forensic psychiatry 2
DESCRIPTION
Brief outline of the subjectTRANSCRIPT
Forensic PsychiatryForensic Psychiatry
Dr.V.P.JoglekarDr.V.P.Joglekar
M.D. (Kaya)M.D. (Kaya)
M.D. (Agad)M.D. (Agad)
DefinitionDefinition
Psychiatry is the science which deals Psychiatry is the science which deals
with study, diagnosis and treatment of with study, diagnosis and treatment of
mental illnessesmental illnesses
Forensic Psychiatry is the application of Forensic Psychiatry is the application of
psychiatry in furtherance of justicepsychiatry in furtherance of justice
Branches of Forensic PsychiatryBranches of Forensic Psychiatry
DiagnosticDiagnosticPsychological profiling of criminal from crime Psychological profiling of criminal from crime
scene investigationscene investigation
Evaluation of the accused Evaluation of the accused
Before the crimeBefore the crime
During the crimeDuring the crime
After the crimeAfter the crime
Branches of Forensic PsychiatryBranches of Forensic Psychiatry
TherapeuticTherapeutic
Treatment of the accusedTreatment of the accused
Treatment of the victimsTreatment of the victims
Therapeutic support to relatives and Therapeutic support to relatives and
associates of the victimassociates of the victim
Branches of Forensic PsychiatryBranches of Forensic Psychiatry
AcademicAcademic
Case studiesCase studies
Data basesData bases
ClassificationsClassifications
ProfilingProfiling
Branches of Forensic PsychiatryBranches of Forensic Psychiatry
PreventivePreventive
Legal reformsLegal reforms
Early indicators in childhoodEarly indicators in childhood
Indicators of impending crimesIndicators of impending crimes
Indicators of impending incidents like suicideIndicators of impending incidents like suicide
Indicators of impending negligent behaviorIndicators of impending negligent behavior
Branches of Forensic PsychiatryBranches of Forensic Psychiatry
JurisprudenceJurisprudence
CivilCivil
CriminalCriminal
Restraint of mentally illRestraint of mentally ill
Diagnosis of mental illnessDiagnosis of mental illness
Diagnostic & statistical manual (DSM IV)Diagnostic & statistical manual (DSM IV)
Axis 1 Major mental disordersAxis 1 Major mental disorders
Axis 2 Personality disordersAxis 2 Personality disorders
Axis 3 General medical conditionAxis 3 General medical condition
Axis 4 Psycho-social & environmental factorsAxis 4 Psycho-social & environmental factors
Axis 5 General psychological functioningAxis 5 General psychological functioning
Axis 1 Major mental disordersAxis 1 Major mental disorders
Anxiety disordersAnxiety disorders Panic attacksPanic attacks Generalized Anxiety disorderGeneralized Anxiety disorder PhobiasPhobias Stress relatedStress related
SchizophreniasSchizophrenias Group of disordersGroup of disorders
Axis 1 Major mental disordersAxis 1 Major mental disorders
Mood disordersMood disorders DepressionDepression HypomaniaHypomania ManiasManias
KleptomaniaKleptomania
PyromaniaPyromania
MutilomaniaMutilomania
DipsomaniaDipsomania
Erotomania /Nymphomania etc.Erotomania /Nymphomania etc.
