Deck 18: Mental Health and the Law

Question 1

What is the major aim of the fitness to stand trial provisions in the Canadian legal system?

A) To protect the general public from dangerous people
B) To protect the fairness of the legal process and to preserve the autonomy of the accused individual
C) To ensure the accused individual is tried in a fair manner and to deliver a correct verdict
D) To ensure that opinions and expertise of mental health professionals are heard by the court

Answer 1

To protect the fairness of the legal process and to preserve the autonomy of the accused individual

Question 2

Which of the following statements is false?

A) People diagnosed with schizophrenia or psychotic symptoms are more likely to be referred for evaluation as to whether they are fit to stand trial
B) Wealthy people are more likely than the poor to be judged unfit to stand trial
C) The presence of disorganized symptoms and hallucinations has a bigger impact than delusional symptoms on whether someone is judged fit or unfit to stand trial
D) Fitness judgments are some of the most frequent types of judgments that mental-health professionals are asked to make for courts

Answer 2

Wealthy people are more likely than the poor to be judged unfit to stand trial

Question 3

Which of the following people would be most likely to be judged as unfit to stand trial?

A) Alf, who has antisocial personality disorder
B) Colleen, who has schizophrenia
C) Nigel, who is an alcoholic
D) Agnes, who has an anxiety disorder

Answer 3

Colleen, who has schizophrenia

Question 4

Lorena Bobbitt's defense of insanity was linked to which of the following psychosocial problems?

A) Spousal abuse and emotional distress
B) Severe depression and economic hardship
C) Schizophrenia and death of her husband
D) Postpartum depression and loss of employment

Question 5

Why should the term "mentally ill" be avoided?

A) It is an outdated term
B) It assumes that the symptoms are not due to a physical problem
C) It implies a medical view of abnormal behaviours
D) It indicates that the only way to treat the problems is with drugs

Question 6

Dr. King has been asked to evaluate someone in order to determine his competence to stand trial. Which of the following factors should he be least interested in?

A) The person's mental state at the time of the crime
B) Whether the person understands the pending charges
C) Whether the person is aware of the proceedings
D) The person's ability to participate in his own defense

Question 7

Which of the following statements is true concerning fitness to stand trial proceedings?

A) They are held to determine whether the accused understand what is happening to them and whether they are able to participate in their own defense
B) They take place in nearly all of all homicide cases
C) The court considers the mental health professional's opinion in making a judgment, but other testimony often takes precedence if it is contrary to that opinion
D) Persons with long histories of psychiatric problems are as likely to be referred for fitness evaluations as persons having acute episodes during commission of the crime

Question 8

Which of the following statements is true regarding the term "insanity"?

A) Insanity is a psychological term as opposed to a legal term
B) Insanity is a legal term as opposed to a psychological term
C) Insanity is a medical term as opposed to a legal term
D) Insanity is a psychiatric term as opposed to a medical term

Question 9

Which of the following statements is false concerning the judgments of mental health professionals in the legal process?

A) They are often asked to make judgments about a person's competency to stand trial
B) They are often asked to make judgments about a person's sanity at the time the crime was committed
C) Their recommendations are always followed by the decision of a judge or jury
D) They make recommendations to the court, but they do not make the final decisions

Question 10

What does the Canadian legal system view abnormal behaviours as?

A) Mental illnesses
B) Emotional disturbances
C) Psychiatric disorders
D) Psychological illnesses

Question 11

Which of the following statements is true concerning the insanity defence?

A) It is one of the most popular applications of psychology to the law
B) It is often celebrated by the general public
C) It has increasingly become the defense for battered and abused women
D) It has been used in every 50 out of 100 felony cases

Question 12

Which of the following people would be least likely to be referred for an evaluation to determine fitness to stand trial?

A) Jared, who is currently a student at university student
B) Keith, who is currently unemployed
C) Bertha, who is severely depressed
D) Chloe, who has hallucinations

Question 13

The legal approach tends to legitimize which view of psychological disorders?

A) Cognitive
B) Behavioural
C) Humanistic
D) Medical

Question 14

Harvey was found to be so mentally incapacitated at the time he murdered his wife that it was determined he could not conform to the rules of society. Which of the following terms best applies to his situation?

