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Lawyers' Attitudes Toward Involuntary Treatment

Daniel J. Luchins, Amy E. Cooper, Patricia Hanrahan and Mark J. Heyrman
Journal of the American Academy of Psychiatry and the Law Online December 2006, 34 (4) 492-500;
Daniel J. Luchins
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Amy E. Cooper
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Patricia Hanrahan
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Mark J. Heyrman
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    Figure 1.

    Vignette recommendations for involuntary hospitalization (N = 84). Scale on the y‐axis: involuntary hospitalization: 1, not at all appropriate, to 7, absolutely essential.

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    Table 1

    Recommendations for Involuntary Hospitalization in Scenerios Depicting Escalating Risk of Harm to Self or Others*

    Vignette DiagnosisNot Yet Begun to DeteriorateShowing Deficits, No HarmEndangerment, but No HarmImminent Risk of Harm
    MeanSDMeanSDMeanSDMeanSD
    State's attorneys (n = 40)1.71.32.71.34.61.66.31.0
    Other publicly funded lawyers' average(n = 23)1.10.31.71.02.91.54.61.8
    Privately funded lawyers' average(n = 18)1.10.32.71.74.12.35.21.9
    All respondents' average recommendationfor both vignettes† (N = 84)‡1.51.02.21.23.81.55.71.4
    • * Scale, involuntary hospitalization: 1, not at all appropriate, to 7, absolutely essential.

    • † ANOVA for level of risk of harm: F = 179.6, df = 3, p < .001.

    • ‡ Note: The number for all respondents is greater than those in the preceding subgroups listed according to self identification, as state's attorneys, etc., due to missing data from four persons who did not answer the self‐identification question.

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    Table 2

    Persons Responsible for Onset and Recurrences of Mental Illness

    OnsetRecurrence
    MeanSDnMeanSDn
    State's attorneys20%213140%2931
    Publicly funded lawyers (not state's attorneys)8%172023%2117
    Privately funded lawyers14%191525%2517
    All respondents*15%206731%2766
    • Data show responses to the question, “On average, what percent of people with mental illness is responsible for the illness' onset and recurrence?”

    • * Note: The number for all respondents is greater than those in the preceding subgroups listed according to self identification, as state's attorneys, etc., due to missing data from four persons who did not answer the self‐identification question.

    • View popup
    Table 3

    Influences on Recommending Hospitalization

    MeanSDRegression(Standardized β)t
    Lawyers obliged to respect client's interests, even if harmful†2.6.94−.45−4.2***
    Clients responsible for recurrence of mental illness (%)31.4%27.0%.323.0**
    Lawyers obliged to encourage treatment†3.3.84.211.9*
    Age (y)4910.7−.20−1.9*
    Cannot predict future, must wait for harm‡3.11.7−.20−1.9*
    • Regression, F = 16.2, df = 2, p < .001, adjusted R2 = 0.34.

    • * p < .10,

    • ** p < .01,

    • *** p < .001.

    • † Scale: 1, strongly disagree, to 4, strongly agree.

    • ‡ Scale: 1, played no role in judgment about involuntary hospitalization, to 7, played significant role.

    • View popup
    Table 4

    Vignette Involuntary Medication Recommendations

    MeanSD
    State's attorneys (n = 39)5.61.4
    Publicly funded lawyers (n = 24)4.02.1
    Privately funded lawyers (n = 18)5.41.9
    All respondents (N = 83)*5.21.8
    • Scale: 1, involuntary medication not at all appropriate, to 7, involuntary medication absolutely essential.

    • * Note: The number for all respondents is greater than those in the preceding subgroups listed according to self identification, as state's attorneys, etc., due to missing data from four persons who did not answer the self‐identification question.

    • View popup
    Table 5

    Influences on Recommending Involuntary Medication

    MeanSDRegression(Standardized β)t
    Psychiatrists cannot predict future, must wait for harm†3.11.7−.30−2.8**
    Dummy variable: publicly funded lawyer——−.25−2.3*
    Lawyers obliged to encourage treatment‡3.3.84.232.1*
    • Regression, F = 9.7, df = 3, p < .001, adjusted R2 = 0.28.

    • * p < .05,

    • ** p < .01.

    • † Scale: 1, played no role in judgment about involuntary hospitalization, to 7, played significant role.

    • ‡ Scale: 1, strongly disagree, to 4, strongly agree.

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Journal of the American Academy of Psychiatry and the Law Online: 34 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 34, Issue 4
December 2006
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Lawyers' Attitudes Toward Involuntary Treatment
Daniel J. Luchins, Amy E. Cooper, Patricia Hanrahan, Mark J. Heyrman
Journal of the American Academy of Psychiatry and the Law Online Dec 2006, 34 (4) 492-500;

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Lawyers' Attitudes Toward Involuntary Treatment
Daniel J. Luchins, Amy E. Cooper, Patricia Hanrahan, Mark J. Heyrman
Journal of the American Academy of Psychiatry and the Law Online Dec 2006, 34 (4) 492-500;
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