Journal of the American Academy of Psychiatry and the Law最新文献

Legal and Ethics Concerns of Psilocybin as Medicine. 将迷幻药作为药物的法律和伦理问题。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-11-19 DOI: 10.29158/JAAPL.240089-24

Stephanie M Schonholz, Jacob M Appel, Harold J Bursztajn, Mohan Nair, Michael R MacIntyre

引用次数: 0

A Review of the Interpretation of the Canadian Test for Fitness to Stand Trial. 加拿大受审资格测试释义回顾。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-11-18 DOI: 10.29158/JAAPL.240081-24

Laeticia Eid, Amina Ali, Leisha Senko, Graham Glancy

引用次数: 0

Clinical and Legal Considerations When Optimizing Trauma Narratives in Immigration Law Evaluations. 在移民法评估中优化创伤叙述时的临床和法律考虑因素。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-10-11 DOI: 10.29158/JAAPL.240080-24

Amy Franks, Diab A Ali, Ahmad Adi

{"title":"Clinical and Legal Considerations When Optimizing Trauma Narratives in Immigration Law Evaluations.","authors":"Amy Franks, Diab A Ali, Ahmad Adi","doi":"10.29158/JAAPL.240080-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240080-24","url":null,"abstract":"Asylum seekers in the United States face complex legal processes that require the construction of coherent and credible narratives to establish eligibility for legal status or immigration relief. In this article, we review clinical and legal considerations involved in optimizing trauma narratives in forensic psychiatric evaluations for immigration courts. We highlight significant challenges faced by asylum seekers, including the emotional impact of trauma and cultural factors affecting their ability to disclose their experiences, including the roles of symptoms and cultural and situational elements in disclosure and narrative development. We emphasize the importance of creating a therapeutic and empathetic environment to facilitate disclosure and partnering with interpreters across multiple culturally sensitive evaluations. We address the roles of common traumatic stressors in narrative development, including cultural challenges related to histories of torture, abduction, sexual violence, and human trafficking prevalent among asylum seekers, providing insights and guidance on each. Further, we address specific potential challenges to the forensic psychiatric evaluator during the narrative development process, such as transference, countertransference, malingering, and vicarious traumatization. We aim to provide guidance on the development of trauma narratives of asylees developed for both therapeutic and medico-legal effectiveness.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flexibility and Innovation in Decisional Capacity Assessment. 决策能力评估的灵活性和创新性。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-10-11 DOI: 10.29158/JAAPL.240087-24

Jacob M Appel

{"title":"Flexibility and Innovation in Decisional Capacity Assessment.","authors":"Jacob M Appel","doi":"10.29158/JAAPL.240087-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240087-24","url":null,"abstract":"Since the 1980s, the four skills criteria have become the most widely accepted mechanism for the assessment of decisional capacity in the United States. These criteria emerged in response to the paternalistic approach to clinical decision-making that had been widely accepted in an earlier era and offered a means of ensuring that physicians honored the rights of capacitated patients to make their own medical decisions. Unfortunately, the criteria are now applied to situations for which they are not suited and in a manner that is often highly inflexible. In an article in this issue of The Journal, Matthew Dernbach and colleagues describe one potential scenario that requires a flexible approach to using the four skills model: situations in which a patient stands at high risk of losing decisional capacity in the near future. Using Dernbach et al. as a starting point, this article offers specific ways in which the four skills model can be improved upon or augmented without abandoning its key principles. These advances include adjusting to empirical evidence, re-emphasizing the importance of autonomy maximization and restorability, and embracing novel conceptual and technological innovations.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health Service Referral and Treatment Following Screening and Assessment in Juvenile Detention. 青少年拘留所中筛查和评估后的心理健康服务转介和治疗。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-10-11 DOI: 10.29158/JAAPL.240082-24

Frank Tedeschi, Sarah McCue Horwitz, Michael Surko, Emily Weinberger, Amanda Bart, Carly Baetz, Fei Guo, Ava Alexander, Jennifer F Havens

