The journal of the American Academy of Psychiatry and the Law
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In summary, to characterize addiction as a disease is not necessarily morally incompatible with saying that addicts are responsible for yielding to it. This is admittedly a demanding approach to responsibility, but our criminal law has always set the bar pretty high. Holding addicts responsible is also strongly supported on utilitarian grounds because the threat of sanctions provides leverage to press them into treatment and to keep them engaged while therapeutic efforts are undertaken. ⋯ In this connection, the similarity between addiction and other chronic diseases, which lies at the heart of the brain disease claim, becomes particularly pertinent. Yes, addiction is best understood as a chronic relapsing disorder. This helps to establish realistic expectations for the benefits of treatment, but it also emphasizes the important role of behavior in disease management and points in the direction of a theory of responsibility for managing one's own illness.
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J. Am. Acad. Psychiatry Law · Jan 2002
Practice Guideline GuidelineAAPL practice guideline for forensic psychiatric evaluation of defendants raising the insanity defense. American Academy of Psychiatry and the Law.
The insanity defense is a legal construct that excuses certain mentally ill defendants from legal responsibility for criminal behavior. This practice guideline has delineated the forensic psychiatric evaluation of defendants raising the insanity defense. The document describes acceptable forensic psychiatric practices. ⋯ The psychiatrist's analysis and opinion should be clearly stated in the forensic psychiatric report. It should be noted that the role of a psychiatric expert witness in the criminal justice system is predicated on the law's interest in individualizing the criteria of mitigation and exculpation. Forensic psychiatric analyses and formulations of opinions are, therefore, subject to change as the legal guidance changes.
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Class action litigation has been instrumental in jail and prison reform during the past two decades. Correctional mental health systems have significantly benefited from such litigation. ⋯ The role of psychiatric experts, with particular reference to standards of care, is described. Specifically discussed are issues relevant to suicide prevention, the prevalence of mentally ill inmates in supermax prisons, and discharge planning.
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J. Am. Acad. Psychiatry Law · Jan 2002
The role of mental health in the inmate disciplinary process: a national survey.
An effective system of inmate discipline is an important aspect of a safely run prison or jail. Historically, mentally ill inmates have had few or no protections against discipline routinely applied to their non-mentally ill peers. Arising from recent class action lawsuits challenging the quality of mental health care delivery in the nation's prisons, prison mental health professionals have been called on to play an increasing role in the inmate disciplinary process. ⋯ Little has been written in the psychiatric literature, however, examining this important role for prison mental health professionals. After first reviewing core legal and constitutional concepts, the author presents the results of a nationwide survey examining the role for mental health professionals in the inmate disciplinary process. To the author's knowledge, this is the first study to provide a comprehensive review of this subject.