第二十九届国际法律与精神卫生大会在巴黎召开

由国际法律与精神卫生学会(International Academy ofLaw and Mental Health,IALMH)举办的第二十九届国际法律与精神卫生大会于2005年7月2日至7月8日在法国巴黎召开,来自世界各地不同国家和地区的一千多名代表出席了本次大会,与会代表有精神卫生专业的学者、法律界人士、政府官员和大学生,代表们对共同关心的182个专题分别进行了专门报告和讨论,涉及司法精神病学各个方面, 有特别法庭作用、伦理学问题(包括知情同意)、少年犯心理卫生干预、民事行为能力、药物依赖与犯罪、刑事责任能力、     

论我国“精神卫生法”的称谓

我国2013年5月实施的《精神卫生法》以“精神卫生法”命名,这一称谓无法涵盖该法的全部规范、立法目的,容易将该法的社会法性质误解成行政法,还可能影响法的实施,与其他国家立法称谓的变化趋势相脱节.因此,基于明确立法目的,保护精神障碍者基本权利的社会法性质,顺应当今全体国民的精神健康追求,以及我国加入的国际人权公约等因素,我国现行“精神卫生法”宜正名为“精神健康法”.     

后现代精神病学对现代精神病学的法哲学反思

中世纪的异教徒"疯子"们被监禁,施以酷刑,流放可谓不堪回首,我们可以说那是因为精神病学的概念还未真正产生。但是,伴随着精神病学的设立,现代精神病学的发展已经由惩罚性收容转变成治疗性措施。精神病人的行为举止让大家感觉到不一样,无法理解。我们对于自己无法理解的事,要么报以莫名的敬畏之心,要么想方设法将它们变得不可见,来获得自己生活的平静,这是对的吗?从法哲学的视角是否应该给予反思和拷问,以探寻精神病学之正义性。本文希望从现代精神病学发展的历史,以法哲学的批判思维分析了现代精神病学的缺陷,并展望后现代精神病学的特质及其替代现代精神病学之发展趋势。     

美国精神卫生制度的发展——兼论我国新《精神卫生法》

美国精神卫生制度的形成经历了从漠视和侵犯人权到尊重和重视人权的发展过程。然而美国现有精神卫生制度领域仍然存在着诸多问题和缺陷,特别体现在医疗服务可获得性缺乏这一问题上。《中华人民共和国精神卫生法》力求在医疗服务可获得性与强制住院之间达到平衡。     

关注精神卫生立法与精神病鉴定的热点——中国政法大学法律与精神医学研究中心首届“法律与精神医学论坛”会议综述

由中国政法大学证据科学研究院、中华医学会精神科分会司法精神病学组、北京回龙观医院、北京市石景山区五里坨医院联合主办的中国政法大学法律与精神医学研究中心成立仪式暨首届＂法律与精神医学论坛＂于2011年7月2日在北京万商花园酒店举行。司法部司法鉴定管理局霍宪丹局长、北京市卫生局方来英局长、中国政法大学张保生副校长、中国政法...     

关注精神卫生立法与精神病鉴定的热点——中国政法大学法律与精神医学研究中心首届“法律与精神医学论坛”会议综述

由中国政法大学证据科学研究院、中华医学会精神科分会司法精神病学组、北京回龙观医院、北京市石景山区五里坨医院联合主办的中国政法大学法律与精神医学研究中心成立仪式暨首届法律与精神医学论坛于2011年7月2日在北京万商花园酒店举行。司法部司法鉴定管理局霍宪丹局长、北京市卫生局方来英局长、中国政法大学张保生副校长、中国政法大学证据科学研究院常林副院长、中华医学会精神科分会司法精神病学学组谢斌组长、北京市石景山区卫生局葛强局长、北京市司法局司法鉴定管理处马志云处长、北京市回龙观医院杨甫德院长、北京市石景山区五里坨医院白玟院长等     

精神发育迟滞者的刑事责任能力评定

本文对８０例精神发育迟滞有违法行为者的智力缺损程度、犯案动机、预谋、自我保护能力及对行为的辨认、控制能力等因素进行分析。鉴定结论，诊断为轻度精神发育迟滞者５８例（７２．５％），中度者１７例（２１．３％），重度者５例（６．２％）。评定无责任能力者１３例（１６．３％），限制责任能力４５例（５６．２％），完全责任能力２２例（２７．５％）。     

