter Answers" button. After completing the post test, you can print your certificate. If you didn't create an account when you downloaded the course materials, just go back to Ce4Less.com click on Course List, then the ‘Ethics for Mental Health Professionals’ course. Click the green "Try the Free Course" button and you will be able to create your account. Ethics for Mental Health Professionals Introduction Most mental health professionals have a working definition of ethics which is simply: “The rules of conduct of my profession”. Our professional codes of ethics often add a word like “enforceable” to further delineate the importance of professional ethics. The American Psychological Association (APA) code of ethics, for example, defines ethics as “enforceable rules for conduct as psychologists.” Ethical standards are generally written in broad statements and apply in varied roles and contexts. The APA guidelines remind us that ethical standards are not exhaustive and even when conduct is not specifically addressed by an ethical standard it does not mean that the conduct is necessarily either ethical or unethical. While this type of definition is generally clear, what sometimes becomes less clear is the comprehensive role that professional ethics play in our daily lives as psychologists, social workers, counselors, and therapists. When asked what ethical issues they have recently faced, many people in these fields are unable to point to any recent ethical dilemmas.
    [Show full text]
  • Constitutional Law – State Authorization Of
    +(,121/,1( Citation: Catherine L. Falvey, Constitutional Law - State Authorization of Forcible Administration of Depo-Provera Invalid under Colorado Statutory Law, 13 J. HEALTH & BIOMEDICAL L. 171 (2017). Provided by: Moakley Law Library at Suffolk University Law School Content downloaded/printed from HeinOnline Sat Jul 6 20:24:51 2019 -- Your use of this HeinOnline PDF indicates your acceptance of HeinOnline's Terms and Conditions of the license agreement available at https://heinonline.org/HOL/License -- The search text of this PDF is generated from uncorrected OCR text. -- To obtain permission to use this article beyond the scope of your HeinOnline license, please use: Copyright Information Use QR Code reader to send PDF to your smartphone or tablet device 171 Journal of Health & Biomedical Law, XIII (2017) 171-183 ©20 17 Journal of Health & Biomedical Law Suffolk University Law School Constitutional Law-State Authorization of Forcible Administration of Depo-Provera Invalid Under Colorado Statutory Law-People ex rel. C.J.R. No. 16CA0915, 2016 Colo. App. LEXIS 1276 (Colo. Ct. App. Sept. 8, 2016). Catherine L. Falvey* Colorado law gives the court responsible for admitting a patient into a state facility the authority to involuntarily administer medication if that patient refuses to accept it.' The Colorado Court of Appeals in People ex rel. C.J.R2 addresses the Denver Probate Court's authorization of chemical castration by means of involuntarily administering Depo-Provera to a male patient exhibiting inappropriate and aggressive sexual behavior. The appeals court held that the probate court could not authorize the state facility to forcibly administer Depo-Provera to the patient, reversing the probate court's initial ruling.' *J.D.
    [Show full text]
  • Legal Update on Duty to Protect
    UW PACC Psychiatry and Addictions Case Conference UW Medicine | Psychiatry and Behavioral Sciences LEGAL UPDATE ON THE DUTY TO PROTECT JENNIFER PIEL, MD, JD CENTER FOR MENTAL HEALTH, POLICY, AND THE LAW DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES UNIVERSITY OF WASHINGTON UW PACC ©2020 University of Washington GENERAL DISCLOSURES The University of Washington School of Medicine also gratefully acknowledges receipt of educational grant support for this activity from the Washington State Legislature through the Safety-Net Hospital Assessment, working to expand access to psychiatric services throughout Washington State. UW PACC ©2020 University of Washington GENERAL DISCLOSURES UW PACC is also supported by Coordinated Care of Washington UW PACC ©2020 University of Washington SPEAKER DISCLOSURES ✓ Nothing to disclose UW PACC ©2020 University of Washington PLANNER DISCLOSURES The following series planners have no relevant conflicts of interest to disclose: Mark Duncan MD Cameron Casey Barb McCann PhD Betsy Payn Rick Ries MD Diana Roll Kari Stephens PhD Cara Towle MSN RN Anna Ratzliff MD PhD has received book royalties from John Wiley & Sons (publishers). UW PACC ©2020 University of Washington OBJECTIVES 1. Understand the legal basis for mental health clinicians’ duty to protect 2. Distinguish legal duties under statutory and common law in Washington 3. Appreciate how to approach the duty from a clinical perspective UW PACC ©2020 University of Washington QUESTION 1 Breach of a patient’s confidentiality may result in all of the following for a physician, except: a. A tort suit b. A criminal conviction c. Sanction by state medical board d. Sanction by the American Medical Association UW PACC ©2020 University of Washington QUESTION 2 The decision in Tarasoff (Cal.
    [Show full text]
  • Involuntary Commitment: What Is the Process?
