Deck 19: Mental Disorder and the Law

Question 1

In Canada, the issue of involuntary hospitalization is a matter of

A) common law.
B) constitutional law.
C) criminal law.
D) human rights law.
E) civil mental health law.

Answer 1

civil mental health law.

Question 2

Given a legal definition of mental disorder, __________ would not normally be considered a mental disorder.

A) schizophrenia
B) chronic major depressive disorder
C) marijuana intoxication
D) intellectual disability
E) dementia

Answer 2

marijuana intoxication

Question 3

According to epidemiological research, about__percent of Canadians will experience a serious mental disorder at some point in their lives.

A) 30
B) 10
C) 20
D) 50
E) 75

Answer 3

20

Question 4

Under the law, mental disorders have the following features EXCEPT

A) internal.
B) volitional.
C) not a reflection of situational or contextual factors.
D) involuntary.
E) stable.

Question 5

Which of the following has not been identified as a potential limitation of compulsory treatment orders?

A) They are still fundamentally coercive, even if they ensure that a patient in need will receive treatment that may be helpful.
B) People may lose their residence or financial support if they fail to comply.
C) They may interfere with the development of supportive and effective treatment relationships with heathcare providers.
D) They may result in "net-widening."
E) There is compelling evidence that these types of orders significantly improve clinical outcomes; however, they do not improve social functioning.

Question 6

The best interests principle holds that

A) a patient's best interests regarding treatment should be given partial weight in the decision-making process.
B) a temporary substitute decision-maker should choose the treatment that maximizes the chances of a good outcome for the patient, taking into account the risks and benefits of all available treatments.
C) a temporary substitute decision-maker should choose a treatment that is on the official list of empirically supported treatments.
D) a temporary substitute decision-maker should choose a treatment that is consistent with the religion and culture of the patient.
E) a temporary substitute decision-maker should choose a treatment in accordance with what the patient's family wants.

Question 7

Comparisons of voluntary and involuntary admissions have found that the primary diagnosis for most voluntary patients is:

A) anxiety disorder.
B) dissociative disorder.
C) depressive disorder.
D) personality disorder.
E) psychotic disorder.

Question 8

Civil commitment can only occur under all of the following circumstances EXCEPT

A) a person is at risk of harming others.
B) a person has a mental disorder.
C) a person is unwilling or unable to consent to hospitalization.
D) a person is deemed in need of hospitalization by a family member.
E) a person is at risk of harming him/herself.

Question 9

The capable wishes principle holds that

A) a patient's personal wishes regarding treatment should be given partial weight in the decision-making process.
B) a patient's personal wishes regarding treatment should be given the greatest weight in the decision-making process.
C) a patient's personal wishes regarding treatment should be given the greatest weight in the decision-making process, regardless of the consequences.
D) a patient's personal wishes regarding treatment should be given minimal weight in the decision-making process.
E) a treatment that maximizes the chances of a good outcome for the patient is chosen.

Question 10

In comparison to the Criminal Code of Canada, the Youth Criminal Justice Act

A) has a more punitive philosophy although the punishments are less severe.
B) has a more rehabilitative philosophy.
C) is based on research findings that young offenders learn well from negative reinforcement.
D) is based on research findings that young offenders show behaviour change in response to brief and intense punishment.
E) includes specific recommendations for behavioural interventions.

Question 11

People who are civilly committed to a psychiatric hospital

A) have specific rights prohibiting recommitment once released.
B) tend to have similar protection of their rights to those dealt with by criminal law.
C) lose their rights just as those convicted of criminal offences do.
D) serve a specific sentence.
E) lose some, but not all, of their rights, unlike those convicted of criminal offences.

Question 12

Which of the following protections for persons with mental disorder is NOT provided by the Charter of Rights and Freedoms?

A) infringement of rights cannot be arbitrary or excessive
B) prohibits restriction of mobility rights
C) prohibits discrimination that may stem from stereotypical attitudes
D) prohibits assuming risk of violence on the basis of mental disorder status
E) requires such persons be afforded equal protection under the law

Question 13

Involuntary hospitalization requires:

A) risk of mental disorder; inability to recognize risk; disorder carries risk of harm
B) presence of mental disorder; unwilling /unable to consent; risk of harm to self /other
C) presence of mental disorder; resistant to treatment; risk of harm to self /other
D) grave risk of mental disorder; unwilling or unable to consent; risk of deterioration
E) risk of mental disorder; unable /unwilling to consent; risk of harm to self /other

Question 14

Which source of law guarantees that people suffering from mental disorder are treated fairly and retain as many of their rights and freedoms as possible?

