<p> Attorneys in the United States suffer from higher-than-average rates of depression, substance abuse, and suicidal ideation. Although these facts are widely accepted, at the time of the study, there was no consensus in the legal or research communities as to the cause of these alarming statistics. The combination of behavioral and psychological distress experienced by attorneys may suggest that burnout is a contributing factor. This study examined the relationship between workplace stressors and professional burnout. The literature review summarized recent and landmark studies in the field, as well as explored characteristics unique to the legal profession that were putting attorneys at risk. In an effort to understand the best practices that reduced instances of burnout in practicing attorneys, the phenomenological study asked participants about their experiences as an attorney, as well as the practices they employed to mitigate professional stress. The research findings supported the literature review and resulted in important implications for law firms, bar associations, law schools, and practitioners.</p><p>

This thesis identifies and analyzes the legal barriers faced by ethno-racial psychiatric consumer/survivors in Ontario, through an analysis of the Consent and Capacity Board (CCB). I employ interdisciplinary research to test the hypothesis that factors such as race, ethnicity, culture, poverty and social exclusion are not fully addressed by the CCB. To critique the CCB, I developed a theoretical framework using the grounded theory approach, in combination with tenets of disability theory, critical race theory and intersectionality. I used the theoretical framework to analyze qualitative research involving twenty interviews of stakeholders including lawyers, psychiatrists, CCB adjudicators, mental health service providers and ethno-racial psychiatric consumer/survivors. The analysis revealed the procedural, systemic/structural and discretionary barriers within the CCB’s pre-hearing, hearing and post-hearing process. Barriers were the result of cultural misunderstandings, misdiagnosis, complex familial relationships, culturally inappropriate care, institutional racism, poverty, discrimination and the CCB’s “color blind approach.” I conclude with prioritized recommendations.

This thesis identifies and analyzes the legal barriers faced by ethno-racial psychiatric consumer/survivors in Ontario, through an analysis of the Consent and Capacity Board (CCB). I employ interdisciplinary research to test the hypothesis that factors such as race, ethnicity, culture, poverty and social exclusion are not fully addressed by the CCB. To critique the CCB, I developed a theoretical framework using the grounded theory approach, in combination with tenets of disability theory, critical race theory and intersectionality. I used the theoretical framework to analyze qualitative research involving twenty interviews of stakeholders including lawyers, psychiatrists, CCB adjudicators, mental health service providers and ethno-racial psychiatric consumer/survivors. The analysis revealed the procedural, systemic/structural and discretionary barriers within the CCB’s pre-hearing, hearing and post-hearing process. Barriers were the result of cultural misunderstandings, misdiagnosis, complex familial relationships, culturally inappropriate care, institutional racism, poverty, discrimination and the CCB’s “color blind approach.” I conclude with prioritized recommendations.

This thesis argues that current treatment in acute public mental health services is counterproductive for the wellbeing of those subject to such services. The consumer/survivor movement activism against the coercive nature of treatment is analysed according to new social movement theory. According to social theorists such as Alaine Touraine, new social movements are characterised by a struggle over identity. Consistent with this theme, what is identified in this thesis as central to the consumer/survivor movement objection to the nature of treatment in acute public mental health services, is the failure of services to respect patient identity as persons. What might account for this failure is analysed in this thesis through an examination of the question of the conceptualisation of the subject in the theory and concepts of psychiatry, in the practice of psychiatry, in mental health law and in government policy. / As a counterposition to the above perspectives, the work of RD Laing, Charles Taylor and Paul Ricoeur are considered in an attempt to develop a conceptualisation of the subject grounded in a historical narrative. Further, Emmanuel Levinas’ and Axel Honneth’s work is drawn on to identify the practical implications of Honneth’s claim for a politics of recognition, which also supports the consumer/survivor movement demand for recognition as subjects in mental health services.

Among the features that distinguish British Columbia’s mental health laws from those in other provinces in Canada is that they accord a high level of discretion to psychiatrists to impose involuntary treatment on patients who have the mental capacity to withhold consent to this treatment. In this research I examine the nature of the medico-legal regime in British Columbia that permits this coercive treatment, describe how it came into existence, and explore how it works in the lives of specific patients. Michel Foucault’s philosophy informs the historical, theoretical, and empirical dimensions of this research and provides a framework for a normative critique of British Columbia’s mental health law regime. In establishing the background to British Columbia’s current mental health laws, I give a historical account of the social forces that produced this province’s laws, which reflect a strong orientation toward neurobiological psychiatric ways of understanding and treating people diagnosed as having mental disorders. Foucault’s writings on governmentality, discourse and human agency provide the theoretical basis in this research for understanding the operation of psychiatric power in British Columbia. These writings also inform the methodology for the analysis of institutional discourse, which I use in the empirical component of this research. In order to conduct an empirical investigation of this British Columbia’s current mental health law regime, I gathered data from transcripts of three administrative tribunal hearings before the Mental Health Review Board of British Columbia and two other decisions from hearings before that board for which transcripts were not available. In these hearings, patients who had been subjected to involuntary psychiatric treatment orders under mental health legislation sought release from detention by challenging the psychiatrists who had issued the orders. The Review Board is legislatively empowered to affirm these orders or discharge the patients from involuntary psychiatric treatment. I use critical discourse analysis to analyze discursive exchanges between patients, psychiatrists and other participants at the hearings, exchanges that disclose power relations between the participants and have significant effects in shaping the outcomes for the patients. My critical discourse analysis of the transcript data and Review Board decisions discloses discriminatory and prejudicial psychiatric practices shaped by British Columbia’s mental health laws. This research lays the groundwork for a normative framework, based on Foucault’s writings on ethics and relational agency, for understanding patients’ rights to consensual medical treatment that overcomes problems associated with traditional liberal conceptions of individual rights and is a philosophically coherent basis for making recommendations to change British Columbia’s mental health law regime. / Graduate

