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ABSTRACTS  
Year : 2016  |  Volume : 58  |  Issue : 6  |  Page : 230-234
Abstracts



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Date of Web Publication27-Dec-2016
 

How to cite this article:
. Abstracts. Indian J Psychiatry 2016;58, Suppl S2:230-4

How to cite this URL:
. Abstracts. Indian J Psychiatry [serial online] 2016 [cited 2019 Aug 18];58, Suppl S2:230-4. Available from: http://www.indianjpsychiatry.org/text.asp?2016/58/6/230/196848


Marriage and Mental Health

S. Nambi

Professor, Sree Balaji Medical College and Hospital, Chennai, India.

E-mail: siva.nambi@gmail.com

Marriage has been, since ancient times, one of the most important social institutions. The concept of Hindu marriage has undergone continuous modification through the ages from sacrament to contract. In India, there are different types of marriages in different cultures and communities. Consanguineous marriages are not uncommon in South India. A Hindu marriage, unlike other marriages in India, is no longer regarded as indissoluble. Marriage maybe stressful for vulnerable people, which may lead to the development of mental health problems. The interplay between marriage and mental health problems has been a known fact. Major mental health disorders may be the cause or effect of marital disharmony. Divorce-seeking couples have a high psychiatric morbidity. Every country and every religion have its personal law. In India, under Article 44 of the Indian Constitution, the state is bound by a constitutional mandate to secularize and homogenize family laws. The following Acts have a bearing on the legal aspects of marriage in India: The Hindu Marriage Act with an Amendment later, The Special Marriage Act, the resolution of the Muslim Marriage Act and the Muslim women protection of rights on divorce, The Parsi Marriage and Divorce Act, The Christian Marriage Act, and The Indian Divorce Act and The Family Courts' Act. The matrimonial relief that one can seek includes: (1) decree for nullity, (2) restitution of conjugal rights, (3) judicial separation, and (4) divorce.

Keywords:
Marriage, matrimonial relief, mental health legislation governing India, mental illnesses

The Relevance of Modern Neuroscience to the Forensic Psychiatry Practice

Manish A. Fozdar 1],[2],[3

1 Triangle Forensic Neuropsychiatry, PLLC, 2 Duke University Medical Center, 3 Campbell University School of Medicine

The exponential growth of neuroscience discoveries fueled primarily by rapid advances in technology has lifted the veil on many hitherto poorly understood brain disorders. This knowledge applies to both organic brain disorders as well as unfortunately misnamed functional brain disorders. Although collectively we have failed to capitalize on this new knowledge at several levels as practitioners of forensic psychiatry, this is the paradox that will be discussed during this presentation. We have failed to inform our legal policy makers of the newly gained insights into brain disorders. By doing so, we are missing an opportunity to construct an evidence-based legal system. Despite these advances, expert testimonies are increasingly disparate when presented with the same set of data in a particular case. This further leads to confusion and mistrust among the triers of the facts. This contradiction must be eliminated by collaborative efforts of different disciplines. Doing so will undoubtedly result in evidence-based criminal and civil jurisprudence by reducing the role of intuition and sociopolitical forces. We can integrate well-established scientific principles at different levels of the judicial process - trial proceedings, sentencing guidelines, parole hearings, future risk determination, disability guidelines, personal injury cases, competency hearings, and juvenile adjudication. On the other hand, the application of neuroscience to the law must not be overzealous to raise concerns about scientific reliability, misapplication, and overreliance on a developing science. By helping to portray a balanced view of modern neuroscience and its possible contribution to the legal world, we can hopefully dilute the paradox.