Axis 2 Personality disordersAxis 2 Personality disorders
Cluster ACluster A ParanoidParanoid SchizoidSchizoid SchizotypalSchizotypal
Cluster BCluster B AntisocialAntisocial HistrionicHistrionic NarcissistNarcissist
Cluster CCluster C AvoidantAvoidant DependantDependant Obsessive compulsiveObsessive compulsive
Some important termsSome important terms
IllusionsIllusionsDelusionsDelusionsHallucinationsHallucinationsConfusionConfusionClouding of Clouding of consciousnessconsciousnessDeliriumDeliriumTwilight stateTwilight stateLucid intervalLucid interval
FugueFugueStuporStuporAmnesiaAmnesia RetrogradeRetrograde AnterogradeAnterograde
MemoryMemory RecentRecent RemoteRemote
AttentionAttention
Mental retardationMental retardation
LevelLevel I.Q.I.Q. Mental ageMental age CapacitiesCapacities
MoronMoron 50-7050-70 6-116-11 Self Self supportivesupportive
ImbecileImbecile 35-4935-49 3-63-6 Supervision Supervision neededneeded
IdioticIdiotic 20-3420-34 33 Nursing Nursing neededneeded
IdiotIdiot <20<20 <3<3 No No capacitiescapacities
Civil SignificanceCivil Significance
PropertyProperty
ContractsContracts
MarriageMarriage
WitnessWitness
ConsentConsent
Testamentary Testamentary capacitycapacity
DrunkennessDrunkenness
CrueltyCruelty
DivorceDivorce
Dying declarationDying declaration
Dying depositionDying deposition
Mental retardation Mental retardation
Criminal significanceCriminal significance
Mens reaMens rea
–The intent behind illegal acts is more The intent behind illegal acts is more
important thanimportant than
Actus reusActus reus
–The illegal act itselfThe illegal act itself
Criminal significanceCriminal significance
MurderMurder
SuicideSuicide
Sexual offencesSexual offences
Anti social behaviorAnti social behavior
ViolenceViolence
TheftsThefts
Drug abuseDrug abuse
CrueltyCruelty
Battered wifeBattered wife
Battered childBattered child
Hawaii declarationHawaii declaration
No procedure against willNo procedure against willExcept when threat to othersExcept when threat to others
Retroactive informed consent presumedRetroactive informed consent presumedCompulsory treatment in the best interest of Compulsory treatment in the best interest of
patient over reasonable periodpatient over reasonable periodIndependent and neutral body for reviewIndependent and neutral body for reviewPatient must be informed of review bodyPatient must be informed of review body
Restraint of Mentally IllRestraint of Mentally Ill
ImmediateImmediate– When there is danger to himself or othersWhen there is danger to himself or others– Must cease with subsidence of symptomsMust cease with subsidence of symptoms
Admission to hospitalAdmission to hospital– VoluntaryVoluntary
In case of minor by guardianIn case of minor by guardian
Review every 90 daysReview every 90 days
By application (friends/relatives)By application (friends/relatives)2 certificates, at least one by govt.hospital2 certificates, at least one by govt.hospital
Review every 90 daysReview every 90 days
Restraint of Mentally IllRestraint of Mentally Ill
Reception order on petition to magistrateReception order on petition to magistrate
– Petition by Petition by
SpouseSpouse
DoctorDoctor
Friend / relativeFriend / relative
– 2 certificates + travel fitness certificate2 certificates + travel fitness certificate
– Review every 30 daysReview every 30 days
– Bond for expensesBond for expenses
Restraint of Mentally IllRestraint of Mentally Ill
Reception order on production before magistrateReception order on production before magistrate
– Wandering and dangerous personsWandering and dangerous persons
Police take chargePolice take charge
Within 24 hoursWithin 24 hours
Bond for expensesBond for expenses
– Neglected personsNeglected persons
Police or private personsPolice or private persons
Court may appoint guardianCourt may appoint guardian
– Review every 30 daysReview every 30 days
Restraint of Mentally IllRestraint of Mentally Ill
Reception order of prisonerReception order of prisoner
Reception order of escaped prisonerReception order of escaped prisoner
– Police or hospital staffPolice or hospital staff
– Not required within 1 monthNot required within 1 month
Reception order on judicial inquisitionReception order on judicial inquisition
– In case of huge propertyIn case of huge property
– District or high court orders inquisitionDistrict or high court orders inquisition
Discharge from Psychiatric hospitalDischarge from Psychiatric hospital
Voluntary admissionsVoluntary admissions
– On requestOn request
OthersOthers
– On review of recoveryOn review of recovery
– On order of magistrate on reassurance by On order of magistrate on reassurance by
relativesrelatives
– On judicial reinquisitionOn judicial reinquisition
