International Journal of Law and Psychiatry最新文献

{"title":"Examining intellectual functioning and disability in Singapore's legal landscape","authors":"Andy Z.J. Teo,&nbsp;Danielle L.J. Sng,&nbsp;Stella W.L. Tan,&nbsp;Lim Xin Xiang","doi":"10.1016/j.ijlp.2025.102137","DOIUrl":"10.1016/j.ijlp.2025.102137","url":null,"abstract":"<div><div>Individuals with intellectual disabilities constitute a significant portion of those managed within the criminal justice system. Courts are increasingly challenged with determining appropriate sentencing. Additionally, many of these individuals have complex social and medical backgrounds, necessitating a multidisciplinary approach to assess their legal and moral culpability. Consequently, these factors impact sentencing outcomes, including decisions regarding incarceration versus rehabilitation programs. This current study utilises all available court judgments involving intellectual functioning and disability recorded on LawNet (Singapore's legal database) from 1985 to 2024 to examine their relationship with sentencing considerations. Broadly, this study reviews sentencing considerations related to individuals' intellectual functioning and the legislation in place to support this population. Specifically, this study further scopes into examining the outcomes of judgments that had the offender undergo an intellectual ability assessment, and its relation to current legislative frameworks' responses to the complex process of judicial decision-making. Hence, this study examines the challenges faced in tailoring legislative frameworks to the complex nature of intellectual functioning and disability in Singapore's legal arena.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102137"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861169","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":"Restricted patients and detention in the community: The human rights implications of supervised discharge under the Mental Health Bill 2025","authors":"Ailbhe O'Loughlin ,&nbsp;Iain McKinnon","doi":"10.1016/j.ijlp.2025.102136","DOIUrl":"10.1016/j.ijlp.2025.102136","url":null,"abstract":"<div><div>This article critically analyses provisions in the Mental Health Bill 2025 that, if passed, will amend the Mental Health Act (MHA) 1983 to create a power for tribunals and the Justice Secretary to discharge restricted patients from hospital subject to conditions that deprive them of their liberty in the community. These provisions pose a threat to the human rights of patients who straddle the divide between the mental health and criminal justice systems. Furthermore, the provisions and the cases that preceded them expose the limits of policies of de-institutionalisation and official ambitions to move people with learning disabilities and autism spectrum disorder out of psychiatric hospitals and to support them to live in the community. Such seemingly progressive moves are tempered by a political drive to continue to control those who are thought to pose risks to others. As this article makes clear, detention in the community is not a lesser form of detention than detention in hospital, and it requires stringent safeguards in light of the UK's obligations under Article 5 of the European Convention on Human Rights. This article advances an alternative solution. Instead of creating a new, and complex, power that could lead to unlawful detentions in the community, suitable community-facing hospital accommodation for restricted patients subject to the same safeguards as hospital settings should be made available.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102136"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766704","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":"A template for a psychiatric advance directive: Co-development and qualitative evaluation with key stakeholders","authors":"Anne-Sophie Gaillard ,&nbsp;Jakov Gather ,&nbsp;Iris Haferkemper ,&nbsp;Jochen Vollmann ,&nbsp;Sarah Potthoff ,&nbsp;Matthé Scholten ,&nbsp;Esther Braun","doi":"10.1016/j.ijlp.2025.102135","DOIUrl":"10.1016/j.ijlp.2025.102135","url":null,"abstract":"<div><h3>Background</h3><div>Psychiatric advance directives (PADs) allow mental health service users to express their treatment preferences for future mental health crises. An accessible template for PADs can improve their implementation in practice.</div></div><div><h3>Aim</h3><div>Developing and evaluating a PAD template tailored to the German context together with key stakeholders.</div></div><div><h3>Method</h3><div>We co-developed a prototype PAD template based on a systematic review of the content of PADs and a review of existing templates in consultation with our research group's lived experience council. The prototype was evaluated in 5 focus groups with service users, relatives, mental healthcare professionals, peer support workers and legal guardians as well as 4 consultation sessions with clinical and legal experts and the research group's lived experience council. We revised the template after each feedback round.