Deck 18: Mental Health and the Law

Question 1

What was the basis for the irresistible impulse test used in the late 19th century?

A) the legal assumption that everyone knows right from wrong
B) the finding that the M'Naghten test was too broad
C) the finding that even though some people intellectually know that their behavior is illegal they still can't control their behavior
D) the observation that some diagnoses are based on evidence of criminal behavior

Answer 1

the finding that even though some people intellectually know that their behavior is illegal they still can't control their behavior

Question 2

In the United States about 1 percent of those charged attempt a defense of not guilty by reason of insanity (NGRI). Of those about what percent are successful?

A) 1 percent
B) 15 percent
C) 25 percent
D) 55 percent

Answer 2

25 percent

Question 3

The mental disorder defense was codified in 1843 when _______was found not guilty by reason of insanity.

A) Freud
B) Hinckley
C) M'Naghten
D) Conan-Doyle

Answer 3

M'Naghten

Question 4

There is considerable overlap between the legal systems in the United States and the mental health professions in the area of expert witnesses. Court rulings have imposed some limits on the expert witnesses, requiring that

A) testimony only be given by psychiatrists or medical doctors.
B) only neutral witnesses be used, ones appointed by the judge in a trial.
C) testimony be based on science.
D) None of the above are accurate.

Question 5

If you were a lawyer defending a client who is mentally ill and you were to use the conditions of the American Law Institute model legislation on the insanity defense (1955) you would have to provide evidence that your client

A) was mentally ill at the time of his offense.
B) lacked substantial capacity to appreciate the criminality [wrongfulness] of his offense.
C) lacked a knowledge of the law that he is accused of due to his mental illness.
D) Any of the above would fit the conditions necessary.

Question 6

What was the major change in the insanity defense contained in the Defense Reform Act?

A) The defense was required to prove insanity on the part of the defendant.
B) The prosecution was now required to proved the defendant was not insane.
C) The court took on the task of proving whether a mental illness existed or not.
D) A new, more stringent, standard was imposed on the defense task of proving the defendant was insane.

Question 7

A 1954 ruling by a Washington D.C. federal court in Durham v. United States broadened the insanity defense to indicated that an accused is not criminally responsible if his or her unlawful act was the product of mental disease or defect. This came to be known as the

A) mental illness test.
B) D.C. test.
C) Durham test.
D) product test.

Question 8

S. law an exception to criminal responsibility is contained in the concept of

A) insanity.
B) mental illness.
C) not criminally responsible.
D) All of the above are recognized as exceptions in U.S. laws.

Question 9

In 1981 John Hinckley tried to kill then president of the United States Ronald Reagan. This case study begins chapter 18 of the textbook. Hinckley had a history of odd behavior and was subsequently found not guilty by reason of insanity. As a result of the Hinckley trial and verdict

A) Hinckley was released.
B) federal laws were rewritten to make it more difficult to achieve the not guilty by reason of insanity defense.
C) Hinckley was released but required to have a secret service agent with him at all times.
D) Hinckley was confined to a mental hospital with no chance of release.

Question 10

In England

A) the M'Naghten rule still applies but is used in only a handful of cases every year.
B) the M'Naghten rule still applies and is used in a much greater percentage of cases than similar defenses in the United States.
C) the M'Naghten rule has been changed to "not criminally responsible due to mental illness" and is used very sparingly.
D) the M'Naghten rule has been changed to "not criminally responsible due to mental illness" and is attempted quite frequently, but not successfully.

Question 11

For more than eight years, Marilyn's husband has subjected her to physical and psychological abuse. As a result, she has been treated in the emergency room more than 10 times for a variety of injuries from bruises to broken bones. Each time she is abused, her husband begs for forgiveness. Finally, one night she takes his gun and shoots him as he is sleeping. She is charged with murder. What problem will Marilyn have when she is tried for murder?

A) The battered woman defense can be used only when a spouse has a mental disorder.
B) A defense of self-defense is typically allowed only when the person's life is in immediate danger.
C) The Supreme Court has determined that "battered woman syndrome" cannot be used in cases involving murder.
D) Mental health professionals cannot testify concerning a defendant's state of mind except in cases in which a defendant pleads "not guilty by reason of insanity."

