When special needs categories for exceptional students overlap mental health diagnoses: The Canadian experience and its Charter implications

This paper explores Canadian 'educational' categorical systems for special needs students and their relation to mental health diagnoses. Parents wishing to access special education services for their children are generally required to consent to their children being formally assessed. Frequently, the school board committee will require a psychological or psychiatric assessment which may lead to diagnosis of a mental health disorder that overlaps with the special needs category to which the child is assigned. This paper explores whether Canadian parents of exceptional students are in fact providing fully informed and voluntary consent given: (a) frequent parental lack of understanding of the overlap between the so-called 'educational' special needs category and a mental health diagnosis; and (b) the power of the school board to proceed with a special education placement based on a particular category even without parental agreement. The argument is made that making special education service eligibility contingent on meeting the criteria for one or more government approved categories of 'disorder' or 'impairments', some of which overlap mental health diagnoses, infringes Canadian Charter s.15 equality rights as well as s.7 liberty and security of the person rights.     

美国精神卫生法庭及对我国的借鉴

精神卫生法庭是一种专门处理涉及精神障碍案件的法庭模式,目的在于将卷入司法系统但是需要治疗的精神障碍者送往合适的医疗机构进行治疗,并由法庭对治疗的过程进行监督和协调,以减少精神障碍者的再次犯罪率,从而节约医疗和司法成本.本文介绍美国精神卫生法庭的定义、操作方法、效果及存在的问题,提出了美国精神卫生法庭制度对我国处理卷入司法系统的精神障碍者的借鉴意义.     

Community mental health and prisons: A model for constitutionally adequate care in correctional mental health

The establishment of judicially acceptable standards of mental health care within a prison setting requires the adoption of a service-delivery model and a constant evaluation of that model in relation to individual and civil rights. This article reviews the experience of the department of corrections in one state in developing a constitutionally adequate mental health system. The report outlines the programs established, the legal basis for decisions, and recent constitutional challenges. Future trends in correctional mental health are also discussed.     

七部地方性精神卫生条例的合法性突变及其修正简

《精神卫生法》实施后,根据《立法法》的相关规定,先行制定并实施的七部地方性精神（心理）卫生条例面临着合法性问题,与上位法相抵触的规定无效并应及时的修改或废止。一方面七部条例＂相抵触的规定＂不仅包含具体条款,还涉及立法理念和原则的变化;另一方面七部条例的性质突变后带来的与其原有形式的矛盾,建议七部条例在《精神卫生法》配套法规完成后采用修订或立新废旧的方式予以修正,使之从创制性法规变为实施性法规;或者对没有存在必要的地方采取单项废止。     

Screening for mental disorder using the UK national offender assessment system

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.     

英美国家关于精神损伤的评估

本文概述了作为英美国家精神损伤赔偿主要法律依据的劳工赔偿法和侵权法.诉讼活动中精神损伤概念的外延大于创伤后应激障碍的范围.精神损伤可分为:躯体创伤所致的精神损伤;精神刺激所致的躯体损伤;精神刺激所致的精神损伤.介绍了临床评估精神损伤的方法、重点和难点.供国内同道参考.     

Why public opinion changes: the implications for health and health policy

Research on stasis or change in public opinion toward health, health policy, and medical care tends to focus on short-term dynamics and to emphasize the impact of discrete messages communicated by individual speakers in particular situations. This focus on what we term "situational framing," though valuable in some respects, is poorly equipped to assess changes that may occur over the longer term. We focus, instead, on "structural framing" to understand how institutionalized public health and health care policies impact public opinion and behavior over time. Understanding the dynamics of public opinion over time is especially helpful in tracking the political effects of the Patient Protection and Affordable Care Act of 2010 as it moves from the debate over its passage to its implementation and operation.     

Therapeutic jurisprudence and mental health courts for Maori

For Maori, indigenous peoples of New Zealand, the Treaty of Waitangi required the Crown to protect all the treasures of Maori. This has been taken to include health and cultural concepts, values and practices. Despite this guarantee studies indicate that half of all Maori will develop a mental disorder within their lifetime. Failure by the Crown to provide adequate services has led to those who have already developed a mental illness more predisposed to engage in behaviour that the law regards as criminal. This article suggests that the Treaty principles such as partnership, active protection and participation place an onus upon the Crown to protect and provide for the health needs and cultural identity of Maori. It is proposed that a Mental Health Court underpinned by therapeutic jurisprudence can provide a solution.     

Regulatory policy and information deficiencies in the market for mental health services

This paper addresses issues related to the regulation of the delivery of mental health services. The focus is primarily on regulations that are aimed at dealing with the consequences of imperfect information in the marketplace. The paper reviews and assesses what is known about the impact of regulations on efficiency and equity. One conclusion is that we know a fair amount about impacts of regulation on prices for mental health service and very little about effects on quality of care. A research agenda is proposed based on the knowledge available in 1988.     

Cyberfraud and the implications for effective risk-based responses: themes from UK research

The nature of the risk or threat posed by ‘cyberfraud’ - fraud with a cyber dimension – is examined empirically based on data reported by the public and business to Action Fraud. These are used to examine the implications for a more effective risk-based response, both by category of fraud and also responding to cyberfraud generally, not just in the UK. A key characteristics of cyberfraud is that it can be globalised, unless there are major national differences in attractiveness of targets or in the organisation of control. This does not mean that all cyberfraud is international, however: not only do some involve face to face interactions at some stage of the crime cycle, but in online auction selling frauds, it appears to be common for the perpetrators and victims to reside in the same country. After reviewing patterns and costs of victimisation and their implications for control, the paper concludes that any law enforcement response must begin by being strategic: which other public and private sector bodies should be involved to do what; what should be the specific roles and responsibilities of the police and where ‘problem ownership’ should lie; what are we willing to pay for (in money and effort) for greater cybersecurity and how to reduce ‘market failure’ in its supply; and, how that security is going to be organised for and/or by the huge numbers of businesses and people that are (potentially) affected.     

Plato and the origin of mental health

This essay examines the history of the concept of mental health. Its origin can be traced to Plato, who argued that immorality is to the soul what disease is to the body. The purpose of this argument was to answer those who thought that morality is a set of social conventions, and in that sense, is contrary to nature. Plato responded by turning to those who made a systematic study of nature – the medical writers of his day – and claiming that if proper balance is needed to maintain a healthy body, the same is true of the soul. Thus the natural state of the soul is one in which the various parts agree on which should rule. This does not mean that Plato sought to excuse immoral behavior by treating it as a medical condition, only that he regarded immoral behavior as contrary to nature and thus treatable. Although later attempts to define mental health are not as rigid as Plato's, it is remarkable how many of his insights are still applicable, in particular the claim that morality and mental health, though not identical, are nonetheless linked. A case in point is the experience of wanting something but not liking the fact that you want it. Plato regarded internal conflict of this sort as a paradigm case of psychic dysfunction. I argue that we can regard it as either a moral failing or a mental one.     

Private regulation in mental health

General hospitals are increasingly important sources of care for chronic and acute mental patients. Joint Commission on Accreditation of Hospitals (JCAH) standards for staffing in general hospitals require the same degree of physician supervision and control for all services, including mental health. This paper considers the economic impact of JCAH standards on the practice of psychologists in hospitals. The “voluntariness” of the standards is assessed and the evidence that these standards foster economic protectionism is considered. We conclude that in light of the demonstrated capability of nonphysician professionals, methods of quality control appropriate for physician health care in general hospitals should be reconsidered as these instutions diversify into mental health services.