    Involuntary Commitment: What is the Process? 2020 Edition LawPracticeCLE Unlimited All Courses. All Formats. All Year. ABOUT US LawPracticeCLE is a national continuing legal education company designed to provide education on current, trending issues in the legal world to judges, attorneys, paralegals, and other interested business professionals. New to the playing eld, LawPracticeCLE is a major contender with its oerings of Live Webinars, On-Demand Videos, and In-per- son Seminars. LawPracticeCLE believes in quality education, exceptional customer service, long-lasting relationships, and networking beyond the classroom. We cater to the needs of three divisions within the legal realm: pre-law and law students, paralegals and other support sta, and attorneys. WHY WORK WITH US? At LawPracticeCLE, we partner with experienced attorneys and legal professionals from all over the country to bring hot topics and current content that are relevant in legal practice. We are always looking to welcome dynamic and accomplished lawyers to share their knowledge! As a LawPracticeCLE speaker, you receive a variety of benets. In addition to CLE teaching credit attorneys earn for presenting, our presenters also receive complimentary tuition on LawPracticeCLE’s entire library of webinars and self-study courses. LawPracticeCLE also aords expert professors unparalleled exposure on a national stage in addition to being featured in our Speakers catalog with your name, headshot, biography, and link back to your personal website. Many of our courses accrue thousands of views, giving our speakers the chance to network with attorneys across the country. We also oer a host of ways for our team of speakers to promote their programs, including highlight clips, emails, and much more! If you are interested in teaching for LawPracticeCLE, we want to hear from you! Please email our Directior of Operations at [email protected] with your information.
    [Show full text]
  • Legal Issues in Crisis Services
    National Association of State Mental Health Program Directors 66 Canal Center Plaza, Suite 302 Alexandria, Virginia 22314 Assessment #5 Legal Issues in Crisis Services August 2020 Alexandria, Virginia Fifth in a Series of Ten Briefs Addressing—Beyond Beds: Crisis Services This work was developed under Task 2.2 of NASMHPD’s Technical Assistance Coalition contract/task order, HHSS283201200021I/HHS28342003T and funded by the Center for Mental Health Services/Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services through the National Association of State Mental Health Program Directors. 1 LEGAL ISSUES IN CRISIS SERVICES Debra A Pinals, MD Lisa Anacker, MD Author Affiliations Debra A. Pinals, M.D., Clinical Professor of Psychiatry, Director, Program in Psychiatry, Law and Ethics, University of Michigan; Medical Director, Behavioral Health and Forensic Programs, Michigan Department of Health and Human Services; Chair, Medical Director’s Division, National Association of State Mental Health Program Directors. Lisa Anacker, M.D., Adjunct Clinical Assistant Professor, Department of Psychiatry, University of Michigan; Attending in Forensic Psychiatry, Center for Forensic Psychiatry, Saline, MI Project Support This work was supported by the Center for Mental Health Services/Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services through the 2020 Technical Assistance Coalition of the National Association of State Mental Health Program Directors. Disclaimer The views, opinions, content and positions expressed in this paper are those of the author and do not necessarily represent or reflect the official views, opinions, or policies of any governmental, academic, or other institution with whom the author is affiliated; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S.
    [Show full text]
  • Mental Health Malpractice in the 1990S
    California Western School of Law CWSL Scholarly Commons Faculty Scholarship 1991 Mental Health Malpractice in the 1990s Steven R. Smith California Western School of Law, [email protected] Follow this and additional works at: https://scholarlycommons.law.cwsl.edu/fs Part of the Law and Psychology Commons Recommended Citation Smith, Steven R., "Mental Health Malpractice in the 1990s" (1991). Faculty Scholarship. 118. https://scholarlycommons.law.cwsl.edu/fs/118 This Article is brought to you for free and open access by CWSL Scholarly Commons. It has been accepted for inclusion in Faculty Scholarship by an authorized administrator of CWSL Scholarly Commons. For more information, please contact [email protected]. LIABILITY MENTAL HEALTH MALPRACTICE IN THE 1990s Steven R. Smith* Table of Contents I INTRODUCTION .................................. 210 I1 CURRENT LEVEL OF MALPRACTICE CLAIMS .......... 212 II TYPES AND AREAS OF MALPRACTICE CLAIMS ........ 217 A. Legal Basis of Liability .................... 218 B. Areas of Malpractice Liability .............. 221 IV. PROTECTING THIRD PARTIES FROM DANGEROUS PATIENTS ...................................... 242 A. The Duty to Protect (or Warn) ............. 243 B. Tarasoff Statutes .......................... 246 C. Reporting Obligations ...................... 250 V. INSTITUTIONAL LIABIIY ......................... 252 VI. LLABIUTY IN PERSPECTIVE......................... 257 VII MALPRACTICE IN THE 1990S ...................... 259 A. IncreasingLiability ........................ 259 B. Reducing Liability ........................