Competency to Stand Trial

Steven K. Hoge

Department of Psychiatry, Division of Law, Ethics, and Psychiatry, Columbia University College of Physicians and Surgeons, New York, USA

The legal concept of competency to stand trial has ancient roots. The history of this legal construct in Anglo-Saxon law will be reviewed. A competent defendant is a requirement of the criminal justice system because it reflects interests related to the dignity of the process, the accuracy of adjudication, and respect for the autonomy of defendants. In the United States, legal decisions have established the contours of the requirements related to competent participation in adjudication. Forensic psychiatrists have operationalized the requirements for assessment purposes. Recent decisions in the United States have expanded earlier notions of competency to include decision-making during the course of adjudication. These decisions will be reviewed. The process of clinical evaluation, use of collateral information, and other aspects of expert opinion formation will be reviewed. In addition, the special problems posed by amnesia, pro se defendants, competency to plead insanity, and unrestorable defendants will be discussed. The use of standardized assessment tools will also be reviewed. The application to the Indian criminal justice system will be discussed.

Do we need Law or Justice or Both?

Nirmala Srinivasan

Ex-Trustee Action for Mental Illness Currently, Founder President Families Alliance on Mental Illness

This presentation from a parent activist is essential to draw the focus of the law makers and human rights activists that many a time the Law itself denies justice to the person with mental illness (PMI) by failing to ignore its impact on the ground reality of mental illness in India. The lapses are illustrated from the appointment of legal guardian PMI under the Mental Health Act 1987; and also under the upcoming "Laws" viz. MHCare Bill 2013 and Rights of Persons with Disabilities Bill 2014.

We plead for a law that does not inhere a dichotomy between the legal provisions and social justice.

Mental Illness, Human Rights, and Law

Brendan D. Kelly

Trinity College, Dublin, Ireland

One in four people will develop a mental illness at some point in life. Some will experience diminished mental capacity, and some will require involuntary care. Traditionally, mental health law has focused on protecting the right to liberty to ensure that involuntary treatment is necessary, proportionate, and in accordance with law. In 2006, the United Nations' (UN) Convention on the Rights of Persons with Disabilities presented new challenges to mental health law and psychiatry around the world. The UN Convention focuses on inclusion, equality, and rights. It states that a deprivation of liberty must not be based on the presence of a disability, and it appears to include severe or enduring mental illness in its definition of "disability." Despite this challenge, the UN Convention offers real opportunities to advocate for better treatment for mental illness, greater social inclusion of the mentally ill and their families, and greater observance of social and economic rights, as well as the right to treatment. In India, the Mental Healthcare Act 2016 (as passed by the Rajya Sabha on 8 August 2016) explicitly aims "to align and harmonize the existing laws" with the UN Convention. This is a major undertaking for any country owing to interpretative challenges with the UN Convention. Nonetheless, it is an exceptionally important task, which can also be usefully informed by the World Health Organization's "Resource Book on Mental Health, Human Rights and Legislation" (2005) and must be underpinned by reform of services delivered to the mentally ill and their families.

Insanity Defense: Related Issues

T. V. Asokan

Department of Psychiatry, SRM Medical College and Research Institute, Kanchipuram, Tamil Nadu, India

For the past 150 years, there is no change in the understanding and knowledge other than autonomy and capacity to choose the right and wrong for criminal liability. The alternative concept that human behavior is the result of an interaction between biological and environmental factors other than free choice failed to impress the criminal justice system because of a direct threat to a society's deep-seated need to blame someone than themselves for criminal harms that occur. The insanity defense has a long history, and is evolved after many tests that have been tried and tested. McNaughton's rules stressed on "understandability of right and wrong" and "intellectual" rather than a moral or affective definition dominated in its formulation. Lack of control and irresistible drives or impulses were neglected. Going by the current understanding of neurological evidence of compulsion and lack of impulse control, rationality tests without the inclusion of lack of control seem to be outdated. Separate "Control determination" than the "Rationality determination" by the jurors may improve the accuracy of Juror's categorizations. There is a suggestion that Relevance ratio is ideal for 'Evidentiary relevance" and there should be a quality control on expert testimonies. With progress in neuroscience, the law may need to abandon or alter some of its current assumptions about the nature of voluntary conduct, which underlies various defenses.


