International Journal of Law and Psychiatry最新文献

{"title":"Psychiatrists’ engagement with advance statement in Victoria, Australia","authors":"Paige Lerman ,&nbsp;Penelope Weller ,&nbsp;Frances Shawyer ,&nbsp;Lisa Brophy ,&nbsp;Bridget Hamilton ,&nbsp;Chris Maylea ,&nbsp;Elisabeth Wilson-Evered ,&nbsp;Graham Meadows ,&nbsp;Ellie Fossey","doi":"10.1016/j.ijlp.2025.102144","DOIUrl":"10.1016/j.ijlp.2025.102144","url":null,"abstract":"<div><div>Psychiatric advance directives have been a prominent theme in mental health system reform. This study aimed to investigate psychiatrists' attitudes towards advance statements following their introduction in the <span><span>Mental Health Act 2014</span></span> in Victoria, Australia (<em>Mental Health Act 2014 (Vic)</em> ss 19–22). Advance statements are non-binding legal documents that permit mental health consumers to outline their treatment preferences, should they become subject to compulsory treatment. The mixed methods design involved psychiatrists completing an online survey based on a clinical vignette (<em>n</em> = 18) followed by in-depth interviews (<em>n</em> = 4). Results showed that psychiatrists viewed insufficient support from their institutions and peers as primary barriers to the effective use of advance statements, suggesting the need for deliberate implementation strategies to ensure psychiatrists make reasonable efforts to give effect to advance statements.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102144"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103018","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":"Symptoms of mental health difficulties in police cell detainees in Iceland: Is it an appropriate place of safety for patients? A mixed methods study","authors":"Rannveig Íva Aspardóttir,&nbsp;Hannah Jones,&nbsp;Alan Underwood,&nbsp;Jennifer Hopton,&nbsp;Georgina Mathlin","doi":"10.1016/j.ijlp.2025.102143","DOIUrl":"10.1016/j.ijlp.2025.102143","url":null,"abstract":"<div><div>Individuals with mental health difficulties in Iceland can be detained in police cells as a last resource place of safety when psychiatrists consider patients unsuitable for admission to a ward, for example, due to being under the influence of substances or being too violent. We aimed to investigate if detainment in a police cell affected symptoms of mental illnesses, and subsequently if police cells are an appropriate place of safety for patients in Iceland. We used a mixed methods approach utilising administrative records of detainees' visible symptoms of mental illnesses and ten semi-structured interviews with mental health professionals and police sergeants. Unpublished secondary data from the Reykjavik Metropolitan Police of detainees (<em>n</em> = 6874) and exceptional incidents in police cells from the 1st of January 2018 to the 18th of August 2022 was analysed. 72.1 % of all suicide attempts and 77.3 % of all self-harming behaviour took place in the initial four hours of detainment. Three themes generated from the interviews with professionals: 1) violent behaviour as a determining factor in using police cells as a place of safety, 2) the detrimental impact of detainment in police cells on mental health, and 3) the lack of support and resources for professionals to appropriately care for individuals with mental health difficulties. The study highlights police cells are not currently suitable places of safety in Iceland. New laws and regulations in Iceland should be developed to support police and mental health professionals to adequately provide safety for individuals with mental health difficulties.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011220","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":"Observations and perspectives of peer professionals involved in civil commitment rulings for individuals with mental illnesses in South Korea","authors":"Hyunsung Oh ,&nbsp;Sohyun Woo ,&nbsp;Soyoun Shin ,&nbsp;Lynn C. Holley ,&nbsp;Michael Shafer ,&nbsp;Heeseung Choi","doi":"10.1016/j.ijlp.2025.102161","DOIUrl":"10.1016/j.ijlp.2025.102161","url":null,"abstract":"<div><h3>Background</h3><div>Following the 2016 South Korean statutory revision that governs psychiatric civil commitment, five regional Admission Suitability Review Boards (ASRBs) were established in 2017. These mental health tribunals were designed to provide public oversight of involuntary hospitalization of people diagnosed with mental illnesses. Most ASRBs are composed of psychiatrists or non-peer mental health professionals. Handful of ASRBs also invited peer professionals—individuals with lived experience of mental illness in recovery—to their civil commitment rulings for deliberation. This study describes observations and perspectives of those peer professionals who served on ASRBs, including their recommendations for improving the processes and outcomes of ASRB hearings.