International Journal of Law and Psychiatry最新文献

{"title":"Is assisted dying a treatment?","authors":"Gareth S. Owen ,&nbsp;Maria Koniarz ,&nbsp;Alex Ruck Keene","doi":"10.1016/j.ijlp.2026.102196","DOIUrl":"10.1016/j.ijlp.2026.102196","url":null,"abstract":"<div><div>This paper focuses on the nature of the assisted dying (AD) decision including the object of the mental capacity test. Specifically, we inquire into whether AD is a treatment decision. In Part I, we analyse how the AD decision is characterised in all international AD statutes also analysing what government guidance says when the primary legislation is ambiguous. In Part II, we address the question normatively: firstly, from the perspective of clinical ethics and secondly from the perspective of legal rules (the doctrine of informed consent and the duties of governments in states with socialised healthcare laws). We found that the nature of AD is variably characterised across international laws with a significant number (10/32) framing AD as a healthcare or treatment decision. In laws where the characterisation is ambiguous (14/32) government guidance tends toward a treatment characterisation. We argue in Part II that AD should not be classified as a treatment for reasons of clinical intelligibility, legal coherence and unintended policy consequences. We conclude with some recommendations, notwithstanding complexities, on a better characterisation of the decision to inform future AD policy research.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102196"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144215","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}

{"title":"“Gut feeling and subtle signals”: Norwegian police officers' strategies for identifying cognitive disabilities in suspects during the initial stages of the legal process","authors":"Nina Christine Dahl ,&nbsp;Veerle Garrels ,&nbsp;Kristina Kepinska Jakobsen","doi":"10.1016/j.ijlp.2026.102204","DOIUrl":"10.1016/j.ijlp.2026.102204","url":null,"abstract":"<div><div>Police officers' ability or inability to identify suspects' cognitive disabilities may directly influence how those suspects are treated and progress through the criminal justice process. Through qualitative interviews with police employees – including both frontline officers and investigators from six districts – this article explores the police's strategies for assessment and identification of cognitive disabilities. Findings show that police officers demonstrate varying levels of understanding of cognitive disabilities and that they base their assessments primarily on personal experience and instinct rather than on formal training and research-based practice. The article further explores legal protection implications by using two international human rights standards: the Convention on the Rights of Persons with Disabilities (CRPD) and the European Convention on Human Rights (ECHR). Findings underscore the importance of structural adaptations and training to ensure that individuals with cognitive disabilities receive fair treatment in the criminal justice system.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102204"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144179","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}

{"title":"Wrong touch regulation: The limits to effective regulation of approved mental health professionals","authors":"Jessica L.H. Fish","doi":"10.1016/j.ijlp.2026.102206","DOIUrl":"10.1016/j.ijlp.2026.102206","url":null,"abstract":"<div><div>Approved Mental Health Professionals (AMHPs) hold essential decision-making authority on whether individuals will be subject to compulsory detention under the <span><span>Mental Health Act 1983 (as amended 2007)</span></span> in England and Wales. Despite exercising profound coercive powers affecting individual liberty, the regulatory architecture surrounding AMHP practice is fragmented and diffuse, with oversight distributed across the Care Quality Commission, Social Work England, and multiple professional body regulators, and with no single body holding end-to-end accountability for decision quality. The dominant regulatory approach in contemporary UK health and social care is Right-touch Regulation (RTR), developed by the Professional Standards Authority and articulated through successive iterations since 2009. RTR presents itself as a model of proportionate, targeted, and risk-based intervention: a ‘third way’ between heavy-handed oversight and regulatory absence. The central claim of this article is that Right-touch Regulation, as currently utilised by the PSA, is structurally unsuited to AMHP oversight. The model presupposes conditions that are not present in AMHP governance. Situating RTR within broader regulatory theories (responsive regulation, smart regulation, and harm-based regulation), the article reviews what RTR claims as lineage but omits in practice. The conclusion argues that, until the preconditions for proportionate regulation are established (visibility, ownership, feedback), the language of Right-touch continues to legitimate a system that does not effectively regulate at all.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102206"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208229","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}