A) common law
B) statutory law
C) constitutional law
D) federal criminal law
E) Civil code of Canada (CCC)

Question 15

Temporary substitute decision makers (TSDMs) for persons committed and deemed incapable of making decisions about treatment are

A) Public Trustees appointed by the state.
B) chosen by the family, by procedures that are specific to jurisdictions.
C) appointed by the person when they are healthy.
D) selected by methods specific to jurisdictions, but such persons are chosen by the individual, family, or are appointed by the state.
E) are selected by methods specific to jurisdictions, but always comprise committees selected by court or tribunal.

Question 16

The ancient common law principle parens patriae is recognized in all provinces EXCEPT

A) Manitoba.
B) Ontario.
C) Quebec.
D) British Columbia.
E) Prince Edward Island.

Question 17

The decision as to whether a person is not criminally responsible on account of mental disorder is one aspect of

A) criminal law.
B) statutory law.
C) civil mental health law.
D) constitutional law.
E) common law.

Question 18

Ken is a welder who lives in Toronto. Recently, he was diagnosed as being mentally ill. Which specific criterion must be examined to determine whether he should be involuntarily committed to a psychiatric hospital?

A) whether or not he will benefit from treatment
B) whether or not his mental illness is recognized by the DSM-5
C) whether or not his mental disorder will result in serious bodily harm to another person
D) whether or not he needs treatment; demonstrated danger need not be present
E) whether or not he will deteriorate mentally or physically if he is not held in hospital

Question 19

Laws regarding involuntary hospitalization

A) explicitly intend to be mildly punitive, for motivation and treatment purposes.
B) attempt to reduce the punitive aspects as much as possible.
C) assume some degree of moral culpability for risks that are posed to the community.
D) cannot be punitive and assume no moral culpability for risks posed.
E) vary, with only some jurisdictions retaining the old English punitive aspects.

Question 20

Canada's Charter of Rights and Freedoms is unique in what respect?

A) it protects people with certain mental disorders, but not others
B) it guarantees that people with mental disorders cannot be charged with a criminal offence
C) it guarantees rights and freedoms to people who suffer from mental disorder
D) it gives some freedoms to people with mental disorders but takes away some rights
E) it allows for the discrimination of people with mental disorders under the law

Question 21

People who are unable to participate actively and effectively in their own defence due to mental disorder are

A) often referred to a substitute decision-maker who decides what the plea will be.
B) automatically declared guilty and sentenced.
C) referred to as unfit to stand trial.
D) referred to as not criminally responsible on account of mental disorder.
E) automatically declared not guilty and acquitted.

Question 22

The Hadfield case (R. v. Hadfield, 1800)

A) preceded the passing of the Criminal Lunatics Act.
B) led to the Unfit to Stand Trial (UST) act.
C) marked the end of the "not guilty by reason of insanity" (NGRI) verdict.
D) defined a standard of insanity known as the M'Naghten standard.
E) led to a guilty verdict.

Question 23

Section 16 of Canada's criminal code recognizes that mental disorder may negate the principle of

A) actus reus.
B) self-defence.
C) mens rea.
D) insanity.
E) good intention.

Question 24

The HCR-20

A) is nondiscretionary with regard to institutional, but not community violence.
B) is a discretionary instrument, although it provides structured professional guidelines and codes risk factors that are based on empirical research.
C) is a nondiscretionary instrument because it provides a predictive score, though it does allow for clinical judgment with regard to some items.
D) is primarily used to develop treatment or management plans and has not fared well in studies of predictive validity.
E) has been replaced with discretionary instruments that have greater inter-rater reliability.

Question 25

What is actus reus?

A) The demonstration that one has acted in good faith.
B) The demonstration that one committed a crime with premeditation.
C) The idea that people can be convicted of criminal offences only when they commit a prohibited act.
D) The demonstration that one was mental ill at the time they committed a crime.
E) The demonstration that one was not able to distinguish between right and wrong at the time they committed a crime.

Question 26

Identify the untrue statement.

