Pub Date : 2025-09-09DOI: 10.1016/j.ijlp.2025.102140
Kate Diesfeld , Greg Young
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.
{"title":"Decision-making capacity law developments in Aotearoa New Zealand","authors":"Kate Diesfeld , 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":"2025-09-09","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}
Pub Date : 2025-09-09DOI: 10.1016/j.ijlp.2025.102141
Chioma Dibia, Agomoni Ganguli-Mitra
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.
1983年《精神卫生法》授权对被认为对自己或他人构成危险的精神失常患者进行强制拘留和治疗。自该法案颁布以来，人们一直担心该法案的强制性权力被不成比例地用于患有精神障碍的黑人。MHA对黑人不成比例的影响最明显地体现在过度使用社区治疗令（CTOs）上。尽管关于cto有效性的证据有限，但它们继续越来越多地用于黑人的护理，最新数据显示，黑人获得cto的可能性是白人的7倍以上（National Health Service Digital, 2024）。这一点尤其令人担忧，因为首席技术官通常被认为具有侵入性，并被描述为一种种族监视形式。在本文中，我们探讨了cto作为种族监视工具的想法，并认为他们继续用于照顾患有精神障碍的黑人是国家侵入性权力的延伸，可能构成种族不公正的一种形式。
{"title":"Blurred boundaries: Community treatment orders as instruments of racial surveillance","authors":"Chioma Dibia, 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":"2025-09-09","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}
Pub Date : 2025-09-08DOI: 10.1016/j.ijlp.2025.102142
Andrew Stickley , Roman Koposov , Johan Isaksson , Tomiki Sumiyoshi , Oleg A. Ponomarev , Vladislav Ruchkin
In many countries little is known about the attitudes and ethical beliefs of practicing psychiatrists towards the use of coercive practices. This is true as regards Russia where coercion was used for political purposes during the Soviet period. However, substantial changes have occurred in the psychiatric system in recent decades with a focus on patients' rights and the idea of consent. This study aimed to investigate the beliefs and attitudes of Russian psychiatrists towards coercive treatment practices in situations of clinical decision making. Data were obtained from 93 (81 % of all practicing) psychiatrists in the Arkhangelsk region in northwestern Russia. The psychiatrists completed three case vignettes to obtain information regarding the use of coercive treatment practices in different clinical situations, and responded to an ethical attitudes inventory. The psychiatrists' decisions regarding coercive treatment, and the extent of information provided to the patients and their relatives were impacted by the severity and risks (violence, suicidality) associated with the patient's disorder. In most instances psychiatrists were not responsive to pressure from the patient's family or other hospital personnel. Very few gender differences in attitudes and practices were found. Psychiatrists generally reported that they encountered different situations with abusive practices primarily in the past. This study suggests that the factors associated with the use of coercive treatment practices by Russian psychiatrists may mirror those in other countries. Further research should elucidate the actual extent to which coercive practices are used in Russian psychiatry and delineate the factors associated with their actual use.
{"title":"Attitudes and ethical beliefs of Russian psychiatrists towards the use of coercive treatment practices","authors":"Andrew Stickley , Roman Koposov , Johan Isaksson , Tomiki Sumiyoshi , Oleg A. Ponomarev , Vladislav Ruchkin","doi":"10.1016/j.ijlp.2025.102142","DOIUrl":"10.1016/j.ijlp.2025.102142","url":null,"abstract":"<div><div>In many countries little is known about the attitudes and ethical beliefs of practicing psychiatrists towards the use of coercive practices. This is true as regards Russia where coercion was used for political purposes during the Soviet period. However, substantial changes have occurred in the psychiatric system in recent decades with a focus on patients' rights and the idea of consent. This study aimed to investigate the beliefs and attitudes of Russian psychiatrists towards coercive treatment practices in situations of clinical decision making. Data were obtained from 93 (81 % of all practicing) psychiatrists in the Arkhangelsk region in northwestern Russia. The psychiatrists completed three case vignettes to obtain information regarding the use of coercive treatment practices in different clinical situations, and responded to an ethical attitudes inventory. The psychiatrists' decisions regarding coercive treatment, and the extent of information provided to the patients and their relatives were impacted by the severity and risks (violence, suicidality) associated with the patient's disorder. In most instances psychiatrists were not responsive to pressure from the patient's family or other hospital personnel. Very few gender differences in attitudes and practices were found. Psychiatrists generally reported that they encountered different situations with abusive practices primarily in the past. This study suggests that the factors associated with the use of coercive treatment practices by Russian psychiatrists may mirror those in other countries. Further research should elucidate the actual extent to which coercive practices are used in Russian psychiatry and delineate the factors associated with their actual use.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102142"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011221","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}
Pub Date : 2025-08-23DOI: 10.1016/j.ijlp.2025.102139
Luke Danagher
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.
{"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":"2025-08-23","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}
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.
{"title":"Examining intellectual functioning and disability in Singapore's legal landscape","authors":"Andy Z.J. Teo, Danielle L.J. Sng, Stella W.L. Tan, 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":"2025-08-18","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}
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.
Aim
Developing and evaluating a PAD template tailored to the German context together with key stakeholders.
Method
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.
Results
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.
Conclusions
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.
{"title":"A template for a psychiatric advance directive: Co-development and qualitative evaluation with key stakeholders","authors":"Anne-Sophie Gaillard , Jakov Gather , Iris Haferkemper , Jochen Vollmann , Sarah Potthoff , Matthé Scholten , 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":"2025-08-05","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}
Pub Date : 2025-08-04DOI: 10.1016/j.ijlp.2025.102136
Ailbhe O'Loughlin , Iain McKinnon
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.
{"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 , 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":"2025-08-04","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}
Pub Date : 2025-08-02DOI: 10.1016/j.ijlp.2025.102138
S.H. Pedersen , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , T. Nilsson
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.
{"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 , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , 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":"2025-08-02","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}
Pub Date : 2025-07-21DOI: 10.1016/j.ijlp.2025.102127
Gavin Davidson , Steph Kerr , Iain McDougall , Claire McCartan , Patrick Hann , Emily Stirling
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.
{"title":"Personality disorder, mental capacity and compulsory intervention","authors":"Gavin Davidson , Steph Kerr , Iain McDougall , Claire McCartan , Patrick Hann , 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":"2025-07-21","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}
Pub Date : 2025-07-16DOI: 10.1016/j.ijlp.2025.102126
Mia A. Thomaidou, Colleen M. Berryessa, Sandy S. Xie
In contemporary criminal justice systems, the integration of neuroscience evidence into legal proceedings poses complex challenges as well as opportunities. This study investigates how judges–shaped by their beliefs and personal characteristics–approach sentencing decision-making in light of scientific explanations of behavior or psychiatric diagnoses. Specifically, it addresses two research questions: (1) How do scientific explanations of behavior influence how judges assess responsibility? (2) What cognitive biases or misconceptions may affect their interpretations of such evidence? We utilized a mixed-methods approach, including Natural Language Processing techniques and qualitative analysis, to analyze data from semi-structured interviews with 34 U.S. criminal court judges. Sentiment analysis revealed differences in emotional tone between judges with varying degrees of belief in scientific determinism and based on gender, age, geographical region, and professional background. Structural Topic Modeling identified key considerations, including determinism, responsibility, treatment needs, and moral concerns. Qualitative analysis enriched these results by unraveling the philosophical and legal considerations that judges grapple with when considering scientific explanations for defendants' behavior. Findings underscore the nuanced interplay between scientific understandings of behavior, personal beliefs, and judicial decision-making.
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