A) Criminally insane
B) Mentally unfit
C) Not guilty on account of a mental disorder
D) Guilty on account of a mental disorder

Question 15

In the United States, approximately what percentage of people charged with a felony is judged "not guilty by reason of insanity"?

A) .25% (1 in 400)
B) 2.50% (2.5 in 100)
C) 25.00% (1 in 4)
D) 33.00% (1 in 3)

Question 16

The police charged Tracy with first-degree murder. She has exhibited an inability to understand her situation and participate in her defense. What will Tracy's lawyer most likely argue before the trial starts?

A) Fit to stand trial
B) Unfit to stand trial
C) Not guilty on account of a mental disorder
D) Guilty, but criminally not responsible

Question 17

Which of the following statements is false concerning the limitations of psychological research in legal discussions?

A) It is difficult to generalize from literature to individual cases
B) The current literature may hold conflicting messages
C) Predictions based on research literature are probabilistic
D) Research makes predictions about what is certain to occur

Question 18

Which of the following factors does not increase one's likelihood of being judged unfit to stand trial?

A) Being female
B) Being white
C) Being poorly educated
D) Being accused of a violent crime

Question 19

Which of the following statements is false?

A) Most people found not guilty on account of a mental disorder have a diagnosis of schizophrenia
B) People who are fit to stand trial and have no current diagnosis of a mental disorder can still be found not guilty on account of a mental disorder
C) Over half of people referred for competency evaluations have been accused of violent crimes
D) Cognitive tests are the most common tools to determine whether an individual is incompetent to stand trial

Question 20

Which of the following is not a typical characteristic of persons who are most likely to be referred for fitness to stand trial evaluations?

A) Previous psychiatric history
B) Lower level of education
C) Troubled marriage
D) Low socio-economic status

Question 21

Which of the following statements is true concerning violence risk predictions?

A) Mental health professionals are more often correct than incorrect
B) Mental health professionals are correct about 5% of the time
C) Mental health professionals are more often incorrect than correct
D) Mental health professionals are correct about 95% of the time

Question 22

Which of the following statements is true concerning predictions of dangerousness to others?

A) They tend to be wrong more often than they are correct
B) They tend to be accurate predictors of violence
C) They are only applied to mentally ill people
D) They are highly correlated with dangerousness to self

Question 23

The court determined that Godfrey could not be held responsible for his crime because he did not know that his actions were wrong. What would be the governing rule in such a case?

A) The M'Naghten Rule
B) The McGrady Rule
C) The Unfit to Stand Trial Rule
D) The Insanity Rule

Question 24

What does research suggest about violent behaviour among mentally ill women?

A) It tends to be overestimated by clinicians
B) It tends to be overlooked by clinicians and psychiatrists
C) It tends to be underestimated by clinicians
D) It tends to be underreported by clinicians and psychiatrist

Question 25

Which one of the following problems is the strongest predictor of violent behaviour?

A) Cognitive impairment
B) Substance abuse
C) Depersonalization
D) Anxiety

Question 26

Research suggests that people diagnosed with which of the following disorders is at higher risk of exhibiting violent behaviour?

A) Substance abuse
B) Cognitive disorders
C) Depersonalization disorders
D) Psychotic disorders

Question 27

What is the standard or rule commonly used for involuntary hospitalization in Great Britain and several other countries around the world?

A) Diagnosis of severe mental illness
B) Grave disability
C) Danger to self and others
D) Inability to care for personal needs

Question 28

If Morris was held in a mental health facility against his will, what would such an action be called?

A) Unjust imprisonment
B) Criminal incarceration
C) Civil incarceration
D) Civil commitment

Question 29

Which of the following individuals is least likely to be violent?

A) Luke, who has been diagnosed with antisocial personality disorder
B) Sarah, who has been diagnosed with generalized anxiety disorder
C) Trina, who has been diagnosed with cocaine dependence
D) Sam, who has been diagnosed with schizophrenia, disorganized type

Question 30

In Canada, which of the following considerations is not required to detain someone involuntarily at a psychiatric facility?

A) Dangerousness to oneself or others
B) Presence of a mental disorder
C) Need for treatment
D) Family history of mental disorders

Question 31

Which definition poses a major problem in applying the M'Naghten rule?

