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Abstract:
The advances of biological sciences have dramatically improved the understanding of schizophrenia and related psychotic illnesses. One of the most compelling findings is the substantial degree in which cognition is impaired in these illnesses such and the remedial effects that antipsychotic drugs have on treating these cognitive impairments. Despite these promising discoveries, legal cases and scholarship remain replete with pejorative associations in terms of antipsychotic drug action. References to antipsychotic medications as mind altering drugs and their effects as synthetic sanity misconstrue the beneficial effects these medicines have on cognition. This paper reviews the prevailing legal attitude of antipsychotic medications and contrasts these views with prevailing scientific knowledge and concludes that legal opinion is misinformed about the effects of antipsychotic medications on cognition.

mental health law, psychiatry, criminal procedure, disability law, evidence

Abstract:
Criminal law scholarship has become absorbed with the ideas of neuroscience. This infatuation has quickly sprung into the nascent field of neurolaw. This mixture of cognitive neuroscience and law suggests that long established conceptions of human agency and responsibility are fundamentally at odds with the findings of science. Using sophisticated technology, cognitive neuroscience claims to be upon the threshold of unraveling the mysteries of the mind by elucidating the mechanical nature of the brain. Despite the limitations of that technology, neurolaw supporters eagerly suggest that those revelations entail that an inevitable and radical overhaul of our criminal justice system is soon at hand. What that enthusiasm hides, however, is a deeper ambition among those who desire an end to distributive punishment based on desert in favor of a prediction model heavily influenced by the behavioral sciences. That model rests squarely on the presumption that science should craft crime policy at the expense of the authority of common intuitions of justice. But that exchange has profound implications for how the law views criminal conduct and responsibility – and how it should be sanctioned under the law. Neurolaw promises a more humane and just criminal justice system, yet there is ample reason to believe otherwise.

neurolaw, cogntive neuroscience, responsibility, intuitions of justice, psychology, criminal law

Abstract:
Law and the behavioral sciences are often at odds with one another. The recent case of Cark v. Arizona is just the latest in a long history of skepticism that courts have openly displayed towards disciplines that offer explanations for social behavior. The disparities between how law and the behavioral sciences understand complicated questions of intentionality, free will, and causation are fundamentally rooted in their different epistemologies. But these theoretical foundations are not formed in isolation. As much as science presents itself as objective and untouched by the influence of politics, it does operate within a political world that shapes and defines its identity and ambitions. This article traces the development of modern psychiatry and demonstrates how its internal politics have resulted in the current state where law and psychiatry - as Clark painfully shows - are further apart than ever.

psychiatry, epistemology, mental illness, law and science

Abstract:
Perhaps one of the most enduring areas of controversy in our criminal law involves questions about mitigation and the insanity defense. These affirmative defenses flow from our legal and cultural traditions which hold mens rea as a key component of a just criminal justice system. Premeditated murder is viewed as a more heinous act than reckless homicide because our criminal justice system values mental states for ascribing the severity of guilt. Yet ascertaining the mental state of defendants remains a difficult enterprise. Thus, our criminal justice system relies upon behavioral science experts for guidance in navigating the opaque world of the mind. In doing so, the behavioral sciences have been roundly criticized for introducing junk science into the courtroom. Such criticisms often fail, however, to account for the fact that the behavioral science experts are invited into a legal system that views the world very differently than science. This melding of science and law is fruitful in some endeavors, but is increasingly leading science and law down a dangerous path where the legal system appears willing to easily entertain novel scientific claims and science has become increasingly politicized by normative questions. In this brief Essay, I discuss this effect by examining two recent Supreme Court cases that involved defendants with very different mental disorders: schizophrenia and psychopathy. I conclude that both law and science could greatly benefit from a healthy dose of modesty when considering novel scientific claims that appear to undermine longstanding notions of individual responsibility and accountability.

psychology, insanity, panetti, landrigan, mitigation, law and science

Abstract:
Psychological tests are frequently used by forensic psychologists engaged in evaluations for family court matters. Since the recommendations that flow from such evaluations can have considerable influence on the disposition of such cases, it is crucial that any tests used by the forensic evaluator possess solid scientific reliability and validity. Unfortunately, one of the most common psychological tests used in family court matters, the infamous Rorschach inkblot test, has serious psychometric deficits that render it unreliable and invalid. This brief essay discusses these limitations and urges attorneys to vigorously challenge expert testimony based upon this flawed test.

child custody, experts, psychological tests, family court

Abstract:
This essay briefly reflects on the seminal Article by William Stuntz, The Pathological Politics of Criminal Law. As Stuntz rightly argues, the pathology which afflicts our criminal justice system lies in its structural politics and power - unlike other institutional bodies, criminal justice can deprive liberty. But the power of the criminal code also lies in its inherent emotional attachment to the people it governs. Most folks rarely concern themselves with the various obtuse regulations which embody our modern legal system - yet almost everyone has a strong notion of how crimes should be punished. Criminal justice policy, however, has steadily tread towards sentencing decisions insulated from participatory influences. Likewise, punishment is now almost entirely a private enterprise. This divorce of the public from the ultimate output of the criminal justice system just might explain some of perverse realities which Stuntz so skillfully describes.

crime, emotions, psychology, sentencing, punishment

Abstract:
OBJECTIVE: An emerging adaptation of the assertive community treatment model is forensic assertive community treatment (FACT), which aims to prevent criminal recidivism. This study examined predictors of arrest among patients in a prototype program and considered the implications of study findings for future development of the FACT model. METHODS: Demographic and clinical data from all 130 patients treated in Project Link from 1997 through 2003 were merged with a statewide criminal record database to identify variables associated with arrest.RESULTS: Poisson regression revealed a history of arrests for violent offenses before treatment and evictions from residential treatment, and antisocial traits were associated with arrest during treatment. Substance abuse was not associated with arrest, but the sample lacked heterogeneity for this factor. CONCLUSIONS: Variables associated with arrest were similar to those seen in the general population. In the absence of a standardized model of intervention, FACT programs should incorporate interventions that target modifiable risk factors in order to prevent criminal recidivism among high-risk patients.

