The prevalence and consequences of the insanity plea, titled "guilty except for insanity" in the State of Oregon, are fraught with misconceptions. The use of the plea requires a complex set of interactions between the mental health and criminal justice systems, and comes with severe costs for people who use it. Most of the research on the psychological aspects of the insanity plea emphasizes empirical validity in the form of risk assessment instruments and/or the biomedical model with its focus on disease and illness. This thesis analyzes from community psychology and critical theory perspectives the decision process of hearings held by the Psychiatric Security Review Board. The critical analysis draws specifically on Michel Foucault's (1977) theory of knowledge and power to address three questions: 1. Are there identifiable prototypical narratives of risk that are constructed around evidence admitted to a hearing? 2a. Are these risk narratives deployed differently in public PSRB hearing as opposed to an individual interview? 2b. Do the District Attorney, Defense Attorney, and clinician deploy risk narratives differently? 3. As professionals that create, administer, and interpret risk assessment instruments, how do clinicians use these risk narratives to support or refute the arguments of each side? Transcripts and audio recordings of hearings were thematically content analyzed and compared to address these questions. One overarching theme and four subsidiary themes emerged from the data that describe how risk is indirectly discussed in the formal procedures of the hearings and in individual interviews. The overarching theme is Insight and the four subsidiary themes are Elopement, Compliance, Drug-use, and Treatment. Compared across settings, the hearings were highly structured whereas the individual interviews allowed for a more complex analysis and explication of positions. In the context of the PSRB hearings, the testimony of the clinician was of primary importance in determination of insight and the source of information on the patient along the subsidiary themes.
| Identifer | oai:union.ndltd.org:pdx.edu/oai:pdxscholar.library.pdx.edu:open_access_etds-1629 |
| Date | 10 December 2012 |
| Creators | Balfour, Abby Kealani |
| Publisher | PDXScholar |
| Source Sets | Portland State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Dissertations and Theses |
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