A) Most people who commit crimes are likely to have mental disorders.
B) Higher prevalence rates of mental illness in inmates have been obtained when samples have consisted only of those inmates referred by jail staff for mental health evaluations.
C) Most people with mental disorders are likely to commit crimes.
D) The prevalence of mental illness among offenders has generally been found to be higher than for people in the general population.
E) Specific rates of mental illness reported for jail inmates vary considerably among studies.

Question 27

In a study comparing patients who had applied for a review of their involuntary hospitalization and those who did not found that those who applied were

A) more likely to be older.
B) more likely to have a diagnosis of intellectual disability.
C) more likely to have fewer education and employment problems.
D) more likely to have a diagnosis of schizophrenic disorder.
E) more likely to be female.

Question 28

Robert has assaulted a neighbor. Even though he understands the act itself, he is declared, according to the M'Naghten standard, to be insane. Which of the following would most effectively help us judge the accuracy of this claim?

A) Robert is unable to give a detailed account of his actions at the time of the offense.
B) Robert had been heavily intoxicated at the time of the offense.
C) Robert had a long history of mental illness during his childhood.
D) It has been determined that at the time of his offense, Robert was suffering from a defect of the mind.
E) Robert is unable to understand that the act is wrong.

Question 29

Ledwidge et al compared the post-release adjustment of 47 involuntary patients from British Columbia who were released after review with 47 patients released by their attending physicians. Which of the following was not one of the findings?

A) Patients who were released after review showed significantly better social re-integration than did the patients released by their physicians.
B) The adjustment of both groups was rather poor.
C) Almost half of patients in the study were readmitted to the hospital, regardless of how they were released.
D) Most patients continued to have serious problems with employment, regardless of how they were released.
E) Irrespective of how they were released, few patients engaged in suicidal or violent behaviour after release.

Question 30

The M'Naghten standard resulted from the fact that

A) M'Naghten's crime was the result of his delusions.
B) M'Naghten accidentally committed murder.
C) M'Naghten tried unsuccessfully to argue that his crime was the result of his delusions.
D) M'Naghten knowingly committed murder.
E) M'Naghten's crime was not the results of his delusions.

Question 31

Clinical factors in the HCR-20 include all of the following EXCEPT

A) employment problems.
B) lack of insight.
C) violent ideation.
D) active symptoms of a major mental disorder.
E) violent intent.

Question 32

A study by Higgenbottom et al. (1985) compared patients in British Columbia who were released after review to those who were not released. Which of the following was not one of the findings?

A) Patients who were released appeared to have less serious mental disorder.
B) Patients who were released spent less time in hospital.
C) Patients who were released were perceived to be at lower risk of harm to self.
D) Patients who were released were more likely to have been represented by legal counsel.
E) Patients who were released tended to have more years of education and were therefore judged to have better chances at employment following release.

Question 33

Grant and his colleagues reported that of 279 psychiatric patients in British Columbia who applied for review of their detention

A) the average age was about 54 years.
B) 68 percent of the patients had a history of suicidal or other self-injurious behaviour prior to hospitalization.
C) almost all patients had prior arrests for violent offences (well above 3/4 of the sample).
D) close to the entire sample was employed prior to admission.
E) 20 percent had a primary diagnosis of a psychotic disorder.

Question 34

Ken is charged with first-degree murder. He fully comprehends and remembers what he has done, yet shows no remorse and is unable to accept moral responsibility for his actions. Ken should

A) be given a normal trial.
B) be found not criminally responsible on account of a mental disorder (NCRMD).
C) be declared unfit to stand trial.
D) be denied the capacity to participate in his legal procedure.
E) be automatically sent for psychiatric treatment in a hospital.

Question 35

Follow-up research examining the community adjustment of patients released from involuntary hospitalization found that __________ percent were readmitted within a year.

A) 45
B) 60
C) 10
D) 25
E) 75

Question 36

The discretionary approach to violence risk assessment is __________, whereas the nondiscretionary approach is __________.

A) actuarial; clinical
B) flexible and idiographic; objective and consistent
C) mechanistic; informal
D) objective and consistent; intuitive and flexible
E) algorithmic; heuristic

Question 37

Comparisons of voluntary and involuntary admissions have found that the primary diagnosis for most involuntary patients to be

A) dissociative disorder.
B) personality disorder.
C) psychotic disorder.
D) depressive disorder.
E) anxiety disorder.