Criminal recidivism, intervention, FACT, modifiable risk factors

Abstract:
The civil commitment of the mentally ill is one of the most contentious areas of mental health law. The legacy of civil commitment has encompassed a dual policy of protecting the public from the dangerously mentally ill and providing treatment for those who are unable to care for themselves. With the continued growth of outpatient mental health care as the predominant means of providing services for the mentally ill, states have adopted statutes that allow for more aggressive treatment. Many of these statutes provide for the commitment of the mentally ill under new statutory schemes that reflect the changing landscape of mental health services. This shift reflects a progressive legislative understanding that certain individuals with severe mental illnesses are chronically ill and will repeatedly decompensate into their illnesses under an "imminent dangerousness" standard, resulting in a "revolving door" of commitments, incarceration, and homelessness.

mental health law, civil commitment

Abstract:
OBJECTIVE: This study examined the risk of incarceration among cohorts of veterans treated in the Department of Veterans Affairs (VA) Connecticut Healthcare System. Incarceration rates of persons with and without mental illness were compared and adjusted for various clinical and service utilization variables. Data were compared before and after the closure of over 80% of the Connecticut VA psychiatric inpatient beds in 1996.

METHODS: Data from five annual cohorts of patients (1993-1997) treated in an inpatient unit in the VA Connecticut Healthcare System (N=36,385) were merged with state Department of Correction data. Logistic regression models were used to identify risk factors for incarceration.

RESULTS: Bivariate analysis showed that incarceration rates were higher for VA patients with psychiatric disorders and with substance use disorders than for those without such diagnoses, but there were no significant increases in likelihood of incarceration over these years of extensive closures. In multiple logistic regression analysis only diagnoses of substance use disorders and major depression were independently associated with an increased likelihood of incarceration, whereas schizophrenia, personality disorders, and co-occurring psychiatric and substance use disorders were not independently associated with increased likelihood in multivariate analysis.

CONCLUSIONS: Alcohol and drug problems appeared to account for much of the risk of incarceration among hospitalized veterans during the study period. Unlike in previous studies, schizophrenia and related psychotic disorders were not independently associated with an increased risk of incarceration.

incarceration, jail, mental illness, veterans

Abstract:
Psychologists are frequently consulted by the courts to provide forensic evaluations in a variety of family court proceedings. As part of their evaluations, psychologists often use psychological tests to assess parents, guardians, and children. These tests can have profound effects on how psychologists arrive at their opinions and are often cited in their reports to the court. However, psychological tests vary substantially in their suitability for these purposes. Most projective tests in particular appear to possess little scientific merit for evaluations within family court proceedings. Despite these serious limitations, expert testimony derived from evaluations using both projective and objective tests is often admitted uncontested. This article reviews the psychometric properties of psychological tests that are widely used in family court proceedings, cautions against their unfettered use, and calls upon attorneys to inform themselves of the limitations of evaluations that incorporate these tests.

family court, psychological evaluations, psychological tests, experts

Abstract:
Mental health courts have quickly proliferated in the United States and represent an attempt to expand legal leverage and enhanced treatment access to select persons with severe mental illness who are also involved in the criminal justice system. A national survey of mental health courts has begun to elucidate the procedural, clinical, and operational aspects of these courts and the defendants they adjudicate. A secondary analysis of survey data was performed to determine the similarities and differences among these courts. Results revealed large variability among existing mental health courts across multiple domains. The implications of this variability are discussed in terms benefits and limitations.

mental health courts, diversion, mental illness

Abstract:
Outpatient commitment (OC) is a growing trend in mental health treatment. The impetus for this movement has been partly due to the public perception that some mentally ill outpatients are prone to violence as result of poor treatment compliance. Numerous studies have shown that poor treatment compliance is associated with increased hospitalization, substance abuse, homelessness, and contact with the criminal justice system. This study examined treatment effectiveness, demographic variables, hospital utilization, and violence among 100 OC participants in New York. Results indicate that OC can be an effective means of increasing treatment compliance and reducing hospitalization and encounters with the criminal justice system.

outpatient commitment, mental health law, empirical studies

Abstract:
This paper is a review of a great book titled MINDS ON TRIAL (Oxford Univ. Press 2006). The book presents an upfront and personal account of twenty of the leading cases in forensic psychology. The influence of behavioral science experts has grown, in large measure, with our culture's reliance of scientific explanations of behavior. These explanations are embedded deep within our social constructions and affect the way we conceive culpability and responsibility.

While our culture is imbued with these notions, the law continues to struggle with them. As the recent Clark v. Arizona case demonstrates, moral ontological constructions are quite different from scientific ones. Yet legal constructions of lawbreakers leave us hungry for more: The law tells us rules, but tells us little about why people break them. Delving into the mind of the offender gives us the motive of the offender and tells us much about human behavior and the law alike. But what are the limits of such explanations?

This Essay briefly explores those limits with an eye towards the legal system's response to insanity and diminished capacity claims. American criminal law is based, in many respects, upon the importance of mental states in ascertaining guilt; the more willful and wicked the intent, the worse the crime. Yet, the trend as represented in cases like Clark is against distinguishing gradations of mens rea. This Essay posits that this outcome is due to the inherent limitations science encounters in explaining the metaphysical mind and because such explanations drive at the heart of culpability - a concept central to our legal construction of human agency.

law and psychology, insanity, evidence, criminal procedure