Vol. 34, No. 4, 54. For Your Health.

• Author: by John Dolores, J.D., Ph.D. Director, Behavioral Health Services Cheyenne Regional Medical Center

Wyoming Bar Journal

2011.

Vol. 34, No. 4, 54.

For Your Health

Wyoming LawyerIssue: August, 2011For Your Healthby John Dolores, J.D., Ph.D. Director, Behavioral Health Services Cheyenne Regional Medical CenterDetermining Suicidality/Homicidality in Court

Law and mental health is an uncomfortable marriage at best. This mar-_riage is demonstrated in various ways, including competency and insanity questions in criminal law, claims for psychological damages in tort litigation, and the determination of suicidality/homicidal-ity in civil court proceedings to decide the necessity of continued commitment. When dealing with the commitment process, the difficulties with the integration of law and mental health start with differing priorities. The law's priorities are that of the patient's/ client's civil rights and ensuring that they are treated fairly and guaranteed the protections afforded by law. The mental health provider's priorities are that of patient safety, the safety of the community, and providing appropriate treatment to the patient/client. The conflict endemic to these differing priorities is obvious. Thus, judges often find themselves in difficult situations requiring them to decide between a client's/patient's desire not to be held against his will and the mental health provider's desire to continue commitment for safety and treatment purposes.

When making such decisions, courts are generally naive to the mental health issues, which is why an expert witness is called to provide testimony. The expert witness will testify to the safety risk and need for continued treatment of the patient if the expert's evaluation arrives at such conclusions. The problem encountered is when the judge must decide between the expert's testimony that commitment be continued and the defense attorney's arguments that statutory criteria have not been met to continue the commitment. The statute requires that commitment be continued if the client/patient demonstrates an imminent risk of harm to self or others. Often, defense...