精神损伤鉴定值得注意的几个问题

精神损伤程度的评定是目前司法精神病学鉴定中经常遇到的问题。近年来,涉及此类鉴定的案件和重复鉴定案件逐年增加,引起了司法精神病学界的广泛重视[1-4]。有关精神损伤程度的鉴定颇为复杂,目前国内尚无统一的鉴定标准,各地的认识和执行差异也较大。笔者现就精神损伤司法鉴定中值得注意的问题谈几点个人看法。1精神损伤的概念和特征1.1概念精神损伤或称精神伤害。是指人体遭受外来各种物理(机械)、化学、生物和社会心理因素损伤后,大脑功能活动发生紊乱,出现认知、情感、意志等方面的异常。广义的精神损伤有以下三种类型:①躯体创伤所致的精…     

第65届美国法庭科学年会及法医病理学分会概况

<正>美国法庭科学年会(the Annual Meeting of American Academy of Forensic Science)自1948年起每年2月份在美国各主要城市轮流举办。每年一届的美国法庭科学年会被公认是全世界法庭科学及法医学研究与应用方面最重要的多领域综合型大会之一。美国法科学年会对现代法医学的进步和发展具有重     

我国精神卫生立法若干问题研究（2）（北京大学2000级法学硕士研究生毕业论文）

现代社会对精神障碍者所产生的种种直接的、显著的影响，主要是通过医学和法律两种评价体系来实现的，这在当前世界具有普遍性，我国也是如此。因此笔者首先将对这两种评价体系做一些简单的归纳、比较和分析。     

Psychiatric symptoms and mental health court engagement

People with mental illnesses are overrepresented in the criminal justice system. Many interventions have been implemented to treat the underlying causes of criminal justice involvement and prevent people with mental illnesses from recidivating. Mental health courts (MHC) are one of these programs. This analysis examines the relationship between psychiatric symptoms and MHC engagement. Eighty MHC participants from two Midwestern MHCs were interviewed. Symptom severity was assessed at baseline using the Brief Psychiatric Rating Scale. MHC engagement was estimated by treatment adherence, substance use, days spent in jail, probation violations, and MHC retention during a six-month follow-up period. Using nonparametric statistical tests and logistic regression, results indicate symptoms of depression, anxiety, and guilt are more severe at baseline for those people who are incarcerated during the follow-up period. Symptoms of anxiety are more severe for people who are terminated or went missing during the follow-up period. Further research is needed to determine the directionality and causality of these relationships. MHCs professionals should be aware of the relationship between symptom severity and MHC engagement and attempt to connect participants with treatment and services as early as possible and individualize treatment plans based on current symptoms and need.     

Long-term recidivism of mental health court defendants

The first MHC was established in 1997 and now, over 15 years later, there are over 300 mental health courts in the United States. In a relatively short time these courts have become an established criminal justice intervention for persons with a mental illness. However, few studies have looked at the long-term outcomes of MHCs on criminal recidivism. Of the studies evaluating the impact of MHCs on criminal recidivism, most follow defendants after entry into the court during their participation, and only a few have followed defendants after court exit for periods of one or two years. This study follows MHC defendants for a minimum of five years to examine recidivism post-exit with particular attention to MHC completion's effect. Findings show that 53.9% of all MHC defendants were rearrested in the follow-up and averaged 15 months to rearrest. Defendants who completed MHC were significantly less likely to be rearrested (39.6% vs. 74.8%), and went longer before recidivating (17.15 months vs. 12.27 months) than those who did not complete. This study suggests that MHCs can reduce criminal recidivism among offenders with mental illness and that this effect is sustained for several years after defendants are no longer under the court's supervision.     