   References Top


  1. Marfatia JC. Psychiatry and law. In: Martindale D, Martindale E, editors. 1972. p. 8109132.
  2. Asokan TV. Daniel McNaughton (1813-1865). Indian J Psychiatry 2007;49:223-4.
  3. Giorgi-Guarnieri D, Janofsky J, Keram E, Lawsky S, Merideth P, Mossman D, et al. AAPL practice guideline for forensic psychiatric evaluation of defendants raising the insanity defense. American Academy of Psychiatry and the Law. J Am Acad Psychiatry Law 2002;30 2 Suppl: S3-40.


POSCO and child abuse

Shekhar Seshadri

Department of Child and Adolescent Psychiatry, NIMHANS, Bengaluru, Karnataka, India

E-mail: shekhar@nimhans.ac.in

A critical aspect of child protection, also a child public health issue, child sexual abuse warrants systemic approaches that are uncompromisingly child-centric. Part of this has to do with preventive programs in schools and other childcare agencies. Focus on prevention has the potential to reduce sexual victimization and even sexual offences in the general population. However, when an event occurs, it is addressed by systems of criminal justice, police, schools, families, and healthcare, which generate a flurry of incoherent activity, albeit in good faith, thereby compromising the child's best interests. The major emphasis of these activities is directed toward the child "victim" through enquiry, interrogation, and intrusive detailing of the event to verify it and then bring the perpetrator to book. The balance between the need for justice and empowered rehabilitation of the child becomes precarious. There is thus an urgent need to develop a protocol-based systemic response ensuring that the child's agenda, i.e. healing and recovery, is at the core of it.

Beyond PINK: When yes should mean No: Guidelines for Doctors on Sexual Boundaries

Sunita Simon Kurpad 1],[2

Departments of 1 Psychiatry and 2 Medical Ethics, St. John's Medical College, Bengaluru, Karnataka, India

E-mail: simonsunita@gmail.com

The 2000-year-old Hippocratic Oath had clear guidelines on the need for doctors to abstain from sexual relationships with patients. The older Indian Charaka Samhita forbade aspiring physicians even "adultery in thought." While the Medical Council of India (MCI) in its Code of Ethics, does state that "adultery and immoral conduct" by doctors is prohibited, this is obviously an inadequate statement for several reasons. Most countries around the world have responded to the need for more detailed guidelines. The Indian Psychiatric Society (IPS) Task Force on Boundary Guidelines, with The Bangalore Declaration Group - a group of doctors from diverse backgrounds (mental health, medicine, surgery, obstetrics gynecology, pediatrics, research, medical education, and medical ethics) - have worked on a document on Guidelines for doctors on sexual boundaries. As IPS has recently taken a pioneering stand by endorsing these guidelines and holding all psychiatrists to its ethical standard, it is hoped that other professional bodies and even the MCI will take "implementable" steps to ensure all doctors maintain sexual boundaries in the doctor patient relationship. While no one would argue that "No means no," these guidelines hope to ensure doctors realize that in the power imbalanced with a patient, even "consensual" sexual activity is construed as a sexual boundary violation. The session will discuss the background and salient features of the Guidelines.

Future of forensic psychiatry in India

Choudhary Laxmi Narayan

Ex-Professor, A. N. Magadh Medical College, Gaya, Bihar, India

E-mail: drclnarayan@gmail.com

Psychiatry is a recently developed specialty in India, and as of now, only 6000 psychiatrists are available for a population of 1300 million. Therefore, forensic psychiatry in India is in a very nascent state of development. Psychiatrists working in government sector are under immense pressure as they have to perform the medicolegal works in addition to their other works. After the proposed Mental Healthcare Bill 2016 comes into force, various provisions such as advance directive, nominated representative, scrutiny of involuntary admissions, approval of some types of treatment by review boards, informed consent, right to information about treatment, and other human rights of persons with mental illness are going to tremendously increase the volume of works related to forensic psychiatric issues. Increasing public awareness about psychiatric disorders and the human rights is going to result in increased works related to other civil and criminal issues of forensic psychiatry. Therefore, there is an urgent need to include topics of forensic psychiatry in both the undergraduate and the postgraduate medical curriculum so that all the medical graduates and psychiatrists are well acquainted. There is an urgent need as well to institute training facilities for the subject of forensic psychiatry for the students pursuing PG courses in psychiatry. There should be some specialized centers in the country where PG students may be posted for few weeks. Inclusion of psychiatry as a separate subject at the undergraduate level would serve a great purpose to achieve the objectives.