{"title":"Mental Health Service Referral and Treatment Following Screening and Assessment in Juvenile Detention.","authors":"Frank Tedeschi, Sarah McCue Horwitz, Michael Surko, Emily Weinberger, Amanda Bart, Carly Baetz, Fei Guo, Ava Alexander, Jennifer F Havens","doi":"10.29158/JAAPL.240082-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240082-24","url":null,"abstract":"Numerous recommendations have been made to address the high rates of mental health disorders among justice-involved youth. Few data are available on the use, quality, appropriateness, or availability of services to address these needs. This study examined the relationship between trauma-informed mental health screening, other referral pathways for diagnostic evaluation, subsequent DSM-5 diagnoses, and treatments for evaluated youth. Eligible participants were all youth admitted to New York City secure juvenile detention facilities from September 17, 2015 to October 30, 2016 who remained in the facility for at least five days (N = 786). Of those, 581 (73.9%) were voluntarily screened and 309 (53.2%) later received a diagnostic evaluation. Youth who screened positive for depression, posttraumatic stress disorder, and problematic substance use were more likely to be evaluated. Treatment received was related to diagnosis rather than reason for referral. For youth who were referred for behavioral or emotional concerns, 99.1 percent (114 of 115) of those diagnosed with a neurodevelopmental disorder had attention-deficit/hyperactivity disorder (ADHD). These data are among the first to describe DSM-5 diagnoses and treatment among youth detainees. They highlight the prevalence of ADHD in detained youth and argue for the coordination of universal trauma-informed mental health screening and a structured referral system for this population.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When a Patient Is at Foreseeable Risk of Losing Decisional and Functional Capacity. 当病人有丧失决策能力和功能能力的可预见风险时。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-09-17 DOI: 10.29158/JAAPL.240070-24

Matthew Robert Dernbach, Peter Ash, Esther Oyerinde, Mark A Oldham

{"title":"When a Patient Is at Foreseeable Risk of Losing Decisional and Functional Capacity.","authors":"Matthew Robert Dernbach, Peter Ash, Esther Oyerinde, Mark A Oldham","doi":"10.29158/JAAPL.240070-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240070-24","url":null,"abstract":"The four-skills model of decisional capacity for providing informed consent for medical treatment developed by Appelbaum and Grisso is codified into most state statutes in articulating the legal criteria for establishing capacity. Decisional capacity is traditionally determined at a point in time based on a narrow clinical question; however, there are clinical scenarios in which patients may currently have decisional capacity but their recurrent nonadherence to care places them at foreseeable risk of being acutely incapacitated, both decisionally and functionally, in the near future. There is a gap in terms of how these four skills ought to be adapted when applied to a patient with recurrent altered mental status, especially delirium, because of nonadherence. To describe this clinical situation, we introduce a new risk factor, \"foreseeable risk of losing decisional and functional capacity,\" and discuss the clinical evaluation of a patient who currently has capacity but for whom this risk factor applies. We consider the implications of being at foreseeable risk of losing capacity and how foreseeable risk can be translated into a capacity determination in the present. We also describe interventions that can serve to protect the patient's rights and safety.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterizing Referrals to Professional Health Monitoring Programs for Unprofessional Sexual Behavior. 因非专业性行为而被转介至专业健康监测计划的特征。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-09-12 DOI: 10.29158/JAAPL.240069-24

Alexandria G Polles, Cristiana N P Araujo, Rosalie S Hemphill, Hanzhi Gao, Lisa J Merlo

{"title":"Characterizing Referrals to Professional Health Monitoring Programs for Unprofessional Sexual Behavior.","authors":"Alexandria G Polles, Cristiana N P Araujo, Rosalie S Hemphill, Hanzhi Gao, Lisa J Merlo","doi":"10.29158/JAAPL.240069-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240069-24","url":null,"abstract":"Concerns about sexual misconduct by health care professionals have been highlighted by recent high-profile cases. Professional health monitoring programs (PHPs) offer an additional layer of protection when health care professionals with a history of unprofessional sexual behavior (USB) return to practice; however, little is known about the characteristics or outcomes of clinicians referred to a PHP because of USB. Data were extracted from over 35 years of PHP records involving USB-related referrals (N = 570). The majority of cases were deemed ineligible for PHP monitoring and handled by other entities (e.g., licensing board, legal system). Of the 232 monitored cases (46.84 ± 9.42 years; 95.7% male), most were physicians (n = 156, 67.2%), with 75.9 percent of monitored cases involving USB with at least one patient. Most (74.9%) PHP monitoring outcomes were classified as \"successful\" or \"very successful.\" Only three individuals (1.3%) who completed their monitoring were rereferred to the PHP. Monitored professionals exhibited less severe USB and were less likely to experience legal or disciplinary consequences (57.3% versus 69.8%, Cramer's V = .174, p < .0001) compared with unmonitored professionals. Findings enhance transparency of the PHP process and highlight its utility in safely returning clinicians to practice. Results may inform policies to prevent USB by health care professionals.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dosing and Misuse of Buprenorphine in the New Jersey Department of Corrections. 新泽西州教养局的丁丙诺啡剂量和滥用情况。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-09-12 DOI: 10.29158/JAAPL.240071-24