</div></div><div><h3>Results</h3><div>Participants valued the inclusion of the options to articulate personal values, preferred types of support in their recovery process, and preferred measures of supported decision-making in the template. They recommended including a summary page with the most important information in a crisis, a section for service users to describe themselves when stable or well, and the option to state preferences for post-inpatient care. There was controversy among study participants on whether the template should include individual indicators of decision-making capacity, preferences regarding treatment setting, and de-escalation strategies.</div></div><div><h3>Conclusions</h3><div>This study presents the development of the first German PAD template together with key stakeholders. The study design can be used as a model for developing templates tailored to other legal contexts.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102135"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773196","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":"Swinging the pendulum from ‘a necessary evil’ to ‘the dignity of risk’: Can new UN legislative guidance help to end psychiatric coercion?","authors":"Laura Davidson","doi":"10.1016/j.ijlp.2025.102102","DOIUrl":"10.1016/j.ijlp.2025.102102","url":null,"abstract":"<div><div>The Convention on the Rights of Persons with Disabilities (CRPD) came into force almost two decades ago. Prohibitive of disability discrimination, Article 1 includes “long-term…mental…[and] intellectual impairments”. Thus, psychiatric coercion and the detention and forced medical treatment of persons with permanent cognitive impairment are unlawful acts. Due to non-compliance with the CRPD, the World Health Organization (WHO) withdrew its legislative mental health guidance several years ago. It has since conducted lengthy consultations with stakeholders, including many with lived experience of psychosocial disability.<span><span>¹</span></span> This has led to new guidance compiled jointly with the UN Office of the High Commissioner for Human Rights (OHCHR), <em>Mental Health, Human Rights and Legislation: Guidance and Practice</em> (2023). The publication is described as a useful resource for states and decision-makers, and a “call to action” to realise the CRPD's vision of a shift from coercive care to equality and non-discrimination. It offers suggestions for legislative provisions that promote human rights and dignity in mental health systems to comply with international human rights norms and standards. Furthermore, it exhorts states to ensure that legislation recognises the “dignity of risk” for service users, which runs contrary to the current dominant biomedical model. This article considers the Guidance's take on key CRPD provisions and reflects on its logic and the legislative solutions it offers to various legal and ethical questions surrounding “hard cases”. The article also discusses some of the likely implications arising from compliance with the Guidance and the CRPD on which it is based, with particular reference to the law of England and Wales.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102102"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535739","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 Mental Health Bill 2024 in the Republic of Ireland: Potential implications for adults with intellectual disabilities","authors":"Dr Bláithín O'Shea","doi":"10.1016/j.ijlp.2025.102112","DOIUrl":"10.1016/j.ijlp.2025.102112","url":null,"abstract":"<div><div>The Mental Health Bill 2024 aims to amend provisions relating to involuntary admission, detention, and treatment of persons with ‘mental disorder’ in mental health centres in the Republic of Ireland. This article critically analyses proposals under the Mental Health Bill 2024 which are most relevant to persons with intellectual disabilities (PWID). In particular, it examines the proposals to remove “significant intellectual disability” from the definition of “mental disorder”, and to prohibit the involuntary detention of a person solely on the basis that they have an intellectual disability. It explores the reasoning behind these proposals and identifies potential gaps and challenges which may be created by the proposed reforms, including the issues which remain for PWID who have co-occurring mental illness; the possibility that PWID who exhibit challenging behaviour – but who are not accused of a crime – may be funnelled into the criminal justice system due to a lack of alternative and appropriate measures and services; and possible contradictions which may exist for persons with intellectual disabilities subject to the Criminal Law (Insanity) Act 2006.