Capital Punishment Defense: Cases from the files of a Schizophrenia Expert

Ananda K. Pandurangi

Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA

E-mail: ananda.pandurangi@vcuhealth.org

Crimes deserving capital punishment are heinous and repelling to any human being. Society understandably feels that those convicted of such crimes deserve no mercy. However, when such a convict is discovered to be suffering from schizophrenia, the perspectives will change. Significant questions include as follows: (1) was there a thorough assessment of the mental condition of the accused/convict, (2) was treatment provided and if so with what purpose, (3) was there adequate legal representation, (3) did the person receive a fair trial, (4) was the sentence appropriate, (5) did the psychiatric condition influence the outcome one way or the other, etc.This lecture will address the above questions from the perspective of an schizophrenia expert witness through presentation of 3-cases of capital punishment in the USA.

ABSTRACT SUBMISSION FOR IAMHLASIA 2016 CONFERENCE IN BENGALURU, INDIA

Evaluation and risk assessment of sex offenders

Angeline Stanislaus

Department of Mental Health, Jefferson City, MO, USA

E-mail: angeline.stanislaus@dmh.mo.gov

In the United States, persistent sex offenders are referred by the courts for forensic psychiatric or psychological evaluations, to determine if the sexual behaviors are driven by paraphilic deviant sexual interest and assess their risk for sexual re-offense.If the sex offender is determined to suffer from a paraphilic disorder such as pedophilia or paraphilic coercive disorder, they can be court ordered to participate in sex offender specific treatment while they are incarcerated or while on community supervision. If it is also determined that their risk to sexually re-offend is high, based on their static and dynamic risk factors for sexual re-offending, they could face higher level of sentencing or be civilly committed to specialized units for sex offender treatment and recovery.In this presentation, Dr. Stanislaus will discuss specific features that differentiate a paraphilic sex offender from a nonparaphilic sex offender. She will also discuss the static and dynamic risk factors that have been empirically correlated with sexual recidivism in sex offenders, and how to assess these risk factors in a forensic psychiatric evaluation process.

NDPS Act (1985): Why it Matters for Addiction Treatment Professionals?

International Academy of Law and Mental Health: Asia Pacific Conference 15-17 December 2016

Atul Ambekar

National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

E-mail: atul.ambekar@gmail.com

The Narcotic Drugs and Psychotropic Substances (NDPS) Act (1985) has been described as a "draconian" anti-drug law. Hastily drawn under the international pressure (with India being a signatory to the three United Nations drug conventions), the Act criminalizes all forms of production, trafficking, trade and even the USE of the listed NDPS. Notably, many of these listed and controlled drugs have legitimate scientific and medical utility, while some others have had sociocultural sanction for use. The Act seeks to control the "abuse" of NDPS while simultaneously ensuring their availability for medical purpose. In practice, however, provisions of the Act are applied more for control of drugs rather than ensuring their availability. While the law provides for treatment of drug addicts caught with possession of small quantities of drugs (in lieu of jail term), this provision is seldom operationalized. Thus, certain aspects to the NDPS Act are relevant for the mental health professionals since their patients fall under the purview of this law (on account of their behavior of consuming NDPS). On the other hand, many health-care professionals use the controlled medications for treatment of their patients and hence remain liable to be affected by the provisions of the Act. In the recent past, three Indian psychiatrists have been to jail on the charges framed under this law. The Act has undergone amendments thrice with each amendment masquerading as a reform and yet bringing-up more complexities. The most recent amendment (2014) has the potential to be a "game-changer" in terms of easing-out the availability of some opioid analgesics for medical treatment. However, certain other aspects of the Act remain a hindrance for provision of effective treatment services to patients who need controlled medications. Mental health professionals must remain aware of the complexities of the law and need to play a proactive role as advocates for legal and policy reforms.