Question 12

Last year Leslie shot and killed her husband after years of abuse. She has rejected a plea bargain and is ready for trial. Her defense attorney is going to call experts on battered woman syndrome. What question will the prosecution want to ask the experts on battered woman syndrome?

A) "Which DSM diagnosis best fits the defendant and her behavior?"
B) "How can you distinguish dissociation from battered woman syndrome?"
C) "Why does the defendant have complete recall for the events surrounding the killing?"
D) "How can someone who is suffering from learned helplessness bring herself to kill?"

Question 13

You are a psychologist hired by the defense in a case involving the issue of not guilty by reason of insanity. Based on changes resulting from the Hinckley case and the Defense Reform Act of 1984 it is likely that the thrust of your testimony would be in support of the defendant's

A) inability to stand trial due to her mental illness.
B) inability to appreciate the nature and quality or wrongfulness of her behavior due to her mental illness.
C) right to treatment versus imprisonment due to her mental illness.
D) inability to discuss the nature of her offense with her attorney due to her mental illness.

Question 14

In most cases of a successful defense based on not guilty by reason of insanity the defendant spends some time in a mental health facility after the verdict. What is true of the time spent in such a facility by the individual?

A) The time spent in a mental health facility is generally shorter than a prison sentence would have been.
B) The time spent in a mental health facility is generally longer than a prison sentence would have been.
C) The time spent in a mental health facility is on average the same as a prison sentence would have been.
D) The time spent in a mental health facility is generally a great deal longer than a prison sentence would have been.

Question 15

The idea that people act out of free will, that they are accountable for their actions when they violate the law, is known as the legal concept of

A) mens rea.
B) innocent until proven guilty.
C) criminal responsibility.
D) individual responsibility.

Question 16

Another attempt to reform the insanity defense was introduced by the American Bar Association in 1995 and was known as

A) not guilty due to mental illness.
B) guilty but mentally ill.
C) guilty but insane.
D) not guilty due to mental mitigation.

Question 17

Harry Jenkins has pled "not guilty by reason of insanity." The state where Harry is being tried uses the M'Naghten test of insanity. What question will the judge use when instructing the jury on the basis of their decision in this case?

A) Did the defendant know right from wrong?
B) Did the defendant experience an irresistible impulse?
C) Does the defendant have the burden of proving insanity?
D) Did the defendant show behavior that was the product of mental illness?

Question 18

The textbook makes the point early in chapter 18 that

A) the legal definition of insanity is not the same as the psychological definition of mental illness.
B) the legal definition of insanity is essentially the same as the psychological definition of mental illness.
C) there is little overlap between the criminal justice system and the field of abnormal psychology.
D) None of the above fit with information presented in the textbook.

Question 19

The Supreme Court of the United States has requested a social science review of the evidence on battered woman syndrome. What will that review reveal?

A) Scientific evidence supporting the syndrome is weak to nonexistent.
B) Proponents of the syndrome are responsible for saving hundreds of lives.
C) Evidence from police officers supports the existence and validity of the syndrome.
D) The battered woman syndrome relies on a collection of diagnostic categories, including dissociation.

Question 20

American psychiatrist Thomas Szasz has taken the somewhat radical position that

A) even people who commit serious crimes should not be imprisoned if they are suffering from a mental disorder.
B) that everyone who commits a crime is mentally ill to some degree.
C) even people who are seriously mentally ill should still be held responsible for their behavior.
D) that all criminals should be allowed access to psychiatric treatment.

Question 21

What type of evaluation is required in all death penalty cases that can take into account mental disorders?

A) judicial
B) mitigation
C) compassionate
D) psychiatric

Question 22

Which of the following is most likely to result in an individual being ruled incompetent to stand trial?

A) they are diagnosed with a psychotic disorder.
B) the crime was so abhorrent that a trial is not necessary.
C) the individual does not have enough money for a lawyer.
D) the individual is unable to communicate with counsel because of brain damage.

Question 23

What is a base rate?

A) how frequently an event occurs in a population
B) the number of guesses made about the event
C) the accuracy of predictions about the event in the past
D) the amount of information available to make a prediction

Question 24

The involuntary commitment of "mentally disordered" individuals to mental hospitals is objectionable to civil libertarians because

A) the state's authority is limited to parens patriae.
B) no crime has usually been committed.
C) police powers belong to the people.
D) mentally disordered people need treatment, not punishment.

Question 25

In the landmark case of Atkins v. Virginia (2002), the U.S. Supreme Court ruled-consistent with laws already in effect in many states-that

A) schizophrenia is a mitigating factor that makes the death penalty unconstitutional.
B) schizophrenia is not a mitigating factor that makes the death penalty unconstitutional.
C) mental retardation is a mitigating factor that makes the death penalty unconstitutional.
D) mental retardation is not a mitigating factor that makes the death penalty unconstitutional.

Question 26

The discovery of antipsychotic drugs in the 1950s lead directly to

A) a drop in the crime rate across the United States.
B) an increase in the populations of mental health institutions as demand for the treatment increased.
C) an increase in the number of mental patients now eligible for the death penalty.
D) the deinstitutionalization of many mental patients.

Question 27

What term refers to defendants' ability to participate in their own defense?

A) sane
B) free will
C) competence to stand trial
D) morally capable

Question 28

With regard to sexual predator laws

A) the Supreme Court ruled them unconstitutional because they constitute "double jeopardy."
B) the Supreme Court ruled them constitutional because they do not constitute punishment.
C) they require forced treatment for repeat sexual offenders.
D) None of the above are accurate.

Question 29

Approximately ___ percent of the mentally disturbed have no history of violence.

A) 10
B) 20
C) 50
D) 90

Question 30

Today, the emergency commitment procedures in most states allow an acutely disturbed individual to be confined to a

A) jail for a few days.
B) mental hospital for a few days.
C) jail until the person agrees to be treated.
D) mental hospital until treatment is finished.

Question 31

Under U.S. federal law how long can a defendant be held once they are found incompetent to stand trial?

A) until they are found competent, potentially for life
B) until the are found competent, up to the maximum length of a jail sentence should they have been found guilty
C) there is a one year maximum under U.S. federal law
D) there is a 10 year maximum under U.S. federal law

Question 32

Most states provide for two types of civil commitment procedures, emergency and

A) psychological.
B) legal.
C) procedural.
D) formal.

Question 33

Which type of mental patient commits acts of violence at a higher rate than others?

A) schizophrenia
B) major depression
C) bipolar disorder
D) any type that also abuses drugs and alcohol

Question 34

In the United States only under certain circumstances can you confine someone on the suspicion that they might commit a crime except in the circumstance of

A) civil commitment.
B) mental health commitment.
C) mental retardation.
D) psychopaths.

Question 35

Davis has incorrectly hospitalized someone as dangerous who is in fact not dangerous. Dr. Eliot has incorrectly released someone from the hospital who is in fact still dangerous. Dr. Davis has made a ___________ error while Dr. Eliot has made a __________ error.

A) justifiable; unjustifiable
B) unjustifiable; justifiable
C) false positive; false negative
D) false negative; false positive

Question 36

At what stage of criminal proceedings may the issue of competence be raised?

A) while the defendant is being read her/his Miranda Rights
B) before and during trial when the defendant needs to instruct his lawyer
C) at the sentencing phase of a trial
D) at any of the stages mentioned above

Question 37

While the grounds for civil commitment vary from state to state there is some commonality. Which of the following is NOT a generally accepted rationale?

A) an inability to care for oneself
B) being a danger to harm oneself
C) being mentally ill
D) being a danger to harm someone else

Question 38

Professional, clinical predictions that an individual patient will behave violently are correct approximately what percentage of the time?

A) 10 percent
B) 25 percent
C) 33 percent
D) 50 percent

Question 39

One justification for civil commitment to psychiatric hospitals is the philosophy of parens patriae. This is the government's responsibility to

A) care for society's weaker members.
B) keep the mentally ill from having children.
C) reimburse family members who care for the mentally ill.
D) provide police power and protection for society at large.