In many jurisdictions, including England and Wales, psychopaths are unable to succeed with an insanity defence. This has been influenced by a legal view of psychopathy as a condition characterised by a reduced ability to comply with the law, which is otherwise fully understood. Evidence from cognitive neuroscience, however, may potentially challenge this traditional legal conception of psychopathy. In this regard it has already been suggested, based partly on scientific evidence, that it may be appropriate for at least some psychopaths to succeed with an insanity defence where they can be shown to lack moral competence. In this thesis, I critically examine this possibility. I first examine the insanity defence in English law, showing how psychopaths have effectively been excluded from the defence by judicial interpretation of the insanity defence criteria. Consequently, if psychopaths lacking moral competence were to be identified, reform (or reinterpretation) of the defence would be required. I then present philosophical arguments in favour of the case that some psychopaths should gain access to an insanity defence, before clarifying which psychopaths ought potentially to succeed, and which criminal offences ought potentially to be relevant, for the purposes of a reformed or reinterpreted defence. In order to clarify which psychopaths are relevant psychopaths (RPs), it is necessary to go beyond existing scientific evidence. It is argued, based on emerging neuroscientific findings and current research techniques, that while it is not currently possible to identify RPs, it may be possible in the future. Even if it this becomes possible, however, the philosophical case for access to an insanity defence remains deeply problematic. Although RPs may lack moral competence, for example, they may nevertheless possess other capacities relevant to criminal responsibility. After closer examination, it is argued that the case for access to an insanity defence may be best viewed as a case for mitigation rather than exculpation. I conclude by considering some of the implications of this analysis in an English legal context, should it become possible to identify RPs. Of particular relevance is the possibility that RPs may be at high risk of causing serious harm to others. This illuminates important possible relationships between responsibility and risk, and diagnostic advancements and risk assessment, in this area. There are also broader implications for the management of psychopaths in the future, given that greater scientific understanding may lead to enhanced predictive abilities that could tempt policymakers towards more radical strategies. This thesis contributes to an ongoing debate about the role that cognitive neuroscience may play in decisions about the criminal responsibility of psychopaths. My main contribution is to clarify how psychopaths lacking moral competence may be identified in the future, and relate this neuroscientific discourse to arguments for providing these persons with access to an insanity defence. It is argued, however, by reference to legal, policy, scientific and philosophical considerations, that the risk such persons would pose, rather than their capacity for criminal responsibility per se, may have significant legal and policy implications in England and Wales in the future.

Located squarely within the experiences of legal aid lawyers, with particular emphasis on the challenges they face in delivering effective representation, this dissertation, designed as an institutional ethnography, problematizes the provisions and practices related to involuntary admission in psychiatric facilities in Poland, as well as the organization of legal aid representation in involuntary admission cases. Through detailed accounts of paramedics, psychiatrists, judges, and legal aid lawyers’ work, connected and coordinated by legal and administrative texts, I demonstrate how the disjuncture between institutional regimes and lawyers’ experiences is institutionally produced by the set of legal, professional, financial, and social relations that organize both the involuntary admission procedure and the system of legal aid in Poland. While I start my exploration with legal aid lawyers’ embodied experiences of performing their work, accounting for how that work is organized and coordinated in local sites, this dissertation moves beyond a solo ethnographic description in seeking to discover relations, especially the social and legal relations mediated by the texts that govern these local experiences and practices. I trace the material and discursive practices that operate in key sites to organize the legal aid system, involuntary commitment procedures, and judicial decision-making. In Poland, the overwhelming majority of involuntary commitment cases are taken on by legal aid lawyers, whose work conduct is bound by both the law and a code of professional ethics. In this dissertation, I advance my thesis by closely reviewing the legal context of involuntary commitment; the material practices associated with legal aid lawyers, such as appointment, client access, and remuneration; the processes through which psychiatric documents are created and attached to admittees; and the role psychiatrist-generated texts play in court. I argue that within the context of involuntary admission, lawyering is organized in such a way that legal aid attorneys are unable to perform at their utmost, in a way that would most benefit their clients. Moreover, through my research I show that―despite perhaps their best intentions―legal aid lawyers not only actively participate in the practices that circumscribe the space for their legal advocacy for admittees, but also reproduce the very discourses and practices that objectify people during involuntary admission procedures to psychiatric facilities in Poland. / Graduate

This thesis is concerned with determining whether South African mental health law and its application in practice is in need of reform. In order to reach its objectives, the thesis measures mental health legislation and criminal law that affect the mentally ill individual or offender against international and local human rights standards, and generally accepted principles and scientific principles applicable in the mental health profession. Particular focus is placed on the admission of a mentally ill person as a voluntary, assisted or involuntary mental health care user, State Patient or mentally disordered prisoner in terms of the Mental Health Care Act 17 of 2002 (?MHCA?), as well a critical review of the MHCA forms used to translate the Act?s provisions into practice. The thesis critically discusses the regulation of mental health care practitioners in terms of the Health Professions Act 56 of 1974, including psychology and psychiatry and the expert witness, and the new Traditional Health Practitioners Act 22 of 2007 and its regulations. An outline of the role of the National Health Act 61 of 2003 in the administration of the health system is provided.The thesis analyses the manners in which mental health affects criminal liability, and Chapter 13 of the Criminal Procedure Act 51 of 1977. Finally a desktop study into the current state of mental health care provision and the implementation of legislation in practice is conducted, followed by conclusions and recommendations for reform to legislation, policy, and the MHCA forms where anomalies have been identified. / Thesis (LLD)--University of Pretoria, 2016. / Public Law / LLD / Unrestricted