Mental illness and pro-women legislations: Is there a need to change the legislations

Indira Sharma, Abhishek Pathak 1

Department of Psychiatry,Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, 1 Department of Psychiatry, Safai Institute of Medical Sciences, Etah

E-mail: indira_06@rediffmail.com

Background: It has been alleged that certain laws, the Dowry Prohibition Act (DPA) (1961), Dowry Death (304B IPC), Protection of women from Domestic Violence Act (2005), of Cruelty by Husband or Relatives of Husband (498A IPC) and Sexual Harassment of Women at Work Place (Prevention, Prohibition and Redressal) Act 2013, which have been enacted to protect women are being used to target men because of which more men than women have suffered. The problems are manifold in the setting of mental illness. There is thus an urgent need to make these laws gender neutral.

Aim: (1) To discuss applicability pro-woman laws, especially in the setting of mental illness. (2) To discuss the need for changing the legislations.

  1. Protection of Women from Domestic Violence Act and mental illness: Does the Act need to be gender neutral?
  2. Mental illness and Of Cruelty by Husband and Relatives of Husband (498 A): Will amendments help in preventing abuse of 498A?
  3. DPA and Mental illness: Has the Act served its purpose? Should the Act be changed?
  4. Sexual Harassment of Women at Work Place (Prevention, Prohibition and Redressal) Act 2013: Is the Act really needed?


Protection of women from domestic violence act and mental illness: Does the act need to be gender neutral?

Abhishek Pathak, Indira Sharma 1

Department of Psychiatry, Safai Institute of Medical Sciences, Etah,

Institute of Medical Sciences, Banaras Hindu University, Varanasi,

Uttar Pradesh, India

Background: Protection of women from DV Act 2005 was enacted recognizing the problem DV against women in the country. Violence against women with mental illness is a greater problem. It is alleged that false complaints are made against to harass male members of the family. Aim: To review court cases to determine the nature of DV, whether complaints of DV are genuine, and the possible causes including psychiatric morbidity Materials and Methods: Recent court cases relating to DV in the state are reviewed to determine the complaint of DV (verbal, physical, economic, or sexual), whether there is objective evidence to support the complaints DV, and the cause (s) of DV (psychiatric morbidity in the victim or perpetrator and psychosocial factors). Results: Verbal, physical, and economic violence was more frequently reported. Economic violence was in the form not providing for maintenance, and confiscation of conjugal right by not allowing the woman to stay with her husband. There was objective evidence of economic violence in most of the cases; in a few cases, there was evidence of physical violence. Psychiatric morbidity was present in some of the cases, both in the husbands and wives. The implications of these findings are discussed. Conclusion: DV against women, especially psychological, physical, and economic, is reported which is largely substantiated. The allegation of false complaints by wives against husbands and his male relatives is not found. Psychiatric morbidity in perpetrators (husband) and victims (wives) needs to be addressed.

MENTAL ILLNESS AND OF CRUELTY BY HUSBAND AND RELATIVES OF HUSBAND (498 A): WILL AMENDMENTS HELP IS PREVENTING ABUSE OF 498A?

It has been alleged that 498A IPC is used to take revenge or harass innocent husbands. It is possible mental illness, in the husband or wife, may be the cause for complaints under 498A.

Mental Health and Pro-women Legislations

N. Keertish

Department of Psychiatry, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India

Aim: To review court cases relating 498A and determine whether there was evidence of psychiatric morbidity in either the husband or wife. Methods: Recent court cases relating to 498A are reviewed to determine whether there was any evidence suggestive psychiatric morbidity in the complainants or their husbands. Results: In some of the cases, there was clear evidence of psychiatric morbidity. In a few cases, husbands were also reported to have mental illness or to have taken treatment for the same. The findings are discussed in light of the implications in preserving the institution of family. Conclusion: Psychiatric morbidity can be a cause of complaints of cruelty by husband and relatives of husband. It should be identified and treated.

Dowry Prohibition Act and Mental Illness: Has the Act Served its Purpose? Should the Act be Changed?