{"title":"Juror decision making: Does juror stigma, mental health literacy, or the description of a defendant's mental health status, impact decision-making in a mock criminal trial?","authors":"Rachel Metcalfe-Hulme ,&nbsp;Cliodhna O’Leary ,&nbsp;Gavin Nobes ,&nbsp;Ian Edwards ,&nbsp;Peter Beazley","doi":"10.1016/j.ijlp.2026.102197","DOIUrl":"10.1016/j.ijlp.2026.102197","url":null,"abstract":"<div><div>There has been limited research considering how different types of mental health information can influence juror decisions of guilt. The present study adopted an experimental methodology in which the amount of mental health information presented to contextualise an alleged offence of Criminal Damage was varied. Participants (<em>n</em> = 243) were randomly assigned to one of three conditions (‘control’: a mental health explanation could be reasonably inferred but was not directly stated; ‘symptoms only’: clear mental health symptoms were described but no diagnosis was provided; ‘symptoms + diagnosis’: which only differed from the ‘symptoms’ condition by additionally describing the condition as ‘paranoid schizophrenia’). Participants watched a series of videos depicting a fictional criminal trial and were asked to make judgements of guilt. Baseline stigma towards mental health conditions and mental health literacy (MHL) were measured using standardised scales. Guilt ratings were measured as the dependent variable. Regression analyses identified that mental health information, stigma, and MHL were all important predictors of guilt, however interaction effects indicated that people with higher MHL were particularly influenced by increasing mental health information (with guilt judgements decreasing more for those with higher MHL). A particularly notable finding was that the addition of a diagnosis of paranoid schizophrenia was associated with a reduction in guilt ratings, even after controlling for all other factors. The results are relevant to the way in which mental health conditions are described in the courtroom, and suggestions are made for future research.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102197"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116600","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}

{"title":"Involuntary treatment of anorexia nervosa in Ireland: Challenges and changes in the legal framework","authors":"Eimear Dunne ,&nbsp;Art Malone ,&nbsp;Alex Ruck Keene ,&nbsp;Brian O'Donoghue ,&nbsp;Nuala Kane","doi":"10.1016/j.ijlp.2026.102193","DOIUrl":"10.1016/j.ijlp.2026.102193","url":null,"abstract":"<div><div>Anorexia Nervosa is an eating disorder typified by low body weight, restrictive eating behaviours, and body image distortion. It is associated with significant risk of medical complications, with one of the highest mortality rates of any mental illness. While the majority of patients receive treatment on a voluntary basis, a small proportion of severely ill patients refuse treatment and are treated involuntarily. The legal mechanisms used for involuntary treatment vary between jurisdictions, including mental health law, capacity-based law, guardianship, and use of inherent jurisdiction, the power of a superior court to rule on matters not included in statute. In Ireland, involuntary treatment of anorexia nervosa occurs within a legislative lacuna, not regulated by either the Mental Health Act 2001, or the Assisted Decision Making (Capacity) Act, 2015. Instead, treatment occurs under the Inherent Jurisdiction of the High Court, resulting in reliance on judicial discretion for decision-making.</div><div>In this article, we explore the gaps in Ireland's current legal framework as applicable to care and treatment of anorexia nervosa, with reference to case law in England and Wales as a comparison. This includes an examination of the potential impact of the proposed changes to legislation as set out in the Mental Health Bill, 2024. We argue that these gaps mean that legislation governing the involuntary treatment of anorexia nervosa is urgently needed to safeguard the rights of this potentially vulnerable patient cohort, and ensure justice, transparency and consistency in legal approach.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102193"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137935","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}