</div></div><div><h3>Methods</h3><div>Nine peer professionals who have served on ASRBs since 2017 participated in semi-structured individual interviews. Seven were currently practicing peer support services outside the ASRB. Virtual interviews, conducted from October 2023 to November 2023 ranged from 31 to 98 min (M = 72 min). We identified themes and codes through reiterative thematic analysis of verbatim transcripts.</div></div><div><h3>Findings</h3><div>Four themes emerged from participant narratives. Peer professionals reported mental illness prejudice and discrimination during ASRB hearings, described structural hurdles and barriers embedded in the statute that authorized ASRBs, offered areas for improving ASRB processes, and described mutual growth of peer professionals and their non-peer board member colleagues that can occur when peer professionals participate in ASRB hearings.</div></div><div><h3>Conclusion</h3><div>Peer professionals play critical roles in ASRBs, which are mandated to ensure fairness for individuals petitioned for civil commitment. By Bridging the gap between petitioned individuals and non-peer colleagues, peer professionals enrich the deliberation process with knowledge and perspectives gained from their own lived experiences. Efforts to enhance procedural justice of ASRBs include clarifying and strengthening ASRB policies and procedures, as well as providing training and technical assistance. These effort should ensure that the voices of petitioned individuals and other stakeholders are heard through ASRB deliberation.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102161"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472183","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":"Decision-making capacity law developments in Aotearoa New Zealand","authors":"Kate Diesfeld ,&nbsp;Greg Young","doi":"10.1016/j.ijlp.2025.102140","DOIUrl":"10.1016/j.ijlp.2025.102140","url":null,"abstract":"<div><div>New Zealand, as well as other jurisdictions, are revisiting their decision-making capacity law regimes. Currently several strands of New Zealand capacity law are under review. Reforms could impact many people across many domains of decision-making. Focussing on adult decision-making, we describe features of New Zealand's approach to decision-making capacity law that resemble other jurisdictions. We then summarise unique features of New Zealand law and explain the urgency of reform, in light of our obligations under the United Nations Convention on the Rights of Persons with Disabilities, research funded by the Human Rights Commission and the findings of New Zealand's Royal Commission of Inquiry Abuse in Care. Analysis of New Zealand's capacity law is timely, given the current review of the two key statutes governing adult decision-making and mental health legislation.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102140"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020698","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":"Replacing the medical member of the first-tier Tribunal (Mental health) with a clinical member for tribunal applications and references made under the Mental Health Act 1983 (England and Wales)","authors":"Carole Burrell,&nbsp;John L. Taylor","doi":"10.1016/j.ijlp.2025.102159","DOIUrl":"10.1016/j.ijlp.2025.102159","url":null,"abstract":"<div><div>The First-tier Tribunal (Mental Health) was established in 2008 to deal with applications and references concerning people subject to the powers of the England and Wales Mental Health Act 1983. Substantive decisions in tribunal proceedings are made by a panel consisting of a legally qualified judge, a specialist member and a medical member. Applicants to the post of medical member must meet statutory and nonstatutory eligibility requirements including holding a consultant psychiatrist post for at least three years. In this paper, comparisons with other common law jurisdictions are drawn and it is argued that the medical member role in this tribunal is outdated and should be replaced by a newly established ‘clinical member’ role. Eligibility should be based on competence and skills rather than professional qualifications. The post would be open to consultant level mental health practitioners from multiprofessional backgrounds who demonstrate they are capable of meeting the specialist needs of the tribunal. Broadening the range of professionals eligible to be appointed to the clinical member post will help alleviate longstanding difficulties in medical member recruitment; will assist with tribunal efficiency; is in keeping with the extended roles introduced by the Mental Health Act 2007; and will encourage diversity in the range of persons available for selection for appointment.