Certification of Mental IllnessCertification of Mental Illness
Section 21 Mental Health Act 1987Section 21 Mental Health Act 1987– Prescribed formPrescribed form– 2 different Psychiatrists should examine 2 different Psychiatrists should examine
separatelyseparately– At least 1 must be from government serviceAt least 1 must be from government service– Application for restraint at least 10 days after Application for restraint at least 10 days after
examinationexamination– Specify nature & severity of illnessSpecify nature & severity of illness– Specify Safety of pt. or othersSpecify Safety of pt. or others
Rights of Mentally IllRights of Mentally Ill
Right to receive treatmentRight to receive treatmentRight to refuse treatmentRight to refuse treatmentChoice of least restrictive alternativeChoice of least restrictive alternativeVisitation and privacy rightsVisitation and privacy rightsRight to communicateRight to communicateEconomic rightsEconomic rightsHabeas corpusHabeas corpus
True and feigned insanityTrue and feigned insanity
FeatureFeature TrueTrue FeignedFeigned
OnsetOnset GradualGradual SuddenSudden
MotiveMotive AbsentAbsent PresentPresent
Predisposing Predisposing causescauses
PresentPresent AbsentAbsent
Facial expressionFacial expression PeculiarPeculiar normal`normal`
Signs and Signs and symptomssymptoms
Particular typeParticular type mixedmixed
True and feigned insanityTrue and feigned insanity
FeatureFeature TrueTrue FeignedFeigned
HabitsHabits Usually dirtyUsually dirty Leaves clean space for Leaves clean space for sleepingsleeping
Effect of Effect of observationobservation
NilNil Bring on symptomsBring on symptoms
Repeated Repeated examexam
Dose not Dose not mindmind
resentsresents
ExertionExertion Not Not exhaustedexhausted
Gets exhaustedGets exhausted
Civil Responsibilities of Mentally IllCivil Responsibilities of Mentally Ill
Management of propertyManagement of propertyContracts invalid except in lucid intervalContracts invalid except in lucid intervalMarriage invalid if insane at the timeMarriage invalid if insane at the timeNo grounds for divorce if laterNo grounds for divorce if laterCompetency as witness only in lucid intervalCompetency as witness only in lucid intervalConsent to certain acts invalidConsent to certain acts invalid
Civil Responsibilities of Mentally IllCivil Responsibilities of Mentally Ill
Civil rights lostCivil rights lostCannot hold driving licenseCannot hold driving licenseCannot hold public officeCannot hold public officeCannot voteCannot voteCannot adopt a childCannot adopt a childCannot be a legal guardianCannot be a legal guardianTestamentary capacity only in lucid intervalTestamentary capacity only in lucid interval
Criminal Responsibility of insaneCriminal Responsibility of insane
Legal testsLegal testsMcnaghten’s ruleMcnaghten’s rule
Inability to know nature and quality of act due to illnessInability to know nature and quality of act due to illness
Durham ruleDurham ruleAct resulting from illnessAct resulting from illness
Currens ruleCurrens ruleNo capacity to regulate behavior to the requirements of No capacity to regulate behavior to the requirements of
lawlaw
Criminal Responsibility of insaneCriminal Responsibility of insane
American law institute testAmerican law institute testCapacity to appreciate wrongfulness of the actCapacity to appreciate wrongfulness of the actCapacity to confirm to lawCapacity to confirm to law
Norwegian systemNorwegian systemInsanity or unconsciousness at the time of crimeInsanity or unconsciousness at the time of crime
Doctrine of partial responsibilityDoctrine of partial responsibilityApplicable in some states like depression, paranoia, Applicable in some states like depression, paranoia,
obsess ional stateobsess ional state
Other pleas in murderOther pleas in murder
DeliriumDelirium
DrunkennessDrunkenness– Only involuntary or Only involuntary or
insanity due to toxicityinsanity due to toxicity
HypnotismHypnotism
Irresistible impulseIrresistible impulse– Valid only if inability to Valid only if inability to
distinguish right and distinguish right and wrongwrong
SomnambulismSomnambulism
SomnolentiaSomnolentia
AutomatismAutomatism– EpilepsyEpilepsy– ConcussionConcussion– HypoglycemiaHypoglycemia– Cerebral diseaseCerebral disease
Some provisions in MHA 87Some provisions in MHA 87
Hospital only on obtaining licenseHospital only on obtaining license
License renewal every 5 yearsLicense renewal every 5 years
Government visitors every month to review all Government visitors every month to review all casescases
Punishment for illegal restraint 2 yearsPunishment for illegal restraint 2 years
Legal aid at state expensesLegal aid at state expenses