Question 40

When Supreme Court Justice Blackmun heard that the prediction of violence is wrong 2 out of 3 times, he concluded that predicting violence using a coin flip would be more accurate. Why was he wrong?

A) The specificity of a coin flip is above 50%.
B) The sensitivity of a coin flip is above 50%.
C) The base rate of violence is much lower than 50%.
D) The coin flip is random, not based on clinical judgment.

Question 41

What is the basic premise of deinstitutionalization for the mentally ill?

A) They should be hospitalized if they are homeless.
B) They should be placed in private, not public, hospitals.
C) They need to be hospitalized under more humane conditions.
D) They can be better served in the community rather than in hospitals.

Question 42

A newer, more assertive form of treating patients who lack insight is the process of court ordered treatment in the community known as

A) deinstitutionalized commitment.
B) outpatient treatment.
C) community commitment.
D) outpatient commitment.

Question 43

The base rate of the actual occurrence of serious violence is what percentage?

A) 1 percent
B) 3 percent
C) 9 percent
D) 27 percent

Question 44

The Wyatt decision established all of the following rights for mental patients except

A) qualified staff.
B) adequate medication.
C) humane conditions.
D) an individualized treatment plan.

Question 45

"Rotting with their rights on" refers to one problem with

A) deinstitutionalization.
B) institutionalization.
C) community commitment.
D) mandatory jail terms.

Question 46

A neutral third party who helps partners in divorce decisions is known as a

A) mediator.
B) unbiased lawyer.
C) facilitator.
D) family counselor.

Question 47

The accuracy of predictions of violence is better when the focus is on

A) violence against others.
B) violence against oneself.
C) imminent violence.
D) violence that may occur over the long term.

Question 48

About what percentage of children alive today in the United States will experience a divorce in their family?

A) 10 percent
B) 20 percent
C) 40 percent
D) 60 percent

Question 49

A mental patient involuntarily admitted to a mental hospital may refuse treatment if they can

A) give a good reason.
B) provide a bond.
C) understand the treatment.
D) provide informed consent.

Question 50

Each form of child abuse is mentioned in the book EXCEPT?

A) physical
B) neurological
C) sexual
D) neglect

Question 51

Individuals can use a legal procedure to list their preferences for treatment should they be found mentally ill in the future through a procedure known as

A) sanity wills.
B) advance psychiatric directives.
C) treatment contracts.
D) community mental health directives.

Question 52

What is the most important issue about the least restrictive environment alternative?

A) Less restrictive environments are often not available.
B) Treatment in these settings is usually prohibitively expensive.
C) Insurance companies won't pay the expenses for alternative treatments.
D) Treatment in a less restrictive environment is usually less effective.

Question 53

What is the general conclusion concerning making predictions of future violence?

A) Clinical judgment is better than chance.
B) Clinical judgment is equivalent to flipping coins.
C) The number of false positives is unaffected by the base rate.
D) Such predictions should be made by individuals with experience in police work.

Question 54

In reviewing hospital security tapes several parents are observed trying to do physical harm to their children. These parents may be diagnosed as having?

A) child abuse syndrome
B) schizophrenia
C) psychopathy
D) Munchausen-by-proxy

Question 55

The goals of family courts have generally been more _______ than legal.

A) procedural
B) psychological
C) lenient
D) semi-professional

Question 56

There have been benefits to the deinstitutionalization of many mental patients, but one serious problem that has resulted is reflected in the percentage of homeless individuals who should be receiving treatment for mental disorders but are not. This percentage is approximately

A) 10 percent.
B) 30 percent.
C) 50 percent.
D) 60 percent.

Question 57

In 1962 Henry Kempe focused public attention on a family problem that had not received much attention when he wrote about

A) a mentally disordered defendant.
B) post traumatic stress disorder.
C) divorce mediation.
D) the "battered child syndrome."

Question 58

What is one of the reasons that deinstitutionalization has not worked as well as its proponents had hoped?

A) Patients end up staying in the hospital for a longer period of time.
B) There aren't enough hospital beds.
C) Patients who are discharged after short stays are admitted more frequently.
D) There are no effective community-based treatment models.

