Punishing the mentally ill
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What is 'sectioning'
- Provisioned in the 2007 mental health act
- It is lawful to detain and treat someone in hospital if:
- They have, or are suspected to have a mental disorder
- The disorder is of a nature or degree which makes hospital treatment appropriate
- Detention is necessary for the health or safety of the patient or for the protection of others
- Appropriate medical treatment is available
- E.g. someone with anorexia refuses to eat and needs naso gastric feeding for their own wellbeing
How are police involved with sectioning?
- Section 136 of the 2007 mental health act gives police the power to remove individuals to a 'place of safety' if they are suspected of suffering from a psychiatric disorder and appear to be in immediate need of care and control
- This place of safety is usually a psychiatric hospital or a police station
- A criminal offence is not required, just unusual behaviour causing nuisance or potential harm
- 2011/12 the UK police did this an estimated 23,600 times
What are the McNaughton rules?
- 1843 Daniel McNaughton tried to kill the PM but killed his secretary instead believing the tories were conspiring against him
- Was not deemed criminally responsible
- We now require both actus rea and men rea for a guilty conviction
- Proof must be presented for both, in order to prove the defendant committed the act and knew what they were doing was unlawful
What determines whether people go to prison or a psychiatric hospital?
- Various factors determine this:
- Request from the police
- Request from the defending solicitor arguing that a psychiatric hospital is more appropriate
- Whether or not psychiatric reports are obtained
- Whether or not the defendant prefers the idea of prison to being labelled as mentally ill
- Whether or not knowing the maximum length in prison is preferable to an unspecified stay in a mental hospital
Can mental illness be reliably identified?
- No - Rosenhan (1973)
- 8 sane people turned themselves into mental hospitals reportedly hearing a voice saying the words 'empty', 'hollow' and 'thud'
- All 8 were accepted and subsequently stopped displaying symptoms
- All were given medication and actions interpreted as abnormal (obsessive note taking)
- All but one diagnosed with schizophrenia in remission
- Upon the publishing of his study, many mental hospitals challenged Rosenhan to send at least 1 stooge over the next month
- 193 were admitted over this time and 41 suspected as stooges
- Rosenhan sent none (owned)
What are the different psychiatric hospitals based on risk?
- Low security (short term, low risk offenders)
- Medium security
- High security (Broadmoor)
What are the two main responsibilities for the forensic mental health services?
- Treat the diagnosed mental disorder
- Reduce the risk of the undesirable behaviour continuing
What is the framework for treatment by forensic mental health practitioners?
- Core assessment of individual (IQ, personality, attitudes)
- Assessment of criminogenic risk factors (substance abuse etc)
- Risk-needs-responsivity (tailor response to specific, dynamic needs)
- Evidence based (particularly when this is for offender sub groups)
What are the treatment types employed by forensic health practitioners?
- Pharmacological: anti psychotic medication for schizophrenics, SSRIs for depressives etc
- Psychological: CBT etc
- Social and occupational therapy: anger management, life skills, cv writing etc
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