{"title":"Sociodemographic and clinical factors associated with jail entry after a mental health crisis","authors":"Rachel Odes ,&nbsp;Janet Myers ,&nbsp;Pamela M. Murnane ,&nbsp;Megan McDaniel ,&nbsp;Deepa Manjanatha ,&nbsp;Glenn-Milo Santos ,&nbsp;Phillip O. Coffin ,&nbsp;Matthew L. Goldman","doi":"10.1016/j.ijlp.2026.102205","DOIUrl":"10.1016/j.ijlp.2026.102205","url":null,"abstract":"<div><div>Individuals who experience mental health crises frequently find themselves in contact with the criminal legal system. Strengthening the capacity of mental health crisis services to engage with those at high risk for incarceration is a priority both for those who experience crises and those responsible for service delivery. This retrospective analysis included 10,269 mental health crisis episodes among 6861 individuals from 2021 to 2022 in San Francisco, California, USA. We examined the sociodemographic and episode-level characteristics most associated with incarceration in the county's jail within the 30 days following the crisis episode using logistic regression. Male gender and homelessness were independently associated with increased odds of incarceration in the 30 days following a crisis. In addition, being placed on an involuntary psychiatric hold was associated with increased odds of incarceration compared to episodes where no hold was initiated during the crisis. Having a crisis service delivered by the city's Street Crisis Response Team was also associated with increased odds of jail entry when compared to other service delivery options, as was any past-year crisis services utilization and another jail entry in the past year. These findings illustrate the challenges individuals experiencing homelessness and serious mental illness face when navigating life in an urban environment embodying multiple social stressors. As cities like San Francisco develop a more robust approach to supporting people with mental health concerns experiencing homelessness, it is essential to coordinate across sectors – including the criminal legal system, social services, and behavioral health – to promote better health outcomes.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102205"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367009","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}

{"title":"Corrigendum to “Psychiatric evaluations for adolescent offenders with delinquency in Taiwan” International Journal of Law and Psychiatry, Volume 104 (2026) 102156/ https://doi.org/10.1016/j.ijlp.2025.102156","authors":"Yu-Ning Her ,&nbsp;Ya-Hsuan Wang ,&nbsp;M. Da-Yuan ,&nbsp;Chieh Chang ,&nbsp;Fan-Jung Wan ,&nbsp;Nian-Sheng Tzeng","doi":"10.1016/j.ijlp.2025.102168","DOIUrl":"10.1016/j.ijlp.2025.102168","url":null,"abstract":"","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"106 ","pages":"Article 102168"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640959","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}

{"title":"Informal coercion towards discharge: The entanglement of formal and informal coercion in social resource introduction","authors":"Hiroyasu Ino ,&nbsp;Akira Akabayashi ,&nbsp;Yoshiyuki Takimoto ,&nbsp;Eisuke Nakazawa","doi":"10.1016/j.ijlp.2025.102183","DOIUrl":"10.1016/j.ijlp.2025.102183","url":null,"abstract":"<div><h3>Background</h3><div>Coercion is a central issue in psychiatric practice, and understanding its nature is essential for developing effective coercion reduction strategies. However, the epidemiology and impact of informal coercion during a single hospitalization, as well as its relationship with formal coercion, remain unclear. This study aimed to estimate the prevalence and characteristics of informal coercion during a single hospitalization; to assess whether informal coercion was associated with the intended effect of introducing social resources; and to identify risk factors associated with its use, particularly formal coercion.</div></div><div><h3>Method</h3><div>This retrospective cohort study was conducted at an urban psychiatric emergency hospital. A total of 659 individuals with acute schizophrenia were examined for experiences of informal coercion in the context of social resource introduction. A quasi-experimental design using inverse probability of treatment weighting and modified Poisson regression was employed.</div></div><div><h3>Results</h3><div>Approximately 22 % of participants experienced informal coercion. Specifically, 9.1 % were subjected to threats, 4.7 % to inducements, and 11 % to persuasion. Threats and inducements increased the likelihood of social resource introduction but were also associated with limitations of the participants' choices regarding discharge and post-discharge life decisions. Involuntary admission was the strongest predictor of informal coercion, and condition for discharge is the most prevalent gain implied in threats.</div></div><div><h3>Conclusion</h3><div>Informal coercion towards discharge was a structurally embedded practice linked to formal coercion. Two forms of informal coercion were identified: extra-legally constructed medical authority and informal legal transplantation. Reducing informal coercion requires limiting formal coercion, clarifying discharge criteria in law, and expanding non-coercive social resources.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"105 ","pages":"Article 102183"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685029","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}