Question 59

Legal custody refers to

A) where the child lives at what time.
B) foster care placement of abused children.
C) winning material possessions in a divorce settlement.
D) how the parents will make decisions about their child's life.

Question 60

Between 1976 and 2006 what has happened to the number of child abuse cases in the United States?

A) they are about the same
B) they have declined
C) they have declined dramatically
D) they have increased dramatically

Question 61

The 1843 M'Naghten decision was the beginning of the __________ defense in Western law.

Question 62

The files at Child Protective Services are piled high. What is most likely outcome of the reports of alleged child abuse?

A) Due to cutbacks, most cases will never be investigated.
B) In most cases, the parents lose custody of their children.
C) Over two thirds of the reports will not be substantiated after an investigation.
D) The majority of cases will be verified and will be turned over to prosecutors.

Question 63

The case of Lake v. Cameron established a patient's right to treatment in what type of environment? __________ __________

Question 64

Each of the following types of medial malpractice claims are common except

A) the inappropriate use of medication.
B) over billing on the part of the therapist.
C) negligent treatment.
D) sexual relations between therapist and client.

Question 65

Your client has just admitted to you that she intends to run her car into her ex-husband's house, hopefully as he answers the door. As a result of which court decision are you now required to inform the police?

A) Megan
B) California
C) Tarosoff
D) Mendonza

Question 66

The question of a patient's right and ability to refuse treatment revolves around the issue of __________ __________ .

Question 67

A new legal device that addresses the issue of treatment for patient's who lack insight yet are eligible for release into the community is outpatient __________ .

Question 68

A friend of yours, who has been carrying a terrible secret about her family, informs you that she is seeing a psychologist and plans to divulge her secret because she knows that what she shares in therapy is confidential. What should you tell her?

A) "You are correct; psychologists have an ethical obligation not to reveal private communications."
B) "Be careful, because mental health professionals sometimes may be compelled by law to reveal confidential information."
C) "There are no restrictions to prevent your psychologist from revealing your secret."
D) "Psychologists are always allowed to share confidential information with members of a client's family."

Question 69

Many psychologists consider it ethical to inform clients before therapy or counseling begins that they can be required to divulge information from the counseling session especially in cases involving

A) child abuse.
B) plans for divorce.
C) repressed memories.
D) tax evasion.

Question 70

In Osheroff vs. Chestnut Lodge, Osheroff successfully sued the lodge because the

A) the scientific literature provided evidence that suggested he should have received a different treatment.
B) the lodge had overbilled him.
C) they treatment provided was not consistent with the type of theoretical orientation the lodge advertised.
D) All of the above were part of his claim.

Question 71

Subsequent California court decisions have extended the Tarasoff decision to the duty to

A) warn.
B) protect.
C) inform.
D) involve.

Question 72

Criminal law assumes that human behavior is the product of __________ __________ .

Question 73

As a therapist you are well aware of your responsibilities with regard to confidentiality. Before you start, however, you need to inform your client that in certain cases you will be required to report your conversation to the authorities. You are required to do this in cases of

A) divorce.
B) involving the IRS.
C) illegal activity.
D) child abuse.

Question 74

The legal case of Tarasoff v. Regents of the University of California (1976) established that therapists must

A) refrain from sex with clients.
B) report suspected cases of child abuse.
C) notify police of a patient's imminent suicide attempt.
D) warn potential victims of a patient's intent to harm them.

Question 75

The legal definition of insanity is not the same as the scientific definition of __________ __________ .

Question 76

_________ _________ syndrome is a term coined by the psychologist Lenore Walker (1979) to describe her observations about the psychological effects of chronic abuse.

Question 77

A defendant's ability to understand the legal proceedings that are taking place against them and to participate in their own defense defines the concept of __________ .

Question 78

Mental health professionals make an assumption that human behavior is determined by biological, psychological, and social forces which is known as __________ .

Question 79

Using legal proceedings to confine an individual to a mental health facility against their will is known as what type of commitment? __________

Question 80

Children taken from their family homes can be adopted, but only in the case of

A) the death of both parents.
B) the divorce of the parents.
C) if the child has been abused in some way.
D) the termination of parental rights.