Observations of reintegrative shaming in a mental health court

This study compares the use of stigmatizing and reintegrative shame - as specified in Braithwaite's Crime, shame and reintegration (1989) - across traditional criminal court and mental health court settings. Items from the Global Observational Ratings Instrument were used to gather data on 87 traditional court cases and 91 mental health court cases, presided over by five different judges. The observational items capture three constructs: respect, disapproval, and forgiveness, as they apply to Braithwaite's theory. We present means tests to examine differences in shaming between court types and judges. Findings show that the mental health court is more likely to use reintegrative shaming and show respect and forgiveness for offenders, and less likely to show disapproval. Similarly, judges who preside in both court types are significantly more likely to practice reintegrative shaming in the mental health court context. We further explore these findings using field notes and illustrate those components of a mental health court that are conducive to reintegrative shaming.     

Effect of behavioral health services and neighborhood disadvantages on recidivism: a comparison of mental health court and traditional court participants

Journal of Experimental Criminology - This study investigates the impact of behavioral health services and neighborhood disadvantage on recidivism among offenders with mental illness in mental...     

Recognition and understanding of goals and roles: The key internal features of mental health court teams

The increasing involvement of people with mental illness in the criminal justice system has led to the formation of specialty programs such as mental health courts (hereafter MHCs). We discuss MHCs and the teams serving these courts. Specifically, we examine team members' perceptions of MHC goals and their own and others' roles on the MHC team. Using a semi-structured interview instrument, we conducted 59 face-to-face interviews with criminal justice and mental health treatment personnel representing 11 Ohio MHCs. Findings from our qualitative data analyses reveal that MHC personnel understand individuals' roles within the teams, recognize and appreciate the importance of different roles, and share common goals. MHCs could foster this level of understanding and agreement by working to recruit and retain individuals with experience in or willingness to learn about both the criminal justice and mental health systems. Future research should explore the impact of MHC team functioning on client outcomes.     

Court outcomes for clients referred to a community mental health court liaison service

Court liaison and diversion services come in a variety of forms, but the similarities and differences between these services are not well characterized. Findings from a six-year audit of the Newcastle (Australia) Mental Health Court Liaison (MHCL) service are reported, including client characteristics, offence and service contact profiles, court outcomes, and interrelationships among these variables. During the audit period, there were 2383 service episodes by 1858 clients (1478 males, 380 females). Drug and alcohol disorders (40.9%) and psychotic disorders (17.0%) were the most prevalent mental health problems, while assault (23.1%), theft (23.1%), offences against justice procedures (15.4%), driving offences (13.4%) and malicious damage to property (8.3%) were the most frequently recorded charges. Among service episodes with a finalized court outcome, 70.0% involved a punishment (bond: 49.5%; jail term: 29.7%). Females were less likely to be punished, but more likely to have their case dismissed under sections of the relevant Act that required further assessment and monitoring. Being married, or having an adjustment or drug and alcohol disorder, were also associated with an increased likelihood of punishment, while clients with a psychotic or bipolar disorder were less likely to be punished. Among clients who were punished, those referred from inpatient mental health services were more likely to receive a non-jail punishment, while unemployed clients were more likely to be jailed. A substantial proportion of clients had court outcomes that required an ongoing involvement with local mental health services. By being part of community mental health services, our MHCL service is able to work efficiently and effectively with the criminal justice system, while facilitating ready access to existing mental health services and continuation of care.     

Health law and mental health law courses in US medical schools

Results of a recent survey of all 127 medical schools in the United States indicate that about two fifths of medical schools offer a separate course that focuses on topics in medicine and law and a number of medical schools integrate health law topics into other courses. Presumably reflecting concern over temporary medical malpractice litigation, most health law courses include informed consent, medical malpractice, privileged/confidential information, and patients' rights. In contrast, schools that offer a course on psychiatry and law are clearly in a minority. It is elective at all but two of the 13 schools with such a course. Although the hours allotted and the format of these courses vary greatly, courses typically cover most of the topics listed on the questionnaire. Most of the courses are led or co-led by a member of the American Academy of Psychiatry and the Law. Information from two additional surveys suggests two related factors that may influence a medical school to present a separate course on health law. Medical licensing boards were surveyed to determine which states require physicians to be examined on health law. In two states that require physicians to pass a separate medical jurisprudence examination for licensure, all four-year medical schools offer a course on health law for medical students. Medical malpractice companies providing coverage in all 50 states and the District of Columbia were surveyed to determine which states have the highest claim rates. The claim rate per 1,000 physicians insured per year was significantly greater in states with health law courses than was the rate in states without such courses.