A) The definition of psychosis
B) The definition of a guilty mind
C) The definition of schizophrenic mind
D) The definition of a disease of the mind

Question 32

What has been a major problem in interpreting the M'Naghten rule?

A) To be accurate in deciding when a defendant is unable to assist in his or her own defense
B) To be accurate in deciding where to hold the accused before trial
C) To define precisely what the term insanity means
D) To define clearly and consistently which disorders constitute diseases of the mind

Question 33

What is the term for involuntary hospitalization?

A) Forced institutionalization
B) Civil commitment
C) Civil confinement
D) Conservatorship

Question 34

Which of the following statements is false concerning violence by mentally ill women?

A) Clinicians underestimate violence by mentally ill women
B) Mentally ill women are less likely to commit violent acts towards others compared to mentally ill men
C) Victims of mentally ill women's violent acts are most likely to be family members
D) Mentally ill men commit more violent acts against strangers than do mentally ill women

Question 35

The case of Violet Hypatia Bowyer was important in the development and awareness of which of the following laws?

A) Civil commitment
B) Insanity defense
C) Fitness to stand trial
D) Dangerous offender rules

Question 36

The criterion of "dangerousness to self" is most often invoked under which of the following conditions?

A) When a person is incapable of caring for his or her personal needs
B) When it is believed that a person is imminently suicidal
C) When a mentally ill person refuses to take required medication
D) When it is believed that a person is a prostitute

Question 37

Which of the following is not part of the M'Naghten Rule?

A) A person must be able to discern right from wrong to be held guilty of a crime
B) A person must be unable to assist in his or her own defense to be held not guilty by reason of insanity
C) A person must have been suffering from a "disease of the mind" at the time of the crime to be held not guilty by reason of insanity
D) A person must not know the nature and quality of the act he or she was doing to be held not guilty by reason of insanity

Question 38

Joshua has been discharged from a psychiatric hospital. He was admitted and treated for major depression. Joshua has discontinued his medications and uses alcohol to self-medicate. He has become increasingly violent. Who is Joshua most likely to use as the target of his violence?

A) Family members
B) Medical doctors
C) Acquaintances
D) Strangers

Question 39

Ivor was sent to a mental institution in Quebec after the court found him criminally not responsible on account of a mental disorder. Given the average length of admission, how long is he likely to stay there?

A) 6 months
B) 1 year
C) 7 years
D) 20 years

Question 40

If Vera has a substance abuse problem, who is she most likely to act violently toward?

A) Friends
B) Neighbours
C) Family
D) Strangers

Question 41

Which of the following statements is true concerning disputes over a patient's right to refuse treatment?

A) Clinicians and family members tend to pressure patients to accept treatment, so many patients agree to treatment after initially refusing it
B) Judges tend to be particularly sympathetic in their rulings to patients' rights to refuse treatment and particularly their concerns about the risks of treatment
C) Family members often want the patient to refuse treatment, but clinicians push for it
D) Due to the patients' rights movements, the refusals are generally respected

Question 42

Which of the following statements is true concerning the differences between Canada and the United States with respect to mental disorders among prison inmates?

A) Canadian prison inmates have a higher rate of substance abuse and dependence than U.S. prison inmates
B) U.S. prison inmates have a higher rate of substance abuse and dependence than Canadian prison inmates
C) The rates of mental disorders are similar in both populations
D) The seriously mentally ill prison inmates receive better care in the U.S. than in Canada

Question 43

What is the clinician's primary duty?

A) To provide competent and appropriate treatment for the client's problem
B) To ensure that the client will not engage in behaviour that is harmful to the self or others
C) To protect the client's confidentiality, even in instances where the clinician believes someone else may be harmed
D) To avoid multiple relationships with clients and to avoid any abuse of authority that may jeopardize the client's treatment

Question 44

Greg Bottoms, as reported in the "Extraordinary People" box, was refused treatment by the "system" for what psychological disorder?

A) Bipolar disorder
B) Schizophrenia
C) Antisocial personality disorder
D) Generalized anxiety disorder

Question 45

Greg Bottoms, as reported in the "Extraordinary People" box, was refused psychiatric hospitalization for what stated reason?