Question 38

In R. v. Chaulk (1990) the Court decided that

A) the word "wrong" should be interpreted to include morally wrong only if the accused does not suffer from a personality disorder.
B) the word "wrong" should be interpreted to include morally wrong.
C) the word "wrong" means wrong according to law and not morally wrong.
D) changes be made to Bill C-30 relating to who can raise the defence of insanity.
E) Bill C-30 was unconstitutional.

Question 39

Legal arguments concerning mental disorder tend to focus on

A) the suffering caused by the accused person.
B) whether the mental disorder causes a specific cognitive impairment.
C) the severity of the mental illness.
D) the criminal act.
E) whether the mental disorder is real or valid.

Question 40

Historical factors in the HCR-20 include all of the following EXCEPT

A) previous violence.
B) early maladjustment.
C) relationship stability.
D) daily stress.
E) prior supervision failure.

Question 41

The case of R. v. F. D. M. is important because

A) it raised doubts about the ability of psychologists to diagnose mental disorders.
B) it raised doubts about the ability of either psychologists or psychiatrists to diagnose mental disorders.
C) it raised doubts about the validity of the psychosis diagnosis.
D) it raised doubts about the ability of psychiatrists to diagnose mental disorders.
E) it raised doubts about the validity of the schizophrenia diagnoses.

Question 42

The four fundamental ethical principles for psychologists in Canada include all of the following EXCEPT

A) integrity in relationships.
B) respect for treatment providers' chosen therapeutic orientation.
C) responsible caring.
D) responsibility to society.
E) respect for the dignity of persons and people.

Question 43

Which of the following is not mentioned in the textbook as something forensic psychologists do?

A) Conduct custody evaluations.
B) Train correctional officers.
C) Investigate cases of discrimination.
D) Provide expert evidence in court concerning the assessment of violence risk.
E) Provide expert opinion on empirically supported treatments for mood and anxiety disorders.

Question 44

The five general ethical principles stated in the code of ethics for psychologists include all of the following EXCEPT

A) principle of beneficence.
B) principle of autonomy.
C) principle of fidelity.
D) principle of science.
E) principle of nonmaleficence.

Question 45

The concepts "fit to stand trial" and "not criminally responsible on account of a mental disorder (NCRMD)"

A) both require the examiner to determine the accused's present mental state.
B) are unrelated issues.
C) are distinct and call for different questions to be answered.
D) both require an examiner to determine the accused's mental state at the time of the offence.
E) mean the same thing.

Question 46

Mental health professionals are viewed as consultants to judges, juries and review boards.

Question 47

Which of the following statements concerning the status of psychology in the legal system is true?

A) psychologists can conduct court-ordered assessments of fitness to stand trial but not assessments of criminal responsibility.
B) psychologists can conduct court-ordered assessments of criminal responsibility but not of fitness to stand trial.
C) in some jurisdictions psychologists have the legal authority to involuntarily hospitalize people.
D) medical practitioners play a more dominant role in many areas in which mental health input is needed.
E) psychologists are rarely, if ever, asked to give evidence before courts as professionals.

Question 48

Historically, which of the following professionals has not been qualified to determine whether a person meets the criteria for civil commitment into a psychiatric hospital?

A) psychologist
B) anaesthesiologist
C) psychiatrist
D) dermatologist
E) general physician

Question 49

Which of the following is true?

A) In determining whether an individual is fit to stand trial, a person need not understand the possible consequences of the proceedings.
B) It has generally been easy to determine the degree of capacity required for fitness for an individual charged with an offence.
C) In R v. Taylor (1992), the Court stipulated that, when communicating with counsel, the accused must have the ability to act in his or her own best interest.
D) The party who raises the issue of an accused's fitness, does not have the burden of proving the issue of unfitness.
E) In determining whether an individual is fit to stand trial, his or her ability to communicate with counsel must be evaluated.

Question 50

The rights and freedoms of persons with mental disorders are protected under the statutory Law.

Question 51

The legal system relies upon psychologists to define the legal concept of mental disorder.

Question 52

To be considered fit to stand trial, a defendant must

A) must have moderate cognitive capacity.
B) must have limited cognitive capacity.
C) must have an IQ of at least 90.
D) must have an IQ of at least 70.
E) must have full cognitive capacity.