Abhishek Pathak, Indira Sharma 1

Department of Psychiatry, Safai Institute of Medical Sciences, Etah,

1 Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Background: With respect to the Dowry Prohibition Act (DPA) (1961), the Court has issued directions to states that husbands and his relatives should be arrested only after a preliminary inquiry based on a checklist is completed because many complaints are frivolous. On the contrary, the women's family claims that hefty dowry was given, and despite this, the woman is being tortured by the husband (s)/in-laws for want of more. In cases of married women, especially those with mental illness, complaints of dowry may be made to prevent dissolution of marriage. Aim: To review court cases to determine whether dowry was demanded/received and whether there was any evidence of psychiatric morbidity in the complainants. Methods: Recent court cases relating to DPA in the state are reviewed to determine whether there is evidence of demanding/receiving dowry. Furthermore, they are examined to see whether there was any evidence of psychiatric morbidity in complainants (wives). Results: There was evidence (partial) of giving dowry. Psychiatric morbidity was present was present in some of the cases. Conclusion:

Despite the DPA, practice of dowry is a part of most marriages, but demands of dowry are often difficult to prove. Dowry may be a nonissue, the real issue being dissolution of marriage.

Sexual harassment of women at workplace (prevention, prohibition, and redressal) Act 2013: Is the Act really needed?

Shruti Srivastava

Department of Psychiatry, University College of Medical Sciences and GTB Hospital, New Delhi, India

Background: Psychiatric morbidity at workplace may have varied presentations. Often, the cause for complaints of sexual harassment of women at workplace could be psychiatric morbidity either in the women employee or her male colleague/employer. Aim: To study cases of sexual harassment at workplace to find out if there is any psychiatric morbidity in the complainants (woman employees) or the male employers (respondents). Methods: The cases of complaints of sexual harassment at workplace are reviewed to determine whether there is any evidence of psychiatric morbidity in either the complainants (women employees) or the male employees/employers against whom the complaint has been made. Results: There is some evidence of axis 1 psychiatric disorder in the women employees. In other cases, some of the male employees have axis 1 or axis 2 disorders. The practical implications of the findings are discussed. Conclusion: There should be an in-built system to identify psychiatric morbidity at workplace and ensure that it is aptly treated so that it does not adversely affect the workplace.

OVERVIEW OF LAWS FOR PROTECTION OF WOMEN IN SAARC MEMBER COUNTRIES

Kuruvilla Thomas 1],[2

Kusumagiri Mental Health Centre, Lisie Hospital, Kochi, Kerala, India

E-mail: drkuruvillathomas@gmail.com

Overview of Laws for protection of women in member Countries of SAARC Psychiatric Federation Kuruvilla Thomas Chief Psychiatrist Kusumagiri Mental Health Centre Kochi - 682030 SAARC Psychiatric Federation consisting of India, Pakistan, Bangladesh, Nepal, Maldives, Bhutan, Afghanistan, and Sri Lanka was formed in 2004. There were 9 International conferences in different countries. IPS President is the current President of the Federation. Article 1 of the constitution of SAARC Psychiatric Federation states: "To promote the subject of psychiatry and allied sciences in all their different branches and to promote the improvement of mental health of the people, research and mental health education in this region with cooperation at all levels between the countries included in this federation." From time immemorial, women have been subjected to neglect and abuse throughout the world. The fact that there are separate Acts to protect women denotes the realization that they require protection. Still the fact remains that they continue to be tortured. It is worthwhile examining the existing Laws for protecting women in the region and find out how it can be implemented or if required modified.