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102112"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170758","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":"Conflicting purposes: Guardianship law, mental health law and involuntary detentions","authors":"Joan Braun","doi":"10.1016/j.ijlp.2025.102111","DOIUrl":"10.1016/j.ijlp.2025.102111","url":null,"abstract":"<div><div>Part 3 of British Columbia's Adult Guardianship Act provides a statutory framework for protecting adults who are abused or neglected and unable to seek support and assistance on their own. The legislation aligns with modern approaches to guardianship with its focus on providing support to vulnerable adults. This statute's philosophy is captured in guiding principles, which affirm the presumption of capability and stipulate that support and assistance must be provided in a minimally intrusive manner. However, there is a gap between the statute's guiding principles and the legislation's application in practice. This is exemplified by using involuntary detentions as a mechanism to protect vulnerable adults from harm. Currently, British Columbia's health authorities rely on sections 22 of the Mental Health Act and 59 of the Adult Guardianship Act for authority to involuntarily detain older adults with dementia without their consent. This article argues that this practice raises serious rights concerns and that the resulting gap between the statute's philosophy and its implementation is due to inadequate procedural protections and overlap between the Adult Guardianship Act and the Mental Health Act. The article examines these issues through an analysis of the legislation, a discussion of relevant literature and judicial consideration of the issues, and identification of relevant rights concerns. Recommendations are made about how to address the gap between the intended purpose of the legislation and current practice.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102111"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255191","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":"RIGHTCARE-PR: Reporting guidelines for human rights in child and adolescent psychiatry","authors":"Elvira Pértega ,&nbsp;Christopher Holmberg","doi":"10.1016/j.ijlp.2025.102110","DOIUrl":"10.1016/j.ijlp.2025.102110","url":null,"abstract":"<div><h3>Background</h3><div>Historically, global mental health has struggled between an evidence based biomedical model and a rights-based approach focusing on user perspectives. A particularly problematic global mental health challenge is the use of restraints in psychiatry, highly regulated but controversial and risky, often deemed incompatible with human rights. Despite calls for an absolute ban, inconsistent terms, definitions, and reporting requirements complicate an accurate understanding. Effective research reporting in light of human rights is crucial for knowledge dissemination and ethical integrity.</div></div><div><h3>Aim</h3><div>This paper aims to provide reporting guidance for the neglected area of restraints in child inpatient psychiatric care, integrating scientific evidence and human rights to enhance mental health service quality.</div></div><div><h3>Methods</h3><div>This study builds upon a previous literature review by Pértega and Holmberg (2023) on child restraints in psychiatric settings that found a lack of human rights considerations in scientific literature in four domains: study context, stakeholders, restraint phenomena, and regulations. Relevance for reporting on these items were consulted through a Delphi process involving international experts from law, psychiatry, and social sciences, providing a comparative perspective on legal and psychiatric practices to refine the guidelines.</div></div><div><h3>Results</h3><div>To ensure evidence-based mental health interventions align with human rights principles, this paper proposes reporting standards that integrate human rights into research on child psychiatric care restraints. The RIGHTCARE-PR guidelines consist of 14 items across four domains, enhancing the clarity and comprehensiveness of research reporting.</div><div>These guidelines provide a robust and practical tool for researchers to improve the quality and ethical integrity of psychiatric research, benefiting authors, editors, reviewers, and readers.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102110"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170757","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":"Hoarding disorder, therapeutic jurisprudence and residential tenancy law: A complex relationship and opportunities for reform","authors":"Adam Finkelstein,&nbsp;Marie Bismark,&nbsp;Rebecca Bentley,&nbsp;Erika Martino","doi":"10.1016/j.ijlp.2025.102125","DOIUrl":"10.1016/j.ijlp.2025.102125","url":null,"abstract":"<div><div>For many, home represents comfort and security. However, for renters living with hoarding disorder, stable housing is often at risk. Hoarding disorder is a chronic mental illness associated with significant public health risks to both communities and individuals across jurisdictions. Internationally, residential tenancy laws often address hoarding using blunt legal measures at odds with the treatment needs of people living with the condition, which can negatively impact their health and wellbeing and potential recovery.</div><div>Leveraging a therapeutic jurisprudence framework to consider biopsychosocial outcomes, this paper examines residential tenancy laws in Victoria, Australia to consider how tenancy laws affect tenure security and the extent to which they hinder the promotion of health and wellbeing among renters living with hoarding disorder. A rapid review of international academic and grey literature, Victorian case-law and relevant parts of the Residential Tenancies Act 1997 (Vic) was conducted.