{"title":"Addressing the false dichotomy between autonomy and preservation of life: Clinical, legal, and ethical considerations in severe and longstanding anorexia nervosa","authors":"Agnes Ayton ,&nbsp;Ali Ibrahim ,&nbsp;Marco Solmi ,&nbsp;Cynthia M. Bulik ,&nbsp;Eric F. van Furth ,&nbsp;Philip S. Mehler ,&nbsp;Maryrose Bauschka ,&nbsp;Angela S. Guarda","doi":"10.1016/j.ijlp.2025.102179","DOIUrl":"10.1016/j.ijlp.2025.102179","url":null,"abstract":"<div><div>Anorexia nervosa (AN) is a serious metabo-psychiatric disorder. Despite a mortality rate approximately five times higher than that of age-matched controls, most deaths result from delayed recognition, fragmented care, and limited access to integrated, evidence-based treatment. Refusal of life-sustaining nutrition in severe or longstanding AN presents profound ethical and legal dilemmas, challenging the balance between autonomy, protection, and the duty to preserve life.</div><div>This paper provides a critical narrative and normative review of how clinical uncertainty, systemic failure, and legal interpretation influence decision-making in treatment refusal. It examines capacity, futility, and best-interests determinations within mental health and capacity law in England and Wales, with comparative reference to other high-income countries.</div><div>The review finds that unvalidated constructs such as “severe and enduring” and end-of-life framing of AN lack empirical and legal foundation. Their adoption risks normalising treatment withdrawal and assisted dying in a treatable psychiatric disorder that predominantly affects women. Ethical analysis grounded in autonomy, beneficence, non-maleficence, and justice demonstrates that autonomy should be supported rather than presumed absolute when reasoning is impaired by malnutrition or psychopathology.</div><div>The paper concludes that aligning clinical and legal practice with the Convention on the Rights of Persons with Disabilities would strengthen supported decision-making, safeguard the right to life, and promote parity between psychiatric and physical healthcare. A shift toward the prevention of avoidable deaths, rather than acceptance of inevitability, is urgently required.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"105 ","pages":"Article 102179"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617329","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}

{"title":"Ethical, clinical, and legal challenges of mental health care in prisons: between constraints and clinical integrity","authors":"Bruna Paulino Alves ,&nbsp;Mariana Pinto da Costa ,&nbsp;Thomas Pollmächer ,&nbsp;Meryam Schouler-Ocak ,&nbsp;Luis Madeira","doi":"10.1016/j.ijlp.2025.102165","DOIUrl":"10.1016/j.ijlp.2025.102165","url":null,"abstract":"<div><h3>Background</h3><div>Prison populations experience disproportionately high rates of mental disorders and suicidality, often receiving inadequate care in settings primarily designed for punishment rather than treatment. Prisons, increasingly serving as de facto psychiatric institutions, present distinct ethical, legal, and clinical challenges for mental health professionals.</div></div><div><h3>Objectives</h3><div>This paper explores the ethical dilemmas in correctional mental health care, focusing on confidentiality, the principle of equivalence of care, and the dual role of clinicians. It critically examines clinical practices such as suicide prevention, psychopharmacological treatment, management of violence, and end-of-life decisions, and offers recommendations for ethical care in prison environments.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using PubMed and major journals in psychiatry and bioethics, supplemented by policy documents from WHO, UN, and WPA. Guided by expert consultation, the thematic analysis included 97 articles and 6 book chapters. Expert feedback from the EPA ethics committee informed the final recommendations.</div></div><div><h3>Results</h3><div>Key findings highlight tensions between institutional control and therapeutic ethics, especially regarding confidentiality breaches, consent, and coercive practices. Structural factors—Overcrowding, under-resourcing, and stigmatization—Compromise the feasibility of equivalence of care. Ethical concerns intensify around suicide, substance use, neurocorrections, solitary confinement, and the death penalty.</div></div><div><h3>Conclusion</h3><div>Correctional mental health care requires ethically robust, rights-based approaches responsive to both clinical needs and institutional constraints. Implementing context-sensitive guidelines, improving training, ensuring continuity of care, and upholding patient autonomy are critical for safeguarding dignity and therapeutic integrity within prisons.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"105 ","pages":"Article 102165"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715600","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}