Legal Borders and Mental Disorders
The Challenge of Defining Mental Illness
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8:30 a.m. – 3:00 p.m., Sutherland Moot Courtroom, S.J. Quinney College of Law
What counts as a mental disorder? Is it when your behavior is statistically unusual, when it impairs your functioning, or when others think it is antisocial? We can define mental illness differently depending on which definition of “disorder” we employ, and the truth is that most of us exist somewhere on a continuum. There is no bright line between sadness and depression, adaptive fear responses and severe anxiety. But for clinical treatment and research, having reliable and discrete labels can help. But what about for the law? Should the law rely on the same diagnoses as psychiatrists do? Doesn’t the law value very different things?
In this symposium we will explore psychiatric diagnosis and its impact on criminal sentencing and civil commitment, education and health benefits, as well as how the system may change in the future. The current manual is called the Diagnostic and Statistical Manual (or, “DSM”) and it is developed by the American Psychiatric Association for clinical use. The most recent version of the DSM was published in May of 2013, and marked the first substantial revision to the manual in over 30 years!
Unfortunately, to many judges and attorneys, a mental disorder is not “real” if it is not in the DSM, and in fact being diagnosed with a recognized DSM disorder is often a prerequisite for receiving legal entitlements and protections, such as disability determinations, health insurance coverage, or even mitigation at sentencing. Despite warnings in the manual itself that it should not be used for forensic purposes, the most recent authors of the manual welcomed input from legal consultants, recognizing that indeed, the DSM is often the only thing upon which courts rely. Much hinges on the changes contained in this recent edition, and we look forward to discussing this with nationally recognized experts in mental health law on November 7th.
Free and open to the public. Lunch provided. 4.5 hours CLE. Email firstname.lastname@example.org for the certificate.
Professor Elyn Saks, Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences, University of Southern California Gould School of Law
Elyn R. Saks specializes in mental health law, criminal law, and children and the law. Her recent research focused on ethical dimensions of psychiatric research and forced treatment of the mentally ill. She teaches Mental Health Law, Mental Health Law and the Criminal Justice System, and Advanced Family Law: The Rights and Interests of Children. She served as USC Law’s associate dean for research from 2005-2010 and also teaches at the Institute of Psychiatry and the Law at the Keck School of Medicine at USC and is an adjunct professor of psychiatry at the University of California, San Diego. Prof. Saks was a 2009 recipient of a MacArthur Foundation fellowship and in fall 2010 announced she is using funds from the “genius grant” to create the Saks Institute for Mental Health Law, Policy, and Ethics. The Institute spotlights one important mental health issue per academic year and is a collaborative effort that includes faculty from seven USC departments: law, psychiatry, psychology, social work, gerontology, philosophy and engineering.
8:30 a.m. – Continental Breakfast and Registration
9:00 a.m. – Welcoming Remarks
9:15 a.m. – Introduction to the Diagnostic and Statistical Manual (DSM): How Psychiatrists Use It
Jan Terpstra, MD
9:45 a.m. – Panel: When Changes to the DSM Affect Health and Education Benefits
Rebecca Johnson, Medical Sociology PhD Candidate, Princeton University
Stacey Tovino, Lincy Professor of Law, Lehman Professor of Law, William S. Boyd School of Law, UNLV
10:45 a.m. – BREAK
11:00 a.m. – Panel: The Role of Psychiatric Diagnosis in Civil Commitment and Sentencing
Sara Gordon, Associate Professor of Law, William S. Boyd School of Law, UNLV
Michael Perlin, Professor of Law, New York Law School
Nancy Haydt, JD
12:30 p.m. – LUNCH
12:45 p.m. – Lunchtime Keynote: Elyn Saks, JD
1:30 p.m. – BREAK
1:45 p.m. – Panel: The Future of the DSM: the ethical and legal implications for revolutionizing the “psychiatric bible”
Jennifer Bard, Alvin R. Allison Professor of Law and Director, Health Law Program, 2003, Texas Tech University School of Law
Teneille Brown, Associate Professor of Law, S.J. Quinney College of Law, University of Utah
2:45 p.m. – Closing Remarks
Law Review Symposium Participants
Professor Teneille Brown, Associate Professor of Law, S.J. Quinney College of Law, University of Utah
Professor Brown joined the faculty in 2009 following two years as a fellow at Stanford University, where she was a post-doctoral scholar in the medical school’s Center for Biomedical Ethics and a fellow with the law school’s Center for Law and the Biosciences. Professor Brown has also been a fellow with the MacArthur Foundation’s ground breaking Law and Neuroscience Project, where she worked for the Network on Legal Decision Making. Before that, she practiced law for two years at Latham & Watkins in Washington DC, specializing in early stage medical device mergers and acquisitions, private equity, and FDA regulatory matters. She also worked on several pro bono cases, including representing asylum seekers, Gallaudet University’s student body, and the Appleseed Foundation. She is a graduate of the University of Michigan School of Law, where she focused on medical ethics and assisted in the creation of the Pediatric Advocacy Initiative, a legal clinic designed to offer free services to patients at C.S. Mott Hospital.