A) His family was wealthy and could afford private psychiatric care
B) He was too young to be institutionalized
C) The family could not prove, to the satisfaction of the authorities, that he was a danger to himself or others
D) He was too dangerous to be housed in a public psychiatric hospital

Question 46

What has research on female prison inmates shown to be the most common mental disorder?

A) Antisocial personality disorder
B) Substance abuse or dependence
C) Major depression
D) Schizophrenia

Question 47

Which of the following problems is particularly likely to go unnoticed in inmates?

A) Antisocial behaviours
B) Self-injurious behaviours
C) Suicidality
D) Depression

Question 48

The notion of informed consent refers to all of the following, except:

A) Providing a patient with a full and understandable explanation of treatment being offered
B) Allowing a patient to make a decision to accept or refuse treatment based on his/her assessment of the risks and benefits involved
C) Allowing the patient to make a fully informed decision about whether to participate in ongoing research that is carried on in many mental health facilities
D) Believing the patient can make a rational decision

Question 49

Which of the following cases established the clinician's duty to protect people who might be in danger because of their client?

A) The M'Naghten case
B) Tarasoff v. Regents of the University of California (1974)
C) The 1930 insanity case of Violet Hypatia Bowyer
D) The André Dallaire case of 1995

Question 50

A Canadian study examining the differences between voluntary and involuntary commitments to psychiatric facilities discovered that voluntary commitment was characterized by which of the following?

A) A history of criminal behaviour
B) Being female
C) A diagnosis of schizophrenia
D) A longer hospital stay

Question 51

Which form of mental health care is most likely to be provided for prison inmates?

A) Psychoanalytic psychotherapy twice a week (hour-long sessions)
B) Weekly Alcoholics Anonymous or Narcotics Anonymous meetings for substance abusers
C) Behaviour modification therapy every day with charts and monitoring of token economies
D) Cognitive psychotherapy once a week (half-hour sessions)

Question 52

conducted a study to compare the rate of violence in a group of former patients released from psychiatric facilities with a control group of non-patients recruited from the same community. What did their results indicate?

A) The rate of violence was significantly higher in the control group than in the former patient group
B) The rate of violence in the former patient group was low during the first six months of discharge but it rose subsequently
C) At the end of one year, the rate of violence in both groups did not differ
D) The presence of anxiety disorders was significantly related to the rate of violence in both groups

Question 53

Lincoln was referred to Dr. Hughes by the Student Health Services, who felt he needed more intensive treatment than they offered. Lincoln reported a history of having been in love with a woman who broke up with him after a 2-year relationship. He is experiencing extreme anxiety and intense anger. At his most recent session, Lincoln told Dr. Hughes that he can't stand to see the woman on campus and plans to get rid of her. He has already bought a gun and has begun following her. Which of the following cases is most relevant to how Dr. Hughes should proceed?

A) The M'Naghten case
B) Tarasoff v. Regents of the University of California (1974)
C) The 1930 insanity case of Violet Hypatia Bowyer
D) The André Dallaire case of 1995

Question 54

Shelia is an inmate at a correctional facility. She has a history of substance abuse. Which treatment will she most likely receive for her crack dependency?

A) Cognitive-behavioural therapy
B) Dialectical behaviour therapy
C) Alcoholics Anonymous
D) Narcotics Anonymous

Question 55

According to the guidelines of their profession, therapists should not become involved in social or business relationships with clients or treat their own family members. What is the reason behind these obligations?

A) Getting involved in multiple relationships can blur therapists' judgment about the right treatment options
B) Therapists should not benefit from engaging in multiple relationships
C) Multiple relationships are good for therapists but potentially very bad for clients
D) Most therapists cannot handle the pressures of multiple relationships

Question 56

Which of the following is a condition under which a client's confidentiality may be breached?

A) When the therapist believes the client needs to be released from the hospital
B) When the client begins to inflict severe verbal abuse on the therapist
C) When the therapist learns through the client that a child has been abused
D) Confidentiality should never be breached

Question 57

Which of the following is not an instance when a patient's right to refuse treatment can be violated?