</div><div>Analysis showed that, in the case of Victoria, the legal framework does not fully align with therapeutic jurisprudence principles, instead relying on impersonal task-centred approaches to address hoarding related issues in rental properties. Consequently, renters living with hoarding disorder are at increased risk of psychological distress, homelessness, and a reluctance to engage with supports. Recommendations with international relevance and applicability are discussed, including sector coordination and capacity building, and common avenues for legislative reform. Future research should prioritise lived experience perspectives, along with generating improved evidence through robust data collection that can inform reform in the rental sector.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102125"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270196","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 Dutch Compulsory Care Act: Possible effects on emergency involuntary admissions, treatment, and length of stay","authors":"S. Gemsa ,&nbsp;E.O. Noorthoorn ,&nbsp;P. Lepping ,&nbsp;H.A. de Haan ,&nbsp;G.J.M. Hutschemaekers","doi":"10.1016/j.ijlp.2025.102113","DOIUrl":"10.1016/j.ijlp.2025.102113","url":null,"abstract":"<div><h3>Purpose</h3><div>The Special admissions Act (1994) was replaced in 2020 by the Dutch Compulsory Care Act (2018). Whereas the former law focused mainly on involuntary treatment during an inpatient admission, the Compulsory Care Act (2018) aims to reduce involuntary care and allows involuntary care in in- and outpatient settings if unavoidable. The main aim of this study is to assess the observed impact of the change in legislation on admission duration and the use of involuntary care options with a focus on medication and seclusion during acute admissions.</div></div><div><h3>Methods</h3><div>Data were collected from a large Mental Health Trust in the east of the Netherlands. We compared health care monitoring data from the years 2016 and 2017 and 2020 and 2021. The data cover involuntary treatment and the short-term law articles warranting these in both inpatient and outpatient settings.</div></div><div><h3>Results</h3><div>In the years studied the number of patients treated involuntarily and the number of short-term involuntary emergency articles were fully comparable. Involuntary medication was used more often in 2020–2021 than in 2016–17; however, seclusion was used much less. The total duration of admissions started within a short-term emergency article decreased significantly from 96 days before the change in the law to 71 days after the law change (Effect size = 0.225, <em>p</em> = 0.012). Days of involuntary inpatient stay within a short-term emergency authorization remained the same. Inpatient involuntary medication almost doubled. Involuntary outpatient care by means of medication was mainly used during and after discharge, seldom before or without admission.</div></div><div><h3>Conclusions</h3><div>After the change in the law, compulsory care was used with similar frequency and for a similar number of patients. In this study an increase in the use of medication was associated with a significant reduction in the length of inpatient admissions. Involuntary medication was used less frequently in an outpatient than in an inpatient setting, despite being possible as a means to avoid involuntary emergency admissions.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102113"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243449","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":"A case study of forensic psychiatry experts' reports analysis through large language models","authors":"Giulia Petroni ,&nbsp;Salvatore Alaimo ,&nbsp;Gabriele Mandarelli ,&nbsp;Roberto Catanesi ,&nbsp;Cinzia Niolu ,&nbsp;Alberto Siracusano ,&nbsp;Alfredo Pulvirenti","doi":"10.1016/j.ijlp.2025.102122","DOIUrl":"10.1016/j.ijlp.2025.102122","url":null,"abstract":"<div><div>The integration of artificial intelligence (AI) technologies in forensic psychiatry has gained significant attention due to their potential to enhance tasks such as outcome prediction and decision-making. In this study, we explored the feasibility and performance of a large language model (LLM-GPT) in extracting both clinical and non-clinical variables from authentic forensic psychiatric reports concerning defendants' criminal responsibility and social dangerousness. We employed GPT-4o to extract relevant data using a set of custom queries, which we applied to two forensic psychiatric expert reports. The results of the study demonstrated that the system was capable of extracting information from the forensic psychiatric reports and generating a summarized version. Identifying the most important parts to construct a meaningful synthesis in a highly specialized application domain is currently a challenge. This study highlights the potential of AI in forensic psychiatry and suggests that this approach could be valuable for collecting semi-automated or automated data from reports, enabling the creation of a large dataset that could be used for further research and analysis.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102122"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279230","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}