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102159"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349330","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":"Blurred boundaries: Community treatment orders as instruments of racial surveillance","authors":"Chioma Dibia,&nbsp;Agomoni Ganguli-Mitra","doi":"10.1016/j.ijlp.2025.102141","DOIUrl":"10.1016/j.ijlp.2025.102141","url":null,"abstract":"<div><div>The Mental Health Act 1983 (MHA) authorizes the compulsory detention and treatment of people with mental disorders who are perceived to pose a risk to themselves or to others. Since its enactment, there have been concerns that the coercive powers of the Act have been disproportionately used for Black people with mental disorders. This disproportionate impact of the MHA on Black people is most clearly seen in the excessive use of Community Treatment Orders (CTOs). Although there is limited evidence on the effectiveness of CTOs, they continue to be used increasingly in the care of Black people, with latest data showing that Black people are over seven times more likely to be issued CTOs than White people (National Health Service Digital, 2024). This is particularly concerning as CTOs are commonly perceived as intrusive and have been described as a form of racial surveillance. In this paper, we explore the idea of CTOs as instruments of racial surveillance and argue that their continued use in the care of Black people with mental disorders is an extension of the intrusive powers of the State and might constitute a form of racial injustice.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011222","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":"Validity and reliability of Mexican version of MacArthur competence assessment tool for treatment decision (MacCAT-T) in patients with schizophrenia","authors":"Ana Fresán ,&nbsp;Ricardo-Arturo Saracco-Alvarez ,&nbsp;J. Mónica Arienti-González ,&nbsp;Rebeca Robles-García ,&nbsp;Carlos-Alfonso Tovila-Zárate ,&nbsp;J. Nicolás I. Martínez-López","doi":"10.1016/j.ijlp.2025.102153","DOIUrl":"10.1016/j.ijlp.2025.102153","url":null,"abstract":"<div><h3>Background</h3><div>The MacArthur Competence Assessment Tool for Treatment (MacCAT-T), a semi-structured interview, is designed to evaluate patient decision-making capacity, a crucial aspect of patient-physician interaction.</div></div><div><h3>Methods</h3><div>A process study was undertaken of a sample of Mexicans diagnosed with schizophrenia aged between 18 and 50 years to determine the validity and reliability of the MacCAT-T in this population. A ROC curve was plotted to obtain discriminant validity, convergent validity was tested with the VAGUS scale and internal consistency was obtained as a measure of reliability.</div></div><div><h3>Results</h3><div>Adequate sensitivity (0.95) and specificity (0.75) were obtained with a cut-off point of seven. Significant correlations were observed between the MacCAT-T and the VAGUS scales (<em>r</em> = 0.54 and <em>r</em> = 0.76, <em>p</em> &lt; 0.05), indicative of adequate convergent validity. Internal consistency values were 0.93 for the total score and over 0.80 for all its dimensions.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the MacCAT-T is a valid, reliable tool that can be used to assess decision-making capacity in Mexican patients with schizophrenia, which could have a heuristic value for promoting ethical clinical and research practices designed to achieve the crucial balance between patient autonomy and safeguarding.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102153"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110033","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":"Personality disorder, mental capacity and compulsory intervention","authors":"Gavin Davidson ,&nbsp;Steph Kerr ,&nbsp;Iain McDougall ,&nbsp;Claire McCartan ,&nbsp;Patrick Hann ,&nbsp;Emily Stirling","doi":"10.1016/j.ijlp.2025.102127","DOIUrl":"10.1016/j.ijlp.2025.102127","url":null,"abstract":"<div><div>In Northern Ireland, the current main legal framework for compulsory intervention is the Mental Health (Northern Ireland) Order 1986. It is a traditional mental health law which enables detention in hospital if mental disorder and risk criteria are met. However, under Article 3(2), it states that people should not be detained “by reason only of personality disorder”. There has been a process of law reform in Northern Ireland to create a non-discriminatory, comprehensive legal framework for