A) When the family has determined that the patient is refusing treatment just to spite them
B) When the patient is judged unable to make a reasonable decision about treatment
C) When it is determined that decisions about a patient's treatment must be made by others
D) When the patient is psychotic or suicidal

Question 58

Which of the following scenarios would not be an appropriate situation to violate confidentiality?

A) To report suspected abuse of children below the age of 5 years
B) To report suspected abuse of children between the ages of 5 and 12 years
C) To consult with the client's physician about his or her symptoms
D) To protect persons who might be in danger because of their clients

Question 59

Rachel has recently been sentenced to prison. She has a history of substance abuse and other forms of psychopathology. Which of the following symptoms will most likely go unnoticed while Rachel is in prison?

A) Depression
B) Substance abuse
C) Borderline personality traits and behaviours
D) Hallucinations

Question 60

Which of the following individuals is most likely to exhibit violent behaviour?

A) Milton, a 27-year-old male, who has not been taking his medication for bipolar disorder for the past month
B) Herman, a 28-year-old White male, who has been arrested three times-for driving under the influence of PCP, for battery, and for a barroom fight
C) Garret, an 18-year-old Black male, who was arrested for selling marijuana
D) Elsa, a 30-year-old White female who attacked her husband after 10 years of spousal abuse

Question 61

Insanity is a psychological and medical term used to reflect the doctrine that people cannot be held responsible for their actions.

Question 62

Involuntary hospitalization is called civil commitment.

Question 63

The fundamental right of people who have been committed is having the right to treatment.

Question 64

If a therapist is unable to communicate with a client in the language that the client prefers, what should the therapist do?

A) Have a family member translate at every session
B) Encourage the client to try to communicate in the therapist's language
C) Make an appropriate referral to a therapist who speaks the language
D) Try to communicate non-verbally

Question 65

During the first session of psychotherapy, Dr. Govin is informed by a client that he sexually abused a young girl last year. What is Dr. Govin obligated to do?

A) Keep this strictly confidential
B) Inform the relevant authorities about this
C) Refer the client to another colleague
D) Inform the patient's doctor and/or family members.

Question 66

When patients with histories of psychiatric disorders resort to violence against others, their victims are most likely to be random strangers.

Question 67

An insanity defense is a means by which guilty people are prevented from serving time.

Question 68

Patients deemed fit have an absolute right of deciding to refuse treatment in all Canadian provinces.

Question 69

A person who is suicidal is considered dangerous to self, but involuntary commitment cannot be implemented in this situation.

Question 70

Most people who are successful in making use of the insanity plea are immediately sent back to live with their families.

Question 71

Most inmates with mental disorders do not receive mental health services.

Question 72

Mumeet has been referred to Dr. Constantine for psychotherapy for his depression. His beliefs involve many catastrophizing cognitions about what will happen if he breaks his cultural taboos or fails to follow the rules of his religion. How should Dr. Constantine proceed?

A) She should encourage him to find a therapist of his own culture and religion
B) She should convince him that his culture and religion are making irrational demands on him
C) She should only provide drug therapy for his depression and send him to a religious counsellor for spiritual guidance
D) She should respect his religious and/or spiritual values since they affect Mumeet's worldview

Question 73

Mens rea is the Latin word for "guilty mind"

Question 74

Which of the following is not a guideline set out by the American Psychological Association for providing ethical service to culturally diverse populations?

A) Educating clients about the processes of psychological intervention
B) Educating clients about the values and beliefs of all major religions of the world
C) Being aware of relevant research and practice issues relating to the population served
D) Recognizing ethnicity and culture as significant variables in understanding psychological processes

Question 75

Mentally ill patients do not have the right to refuse treatment.

Question 76

There are ten criteria for involuntary commitment.

Question 77

Dr. Smith is treating a couple with sexual dysfunction. Both individuals are from different cultural backgrounds. According to guidelines for ethical services, what should Dr. Smith do?

A) Side with the client who has a similar culture
B) Respect both clients' cultural orientations
C) Encourage the clients to seek separate cross-cultural counselling
D) Encourage the clients to accept his worldview

Question 78

The M'Naghten rule states that a person did not intend to commit the illegal act and cannot be held responsible for the act.

Question 79

The fear that mentally ill patients are dangerous is greatly exaggerated.

Question 80

People who cannot testify in their own defense are said to be fit to stand trial.