LEGAL ASPECTS OF SUICIDE SPECTRUM

Lakshmi Vijayakumar

Consultant Psychiatrist, Chennai, Tamil Nadu, India

Suicide is a major mental health problem worldwide. In many countries, suicide ranks among the top ten causes of death. According to the WHO report 2014, every 40s, a person dies by suicide in the world. The legal issues in suicide vary greatly across countries in the world and sometimes even within a country. In Ancient times, suicide was an event. It was St. Agustin, in 4 th century AD who proclaimed that suicide as a sin and thereafter it was considered a criminal act. However, humaneness prevailed and many countries in the world have repealed the anti-suicide law in their respective countries. According to the World Health Organization report, it has been found that attempted suicide is still a criminal offense in 25 countries of the world. The various steps leading up to decriminalization of suicide attempt in India will be discussed. The other legal issues around suicide are euthanasia, assisted suicide, liability and implication regarding insurance, and responsibility.

Teaching forensic psychiatry

Phillip J. Resnick

School of Medicine, Case Western Reserve University, Cleveland, OH, USA

In the United States, the Accreditation Council for Graduate Medical Education determines the curriculum required for fellows in forensic psychiatry to become board certified as a subspecialist. Areas that must be covered during the 1-year fellowship include criminal issues, such as insanity; civil issues, such as tort law and Workers' Compensation; legal regulation of psychiatry, such as confidentiality and involuntary hospitalization; and correctional psychiatry issues, such as dual agency and prisoner's rights. Fellows are also expected to have knowledge about juvenile courts, the structure of the legal system, and child custody issues. In addition, fellows are required to analyze complex cases and write forensic reports which are well reasoned. Teaching methods include lectures, storytelling, use of video vignettes, and mock trials. Additional teaching methodologies include group supervision of fellows in their report writing and direct observation of giving testimony. During the year, we see fellows evolve and shift their orientation from being an advocate for patients to perceiving their role as serving justice.

Management of rape and sex offenders

T. S. Sathyanarayana Rao

Department of Psychiatry, JSS University, JSS Medical College Hospital, Mysore, Karnataka, India

E-mail: tssrao19@yahoo.com

Sexual behavior in many societies is a subject fraught with moral codes, norms, expectation, myths, and unscientific conclusions. Even though sexual offenders are frequently viewed as a homogeneous class of individuals, they often differ widely in the type and nature of sexual activity, age, background, religion, beliefs, attitudes and interpersonal skills. There is no single profile to explain their crime, gender, age, planning, and amount of violence. Causatively it would be multifactorial and like in aggression characteristics, motivation and methods vary. The presentation also looks at the offender characteristics, their classification, possible typologies, its relationship to pornography, and paraphilias. The presentation emphasizes varied treatment options and characteristic resistance to change their deviant patterns. It will elaborate on evocative therapies which includes individual, group, couple/marital, and family counseling on the one hand while on the other psycho-educational counseling, drug treatment, and cognitive behavior therapy. It will also elaborate on relapse prevention strategies to emphasize the importance of combining treatment for both the cessation of the antisocial conduct and the maintenance of improvement.

Mental illness, Death Penalty and Competence to be Executed

Navneet Sidhu

Saint Elizabeths Hospital, Washington DC

Although 141 countries in the world have abolished the death penalty, it remains an issue of significant concern. In 2015, China led the world in executions that are estimated to be in the thousands. Other countries with high rates of executions include Iran, Saudi Arabia, Iraq, US and Pakistan. The US is the only G-7 country that continues to employ the death penalty and there were 28 executions in 2015. The US was the first county to adopt the lethal injection as a means of delivering capital punishmentIt is a well-established fact that in many countries, these executions are motivated by race, religion and political leanings. In most cases, the mental health and competence of the individual to be executed is not questioned.The constitutionality of death penalty for the mentally ill has been raised several times in US courts. The American Psychiatric Association( APA), National Alliance on Mental Illness( NAMI), among others have issued amicus briefs that focus on the appropriate standards to be executed. In this presentation, I highlight the ethical and moral dilemmas involved in cases of mentally ill defendants facing the death penalty.


   References Top


  1. Death Penalty Information Center (2010). ͻPart I: History of the Death Penalty, Death Penalty Information Center΋. Retrieved August 29, 2016.
  2. Bordenave, Franklin J., and D. Clay Kelly. "Death Penalty and Mentally Ill Defendants." Journal of the American Academy of Psychiatry and the Law Online 38.2 (2010): 284-286.


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