Question 53

The Fitness Interview Test (FIT-R)

A) identifies whether a person committed an act intentionally or not.
B) helps determine what mental disorder a person is suffering from, according to the law.
C) was of key use in the Owen Swain case.
D) is only used with the most violent offenders.
E) helps psychologists and psychiatrists assess whether an individual is fit to stand trial.

Question 54

Persons deemed unfit to stand trial are specifically, on account of mental disorder, unable to do each of the following EXCEPT

A) understand the nature of the proceedings.
B) clearly relate the important facts about their offence to a judge.
C) understand the possible consequences of the proceedings.
D) communicate with counsel.
E) understand the object of the proceedings.

Question 55

What is true regarding the four fundamental principles in the Code of Ethics?

A) All four of the principles are considered equally important.
B) Principle III is considered the most important of all four principles.
C) The principles are ranked from most important to the next most important.
D) It is up to the psychologist to determine which principles is important for him/her.
E) The principles are ranked from least important to most important.

Question 56

In common law, the King (or Queen) was not obligated to protect and provide care for those who were incapable of caring for themselves.

Question 57

Exclusion of psychological testimony with the claim that psychologists are unable to diagnose mental disorders is contrary to:

A) federal guidelines
B) several provincial statutes governing the profession of psychologists.
C) the Canadian Code of Ethics.
D) Canadian labour law.
E) regulatory body guidelines for psychologists.

Question 58

Which of the following is true regarding NCRMD?

A) Of those claiming to be NCRMD, most are found to be NCRMD.
B) Of those claiming to be UST, most are found to be UST.
C) Very few people charged with criminal offences claim to be NCRMD.
D) A large number of people charged with criminal offences claim to be NCRMD.
E) A large number of people charged with criminal offences claim to be UST.

Question 59

Respect for self-determination is the principle of

A) beneficence.
B) justice.
C) nonmaleficence.
D) autonomy.
E) fidelity.

Question 60

Three important themes in the Specialty Guidelines for Forensic Psychology are:

A) advocating effectively for one's client; establishing, maintaining and practicing within one's area of competence; obtaining knowledge of the law
B) objectivity and neutrality; precision in diagnostic competence; obtaining knowledge of the law
C) objectivity and neutrality; precision in formulating clients' mental state; obtaining knowledge of the law
D) objectivity and neutrality; expanding the practice of forensic psychology; building one's knowledge of the law
E) objectivity and neutrality; establishing, maintaining and practicing within one's area of competence; obtaining knowledge of the law

Question 61

Although the standard of insanity known as the M'Naghten standard became the accepted rule in England, in the United States and Canada it could not be labelled as

Question 62

What are the two requirements for conviction of an offence in Canada? Use and define the legal terms. What are the two ways that mens rea can be affected by psychological concepts?

Question 63

What are the important elements of the legal definition of mental disorder?

Question 64

The capable wishes principle does not grant any weight to a patient's personal wishes even if they were competent at the time that they were expressed.

Question 65

An individual who is assessed as unfit to stand trial due to a mental disorder does not understand the possible consequences of the proceedings.

Question 66

Why are certain individuals found unfit to stand trial? What means are available to make this assessment in Canada?

Question 67

Describe the evolution of the insanity defence.

Question 68

Legal arguments tend to focus on whether a person's mental disorder is valid according to the law.

Question 69

What is the status of psychologists in the legal system?

Question 70

What specific type of mental disorder can result in a person being acquitted, or NCRMD?

Question 71

The rights and freedoms of individuals with a mental disorder are protected by The Charter of Rights and Freedoms.

Question 72

Conditional discharge and detention in hospital are the two disposition options available to individuals found "not criminally responsible of a mental disorder" (NCRMD).

Question 73

What are forensic psychologists? What roles do they play in the legal system? Give examples.

Question 74

Psychiatrists, but not psychologists, are able to determine when a person has a mental disorder that satisfies the NCRMD criteria.

Question 75

Although Canadian involuntary civil commitment criteria vary from province to province, similar elements do exist. List these and indicate how involuntary civil commitment in Canada differs from the conviction for a criminal offence.

Question 76

The Canadian Criminal Code allows for general practitioners to make judgments in a court of law regarding a defendant's sanity.

Question 77

With regard to involuntary hospitalization, all jurisdictions require that there be risk of harm to self or others; some jurisdictions allow risk of deterioration in health to satisfy the risk of harm criterion.

Question 78

Discuss available research pertaining to the rate at which a person faces rehospitalization after being released by a review panel.