Professor Stacey A. Tovino is a leading expert in health law, bioethics, and the medical humanities. She has particular expertise in the regulatory and financial aspects of health law, and she frequently explores issues that lie at the intersection of health law and other fields, such as gaming law. Educated as both a lawyer and a humanist, Professor Tovino publishes her interdisciplinary work in textbooks, casebooks, edited readers, law reviews, medical and science journals, and ethics and humanities journals. Recent law review publications include articles in the Washington and Lee Law Review, Tulane Law Review, Florida State University Law Review, Houston Law Review, University of Richmond Law Review, Kentucky Law Journal, Penn State Law Review, Harvard Journal on Legislation, and Harvard Journal of Law and Gender, among many other general and specialty journals.
Professor Bard writes and teaches in the areas of public health law, constitutional law, tort law, bioethics, mental disability, the insanity defense and correctional health. She is frequently asked to speak on these topics on a national and international level. She is assistant director for international human subject testing of the Center for Biodefense, Law & Policy. In connection with the Center she is currently a consultant to the Department of Health and Human Services, Public Health Services The Law, Policy, and Ethics Core (LPEC) which provides support for the Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research (WRCE) through research, study, and analysis of policy, laws, and regulations which impact research and scientists in biodefense.
Professor Sara Gordon, Associate Professor of Law, William S. Boyd School of Law, UNLV
Professor Gordon earned her B.A. in Psychology from Pitzer College and her J.D. from the University of Arizona James E. Rogers College of Law, where she served as Managing Editor of the Arizona Law Review. Prior to joining the faculty at the Boyd School of Law, Professor Gordon practiced commercial and employment litigation with the firm of Hale Lane, now Holland & Hart, in Las Vegas. Her research focuses on law and psychology, the impact of cognitive and social psychology on decision-making, and access to mental health care. She is also a Lead Editor for Legal Communication & Rhetoric: Journal of the Association of Legal Writing Directors. Professor Gordon teaches Lawyering Process, Community Property and Evidence.
Professor Michael L. Perlin, Professor of Law, New York Law School
An internationally-recognized expert on mental disability law, Michael L. Perlin has devoted his career to championing legal rights for people with mental disabilities. A prolific author of 23 books and nearly 250 scholarly articles on all aspects of mental disability law, Professor Perlin says that his ninth book, THE HIDDEN PREJUDICE: MENTAL DISABILITY ON TRIAL (American Psychological Association Press, 2000), “reflects the essence of the work he has done throughout his career.” The book is an attempt to educate society about how the fear of persons with mental illness creates a hidden bias against them that prevents equal justice, a form of discrimination he calls “sanism.”
Rebecca Johnson, Medical Sociology PhD Candidate, Princeton University
Rebecca is a PhD candidate in sociology at Princeton who focuses on medical sociology. Previously, she was a research fellow at the NIH Department of Bioethics, and earned her B.A./M.A. in psychology and philosophy at Stanford. Past research has focused on the role of disease advocacy groups in influencing DSM categories, cultural groups that form around medical diagnoses like Asperger’s, and stigma surrounding pre-clinical Alzheimer’s disease.
Jan Terpstra, Assistant Professor of Psychiatry, University of Utah School of Medicine
Jan Terpstra, M.D. is an Assistant Professor of Psychiatry at the University of Utah School of Medicine, and the Director of its Medical Student Wellness Program. He is a graduate of the University of Arizona College of Medicine, and completed his residency in Adult Psychiatry at the University of California-San Francisco. His clinical work involves the inpatient care of severely mentally ill patients, as well as, the outpatient care of medical students with mental health needs. He has taught extensively in the School of Medicine on variety of topics related to psychopathology and its care, and has been the recipient of numerous local and national teaching awards. His current academic interests include medical student education, physician and medical student mental health, and the development of psychiatric nosology.
Nancy Haydt, Attorney
Nancy Haydt is a criminal defense attorney with a background in engineering. She has represented capital murder defendants in cases of mental illness and intellectual disability. She is an amicus author to the Supreme Court. Her recent publications discuss constitutional law and criminal procedure in capital cases involving intellectual disability.
For questions contact Miriam, 801-585-3479.
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