all. This resulted in the Mental Capacity Act (Northern Ireland) 2016. The Act, when fully implemented, will replace the Order for everyone aged 16 and over, which is in contrast to most other countries where there are both mental health and mental capacity laws. Under the new Act there are no specific exclusions so, if a person is unable to make the relevant decision, including if the cause of impairment relates to issues associated with personality disorder, then compulsory intervention is allowed as long as the proposed intervention is in the person's ‘best interests’. The Act was partially implemented in 2019 and currently is only used when the Order does not apply. This article explores: the development of this new legal framework; the implementation of the Act; and some of the ongoing debates, and practice complexities, related to services for people with a diagnosis of personality disorder.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102127"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679708","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":"The practical goals of inpatient forensic mental health services in Sweden – A qualitative comparative analysis of met and unmet rehabilitative needs in the transition to outpatient care","authors":"S.H. Pedersen ,&nbsp;F. Lindström ,&nbsp;J. Nyman ,&nbsp;A.G. Crocker ,&nbsp;L. Eriksson ,&nbsp;T. Nilsson","doi":"10.1016/j.ijlp.2025.102138","DOIUrl":"10.1016/j.ijlp.2025.102138","url":null,"abstract":"<div><div>Forensic mental health services (FMHS) seek to alleviate mental illness and reduce the risk of (violent) recidivism, but they may also be understood to be responsible for supporting patients with many other aspects of their often challenging lives. In practice, the task of an inpatient institution such as FMHS is concluded when the patient can transition to outpatient care, a move which is governed by law. Therefore, the practical goals are at least partly set by legal criteria for transition to outpatient care. Using qualitative comparative analysis, this study identifies systematic patterns of rehabilitative needs as assessed by clinicians that differentiate between FMHS patients who are deemed ready for outpatient care and those who are not. It also identifies how such systematic patterns align with legal criteria governing the transition to outpatient care. We find systematic patterns of rehabilitative needs that are associated with being considered ready for outpatient care and that these patterns map meaningfully onto the legislative criteria for forensic psychiatric care in Sweden. Mental health needs, violence risk needs, and needs associated with social functioning all bear on readiness for outpatient care but only in conjunction with one of the other. The results indicate that the transition to forensic outpatient care in Sweden depends on aspects outside the core objectives of non-recidivism and mental health, and rest on efforts by actors external to FMHS. This places high demands on clarity of institutional boundaries and the role of social functioning needs in decisions about compulsory care.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102138"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756803","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":"Psychopathy, neuroscience, and critical issues: A legal primer","authors":"Luke Danagher","doi":"10.1016/j.ijlp.2025.102139","DOIUrl":"10.1016/j.ijlp.2025.102139","url":null,"abstract":"<div><div>Psychopathy occupies a pivotal yet unsettled position at the intersection of neuroscience, business ethics, and criminal jurisprudence. Despite rapid scientific advances, core uncertainties remain. This article examines five issues of immediate legal relevance: (1) the contested neurobiological basis of psychopathy; (2) reproducibility concerns linked to the broader replication crisis in psychological and neuroscientific research; (3) limitations of leading assessment instruments (e.g., PCL-R), and the risks of reifying cut-off scores; (4) accumulating evidence favouring a dimensional understanding of psychopathy- an approach which sits uneasily alongside law's often binary demands; and (5) the construct's extension into non-forensic domains, illustrated by workplace psychopathy, which raises questions about conceptual expansion beyond its clinical and correctional roots. In synthesising these literatures, the article offers guidance for courts and legal practitioners in applying current science cautiously, transparently, and accurately.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102139"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889514","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}