A Review of the Role of Chronic Traumatic Encephalopathy in Criminal Court.

Chronic traumatic encephalopathy (CTE) is believed to be a degenerative brain disease characterized by repetitive brain trauma resulting in a specific pattern of neuropathological changes, which some have linked to functional disturbance and aggression. The diagnosis has gained greater public attention after these same neuropathological changes were discovered in multiple deceased National Football League (NFL) players, many of whom had exhibited signs of aggression, impulsivity, and poor executive functioning, according to a widely publicized study. When an NFL player convicted of murder was found to have the neuropathological changes associated with CTE following his suicide, the New York Times editorial section asked whether CTE was a defense for murder. This idea raises an interesting legal and philosophical question about whether an individual's criminal actions can be determined by something outside their control, such as past head trauma. To begin to attempt an answer, this article reviews what is currently known about the neurobiology of traumatic brain injury, CTE, and morality. By looking at how U.S. criminal law courts have handled cases of dementia and traumatic brain injury in the past, we can better understand how to consider this postmortem diagnosis in its forensic context.

Individualizing justice after Atkins.

On August 6, 2005, newspapers and other media outlets reported that Daryl Atkins had been determined by a Virginia jury not to be retarded and therefore was mentally competent to receive the death penalty. A judge immediately scheduled his execution for December. Atkins, of course, is the convicted murderer whose case three years earlier had led the U.S. Supreme Court, in a landmark ruling, to declare that mentally retarded offenders are constitutionally exempt from the death penalty. While a bitter irony for Atkins, his family, and supporters, the Virginia jury's finding suggests that the practical effects of the Supreme Court's decision are less dramatic than many had anticipated. It shows that mere labels need not be determinative and that judges and juries as well as mental health experts called to assist them in capital cases can continue to work toward an individualized brand of justice.

Competency to stand trial: rationalism, "contextualism" and other modest theories.

Determinations of competency to stand trial in criminal cases are complicated and rendered unpredictable by two sub-surface issues that are rarely articulated: (i) the place of the defendant's rationality in the substantive standard(s) for competency and (ii) the level or degree of incompetency required to stop the criminal process. The rare references to these issues, mostly indirect, that are made in the cases, commentary, and competency testing instruments devised (including those civil as well as criminal) are examined. The conclusion that emerges is that the level of capacity and rationality required of the defendant depends much on context-the type of case, its relative complexity, and the values and stakes implicated in the outcome.

Violence in the workplace: new perspectives in forensic mental health services in the USA.

BACKGROUND: This paper reviews current research on workplace violence in the USA and offers suggestions concerning the roles that mental health professionals with forensic expertise can play in this expanding field. AIMS: To clarify the role of the mental health professional in evaluating issues related to workplace violence. METHOD: Manual and computer literature searches were performed. RESULTS: The incidence of reported workplace violence is on the rise and can be devastating beyond the immediate injury. Forensically oriented mental health professionals can assist companies by providing pre-employment screenings, fitness-for-duty evaluations and threat assessment by using the results of current research on potentially violent individuals. CONCLUSIONS: With the growing interest in workplace violence come many opportunities for mental health professionals to assist companies in assessment, intervention and prevention.

Legal liability and workplace violence.

Workplace violence is a growing social problem. Some of this growth may be perceptual, reflecting our new awareness of what constitutes violence in the workplace. Furthermore, much of what falls under its current rubric does not correspond to the classic image of worker-on-worker or worker-on-employer mayhem. Nevertheless, the total number of incidents is alarmingly large; the problem is real. It is natural to consider law (i.e., legal liability) as a potential solution. Aiming the liability threat at the employer may be the most effective and efficient strategy. There are ample theories to choose from: negligence (tort) law, agency law, contract, civil rights, and regulatory law. Judges and juries appear eager to hold employers accountable for violent incidents in the workplace, sometimes in the face of other, more logical constructions of the facts or theory. One's best hope is that the fear this strikes in the hearts of employers will make for maximum preventive results.

Crime, psychiatry and the insanity defence: a report on some recent reforms in the United States.

There have been substantial developments in mental health law in the United States over the last 10-15 years. Once focal point has been the insanity defence, discussed here. The operational consequences of the legal changes remain to be assessed empirically, but informed speculation is possible. Both a description of the reforms and the assessment of their potential effect are relevant to members of the psychiatric profession in Australia, whether they be forensic specialists or traditional practitioners or researchers. Selective consideration of the American experience, as opposed to contemplating Wholesale transposition, is the appropriate posture for Australian policymakers.

Threats to Secret Service protectees: guidelines on the mental health services provider's duty to report.

This article presents a set of proposed guidelines for mental health care providers faced with the not uncommon problem of having a patient under treatment who makes statements that can be interpreted as threatening the life of the President of the United States or another protectee of the Secret Service. What is the provider's duty in this situation? When should such a "threat" be reported? What should be reported? And to whom? The questions are difficult ones that confront both the dictates of the federal presidential threat statute and the general duty-to-warn law of the state where the provider resides and practices. Professional ethics and common sense must, of course, also figure in the calculus of the proper course of action. This article begins with a brief history of the Secret Service, its formal responsibilities, as well as its evolving contacts with the mental health community, driven by the Service's own recognition of the need for mental health expertise in evaluating the intentions and capacities of those who issue presidential threats. Next, this article presents the guidelines themselves, followed by commentary that sets out their legal, ethical, and pragmatic underpinnings.