Chapter 17 Contemporary and Legal Issues In Abnormal Psychology ABNORMAL PSYCHOLOGY, SIXTEENTH EDITION James N. Butcher/ Jill M. Hooley/ Susan Mineka Chapter 17 Contemporary and Legal Issues In Abnormal Psychology © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Perspectives on Prevention Subcategories of prevention efforts Universal interventions Selective interventions Indicated interventions © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Universal Interventions Key tasks of universal interventions Altering the conditions that can cause or contribute to mental disorders Establishing conditions that foster positive mental health © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Universal Interventions Biological strategies Psychosocial strategies Sociocultural strategies © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Selective Interventions Aimed at specific subgroup of population considered at risk for developing mental health problems © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Selective Interventions Selective prevention strategies School-based interventions Intervention programs for high-risk teens Parent education and family-based intervention programs Extracurricular strategies Internet-based intervention programs Comprehensive prevention strategies © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Indicated intervention Emphasizes early detection and prompt treatment of maladaptive behavior in person’s family and community setting © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Mental Hospital as a Therapeutic Community “Milieu therapy” Incorporates ongoing activities of hospital into treatment program Social-learning programs Uses techniques such as token economies to shape more socially accepted behavior Aftercare programs Provide support for transition from institutional to community life © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Deinstitutionalization What do you think? There has been much controversy over deinstitutionalization. What are the key elements of this controversy? There has been a great deal of controversy over deinstitutionalization and the failure to provide adequate follow-up of these patients who may find themselves homeless or in prison. © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Controversial Legal Issues and the Mentally Disordered Forensic psychology or forensic psychiatry Intersection of mental health and legal issues © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Controversial Legal Issues and the Mentally Disordered Prominent issues Right to treatment Right to less restrictive treatment Right to refuse treatment Right to live in a community © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Civil Commitment To be committed, an individual must be Dangerous to themselves or others and/or Incapable of providing for their basic physical needs and/or Unable to make responsible decisions about hospitalization and In need of treatment or care in a hospital © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Assessment of “Dangerousness” True or false? Most psychiatric patients are not dangerous, but some are violent and require supervision or confinement True © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Assessment of “Dangerousness” Practitioners are often asked to evaluate patient dangerousness Very difficult to predict Often over-predicted by mental health professionals © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Assessment of “Dangerousness” Tarasoff decision Set precedent for therapists’ duty-to-warn Some confusion exists about which situations merit warning Set precedent for therapists’ duty-to-warn Client stated intent to kill ex-girlfriend Therapist notified authorities but not ex-girlfriend Client killed her; her parents successfully sued for not warning her © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Insanity Defense Insanity defense Insanity plea for capital crimes Important issue in forensic pathology “Not guilty by reason of insanity” (NGRI) defense questioned © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Defining precedents The Insanity Defense The M’Naghten Rule (1843) The Irresistible Impulse Rule (1887) The Durham Rule (1954) The American Law Institute Standard (1962) The Federal Insanity Defense Reform Act (1984) The M’Naghten Rule held that the accused must have been laboring under such a defect of reason as not to know The nature and quality of the act That the act was wrong The American Law Institute Standard leaves open the possibility of valid insanity pleas by people who are not diagnosed to be psychotic © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Insanity Defense Some states have adopted optional plea/verdict of “guilty but mentally ill.” What do you think? Defendant can be sentenced but placed in a treatment facility rather than in prison Remains in custody until full sentence is served Cannot be released because found rational and without need for further treatment © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Organized Efforts for Mental Health Mental health programs Aim to better understand, treat, and prevent mental illness Influenced in many countries by public awareness about and broad-based interest in mental health problems Influenced in many countries by Public awareness of mental health problems Interest of government, professional, and lay organizations © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

U.S. Efforts for Mental Health Federal agencies The National Institute of Mental Health The National Institute on Drug Abuse The National Institute on Alcohol Abuse and Alcoholism Federal agencies devoted to promoting research, training, and service in mental health community © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

U.S. Efforts for Mental Health Stop and think! How many private organizations active in programs to promote mental health can you identify? The American Psychological Association The American Psychological Society The American Psychiatric Association The American Medical Association The Association for the Advancement of Behavior Therapy The American Association for Correctional and Forensic Psychology The National Association for Social Work © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

International Efforts for Mental Health Leaders in international efforts for mental health World Health Organization World Federation for Mental Health © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Challenges for the Future Much more progress in mental health must be made. Related or underlying social problems need to be addressed. More planning and collaboration at community, national, and international levels is imperative. Challenges U.S. and international efforts are encouraging, but much more progress in mental health remains to be made Social problems contribute heavily to psychological problems of individuals It seems imperative that more effective planning be done at community, national, and international levels if mental health problems are going to be reduced or eliminated © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Individual’s Contribution Fill in the blank! The history of abnormal psychology provides clear examples of ________ whose efforts were instrumental in changing the way we think about problems The history of abnormal psychology provides clear examples of individuals whose efforts were instrumental in changing the way we think about problems © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Individual’s Contribution: How Each Citizen Can Help Volunteer at a mental hospital, community mental health center, or service organization Support realistic measures to ensure comprehensive health services for all ages Work to improve public education and government, reduce prejudice, and establish harmony © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Unresolved Issues HMOs and mental health care… Regarding mental health treatment, who should decide what kind and how long? Is time-limited therapy effective? In recent years, HMOs have increasingly influenced these decisions. Should this continue? © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.