    [Show full text]
  • The Emerging Professional Liability of Mental Health Providers
    Parity at a Price: The Emerging Professional Liability of Mental Health Providers THOMAS L. HAFEMEISTER* LEAH G. MCLAUGHLIN** JESSICA SMITH*** TABLE OF CONTENTS I. INTRODUCTION .................................................................................................... 30 II. PRIMER ON PROFESSIONAL LIABILITY SUITS TARGETING MENTAL HEALTH CARE PROVIDERS ................................................................................... 35 III. THE IMPACT OF THE DECREASE IN STIGMA ASSOCIATED WITH MENTAL ILLNESS ........................................................................................ 44 IV. THE IMPACT OF IMPROVED TREATMENT OUTCOMES ............................................. 48 V. THE IMPACT OF THE INCREASED USE OF PSYCHOTROPIC MEDICATIONS ................ 54 VI. THE EXPANDING ROLE OF PRIMARY CARE PHYSICIANS AND PRESCRIBING PRIVILEGES .................................................................................... 58 VII. PEDIATRIC PSYCHOTROPIC MEDICATIONS ............................................................ 62 VIII. INFORMED CONSENT AND ADVANCE DIRECTIVES ................................................. 69 IX. TARASOFF-RELATED LIABILITY ............................................................................ 75 X. CONCLUSION ....................................................................................................... 87 * J.D., Ph.D., Associate Professor, School of Law; Associate Professor of Medical Education, School of Medicine; University of Virginia. The Authors would like to thank
    [Show full text]
  • Volk V. Demeerleer: an Unprincipled Divorce of Dangerousness and the Tarasoff Duty to Protect Jaclyn Greenberg
    Washington Law Review Online Volume 92 Article 2 2017 Volk v. DeMeerleer: An Unprincipled Divorce of Dangerousness and the Tarasoff Duty to Protect Jaclyn Greenberg Follow this and additional works at: https://digitalcommons.law.uw.edu/wlro Part of the Medical Jurisprudence Commons Recommended Citation Jaclyn Greenberg, Volk v. DeMeerleer: An Unprincipled Divorce of Dangerousness and the Tarasoff Duty to Protect, 92 wash. l. rev. online 13 (2017). Available at: https://digitalcommons.law.uw.edu/wlro/vol92/iss1/2 This Article is brought to you for free and open access by the Law Reviews and Journals at UW Law Digital Commons. It has been accepted for inclusion in Washington Law Review Online by an authorized editor of UW Law Digital Commons. For more information, please contact [email protected]. Document1 (Do Not Delete) 6/22/2017 3:23 AM VOLK V. DEMEERLEER: AN UNPRINCIPLED DIVORCE OF DANGEROUSNESS AND THE TARASOFF DUTY TO PROTECT Jaclyn Greenberg* Abstract: Since its inception in Tarasoff v. Regents of the University of the California, the duty to protect third parties imposed on mental health professionals (MHPs) has been the subject of considerable scrutiny. Clinicians and legal scholars alike derided the original duty to protect “anyone foreseeable” as unworkable—undermining the therapeutic relationship and placing MHPs in the impossible position of having to predict their patients’ violent future. Over time, case law and legislation narrowed the duty to something less problematic: a “duty to warn” identifiable victims who face imminent threat of serious harm. However, Volk v. DeMeerleer, reset the duty for Washington MHPs to its original expansiveness, and arguably broadened the basis for imposing the duty.
    [Show full text]
  • Mental Health and the Criminal Justice System in the United States
    2014] “ARE THERE NO PRISONS?” 103 “ARE THERE NO PRISONS?” MENTAL HEALTH AND THE CRIMINAL JUSTICE SYSTEM IN THE UNITED STATES Robert Rigg* I. INTRODUCTION 103 II. A BRIEF HISTORY OF MENTAL HEALTH HOSPITALIZATION IN THE UNITED STATES 107 III. PENROSE’S LAW 110 IV. CURRENT TREATMENT RECOMMENDATIONS 111 A. Symptoms 111 B. Multi-Faceted Treatment Approach 113 V. THE CRIMINAL JUSTICE SYSTEM AND COMPETENCY 115 A. Law Enforcement Interaction with Individuals Having Mental Health Issues 115 B. Duty of Defense Counsel 118 C. Issues Regarding Medication 120 D. Insanity and Diminished Responsibility 121 E. The Criminal Justice System’s Inability to Address Mental Health Issues 123 VI. MENTAL HEALTH COURTS AND DIVERSION PROGRAMS 124 A. Prebooking Diversion 124 B. Mental Health Courts 125 C. Postbooking Diversion 126 VII. CONCLUSION 127 I. INTRODUCTION Charles Dickens penned his famous words “are there no prisons?” in 1843’s A Christmas Carol, as a part of a dialogue between Ebenezer Scrooge and two gentlemen soliciting donations for the poor.1 Two years prior to the release of A Christmas Carol, Dorothea Dix began a crusade to reform the treatment of mentally ill inmates after * Robert Rigg is a professor of law and the director of the Criminal Defense Program at Drake University Law School. I want to thank my research assistants Ashley Sparks, Meredith Lamberti, and Austin Mouw for their assistance with this article. 1 CHARLES DICKENS, A CHRISTMAS CAROL 13 (W. Heinemann ed., Windmill Press 1962) (1843). (“‘At this festive season of the year, Mr. Scrooge,’ said the gentleman, taking up a pen, ‘it is more than usually desirable that we should make some slight provision for the Poor and Destitute, who suffer greatly at the present time.
    [Show full text]