Anthony Tamburello, Tracy L Martin

{"title":"Dosing and Misuse of Buprenorphine in the New Jersey Department of Corrections.","authors":"Anthony Tamburello, Tracy L Martin","doi":"10.29158/JAAPL.240071-24","DOIUrl":"https://doi.org/10.29158/JAAPL.240071-24","url":null,"abstract":"Opioid use disorder is common in incarcerated persons, and concern about the diversion of buprenorphine is a barrier to treatment. We conducted a retrospective chart review of incarcerated persons in the New Jersey Department of Corrections who received charges for misuse of medication, including buprenorphine, hypothesizing that the prescription of buprenorphine monoproduct, multiple tabs or films of buprenorphine, or higher doses of buprenorphine would be associated with more diversion incidents. Within the dosing range of 2 to 12 mg, there were more incidents of diversion of buprenorphine monoproduct (24.3%) compared with buprenorphine-naloxone (10.7%, p = .004). More incidents of diversion were seen when multiple films or tabs of buprenorphine product were prescribed (21.7%, comparison 12.7%, p = .01). This observation held when considering multiple buprenorphine-naloxone films, but not multiple buprenorphine tablets. No statistically significant association was found for institutional diversion charges related to higher doses of buprenorphine products. These results suggest that, within the dosing range of buprenorphine used in the New Jersey Department of Corrections, misuse charges were not associated with higher doses although were associated with prescribing buprenorphine monoproduct and multiple films of buprenorphine-naloxone.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health and Social Correlates of Reincarceration of Youths as Adults. 青少年成年后再监禁的心理健康和社会相关因素。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-09-03 DOI: 10.29158/JAAPL.240039-24

Alec Buchanan, Bin Zhou, Taeho Greg Rhee, Elina A Stefanovics, Robert Rosenheck

{"title":"Mental Health and Social Correlates of Reincarceration of Youths as Adults.","authors":"Alec Buchanan, Bin Zhou, Taeho Greg Rhee, Elina A Stefanovics, Robert Rosenheck","doi":"10.29158/JAAPL.240039-24","DOIUrl":"10.29158/JAAPL.240039-24","url":null,"abstract":"The rise in the U.S. prison population over the past 40 years has heightened scrutiny of the incarceration of children and adolescents. Correlates of later reincarceration in this group, especially correlates relating to psychiatric and substance use disorders, are understudied in the U.S. population. We aimed to establish the prevalence and correlates of the reincarceration as adults of people incarcerated before age 18. Data were derived from clinical interviews and from validated diagnostic and psychometric instruments. They were obtained as part of a cross-sectional representative survey of the civilian U.S. population, the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). We identified 1,543 adults (4.3% of the NESARC sample) who had been incarcerated before they were 18. Of these, 55.9 percent had subsequently been incarcerated as adults. In addition to variables that have been repeatedly identified in criminological research (less education, past antisocial behavior, and parental imprisonment), substance use disorder, bipolar disorder, and longer childhood incarceration were independently associated with incarceration as an adult. The possibility that psychiatric treatment could reduce reincarceration in this group warrants longitudinal and experimental research.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"294-303"},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health Aftercare Availability for Juvenile Justice-Involved Youth in New York City. 纽约市触犯法律的青少年的心理健康善后服务。

IF 2.1 4区医学

Journal of the American Academy of Psychiatry and the Law Pub Date : 2024-09-03 DOI: 10.29158/JAAPL.240040-24

Tiffany Martin, Nicolette Karim, Eric Whitney, Tomika Carter, Radhika Mattoo, Sarah Horwitz

{"title":"Mental Health Aftercare Availability for Juvenile Justice-Involved Youth in New York City.","authors":"Tiffany Martin, Nicolette Karim, Eric Whitney, Tomika Carter, Radhika Mattoo, Sarah Horwitz","doi":"10.29158/JAAPL.240040-24","DOIUrl":"10.29158/JAAPL.240040-24","url":null,"abstract":"The goal of our study was to describe the availability of community child and adolescent mental health services, trauma-informed care, and the geographic accessibility of these services for juvenile justice-involved (JJ) youth who received mental health services while in secure detention. Data collection occurred through direct contact with the child and adolescent outpatient clinics listed on the New York State Office of Mental Health website. Zip codes were collected from the juvenile secure detention census. Of the clinics contacted, 88.5 percent accepted JJ youth; however, 43.5 percent accepted them on a conditional basis. Only 62.1 percent offered trauma-informed care, including evidence-based interventions and unspecified care. Although 84.5 percent of the clinics that would accept this population reported currently accepting new patients, reported wait times were as high as six or more months. When JJ residents' home zip codes and those of the clinics were geographically mapped, there were few clinics in the zip codes where most residents lived. The clinics that accepted youth on a conditional basis often refused high-risk patients, essentially ruling out a large majority of this population. The geographical inaccessibility of these clinics limits their ability to provide care for this vulnerable population.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"286-293"},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0