November 7th, 2011 by AnneHansonMD in Opinion
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Regular readers know that every year I tweet and blog from the conference of the American Academy of Psychiatry and Law. This group of forensic psychiatrists consists of about 1800 of the country’s practitioners. Topics are quite diverse and sometimes rather unusual. It’s a lot of fun. Here’s just a small smattering of factoids I picked up last week:
- The “sovereign citizen” defense can prompt a competency eval, but is not a delusion. The sovereign citizen movement is a recognized subculture of people who believe the government has no jurisdiction over them.
- Of 200 defendants cleared by DNA, one-fourth had confessed to the crime.
- According to FBI uniform crime reports, Read more »
*This blog post was originally published at Shrink Rap*
August 10th, 2011 by AnneHansonMD in Opinion
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I’ve always been struck by the similarity between solitary confinement inmates and monks. Historically, monks were kept under the vow of silence. They could only leave their cells to attend religious services. The only visitors they were allowed tohave were their religious advisors. (If any of you have seen the movie Into Great Silence you’ll know what I’m talking about.) The idea of the modern penitentiary came from this ‘penitence’ process: put someone in a room by himself, give him religious guidance while he’s there and he’ll reflect, repent and reform. This was how prisons were run in the Nineteenth Century too: prisoners were kept under the rule of silence and they could only come out of their cells for religious services or for work. No one ever alleged that monks became psychotic because of this though.
Then there’s the psychiatric seclusion room. Again, a bare cell with a bed or a mattress, no visitors, no clothes except a hospital gown. There is no ‘vow of silence’ or ‘rule of silence’ though.
So what makes the difference between the prison segregation cell, the monk’s cell and the psychiatric seclusion room? Read more »
*This blog post was originally published at Shrink Rap*
July 8th, 2011 by AnneHansonMD in Opinion
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In Dinah’s post “The Chapter I Wish We Had Written” an anonymous commenter wrote about his problems finding an expert witness for his or her employment discrimination case (since I don’t know if Anonymous is male or female I’m going to use a standard male pronoun in this post—apologies if I got this wrong). Anonymous asked his doctor to help with the case, but he refused. He explained to Anonymous that he would be a biased witness and Anonymous also understood that the doctor’s involvement might affect the therapeutic relationship. Anonymous’s doctor gave her a number of referrals to forensic psychiatrists, but since he was not working with an attorney no expert would take the case. Anonymous was understandably frustrated by this situation.
I wanted to write about this because this situation comes up fairly often and I get calls from friends, colleagues and former students asking how to handle it. I’ve already written about what to do when you get served with a subpoena in my post “When Lawyers Call.”
First of all, I think Anonymous’s doctor was particularly astute to recognize the dilemma that arises when trying to help patients in situations like this. Read more »
*This blog post was originally published at Shrink Rap*
June 25th, 2011 by AnneHansonMD in Health Policy, Opinion
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From the New York Times today we have a story entitled, “A Schizophrenic, A Slain Worker, Troubling Questions,” a horrible story about a mentally ill man who killed a social worker in his group home. The story highlights the defendant’s longstanding history of violence with several assaults in his past. He once fractured his stepfather’s skull and his first criminal offense involved slashing and robbing a homeless man. (On another post on this blog Rob wondered why the charges were dismissed in that case; from experience I can tell you it’s probably because the victim and only witness was homeless and couldn’t be located several months later when the defendant came to trial.) The defendant, Deshawn Chappell, also used drugs while suffering from schizophrenia. Before the murder he reportedly stopped taking his depot neuroleptic and was symptomatic. The news story also suggested that he knew he was committing a crime: he got rid of the body, disposed of the car and changed out of his bloody clothes. Nevertheless, he was sufficiently symptomatic to be found incompetent to stand trial and was committed to a forensic hospital for treatment and restoration. At his competency hearing the victim’s family thought that the defendant was malingering his symptoms, while the victim’s fiance was distraught enough that he tried to attack Chappell in the courtroom. The point of the Times article appears to be an effort to link the crime to cuts in the Massachusetts mental health budget.
So what do I think about this story? Read more »
*This blog post was originally published at Shrink Rap*
June 17th, 2011 by AnneHansonMD in Opinion
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The voice at the other end of the line was angry and accusatory: “You didn’t even talk to me! You never knew my son! You didn’t talk to any of us!”
I explained to her that since she had never even met the defendant, there was no way she could have any information that would be relevant to the accused’s state of mind at the time of the crime. The victim and the defendant were total strangers and there was no apparent reason for the killing, which made the crime even more tragic. Her son was dead in a random incident, in a crime that was unquestionably motivated only by the defendant’s untreated psychiatric symptoms.
The defendant’s family was equally shocked and horrified. They were all hardworking solid citizens, with no history of criminal contacts, substance abuse or mental illness. When their daughter started getting sick Read more »
*This blog post was originally published at Shrink Rap*
Regular readers know that every year I tweet and blog from the conference of the American Academy of Psychiatry and Law. This group of forensic psychiatrists consists of about 1800 of the country’s practitioners. Topics are quite diverse and sometimes rather unusual. It’s a lot of fun. Here’s just a small smattering of factoids I picked up last week:
