Mental health law and mental health care: introduction.
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Biomedical subjects
Publications and source records attributed to D W Shuman.
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The DSM is designed with the intention that it will be used in clinical and research contexts, not as a guide for the courts. Increasingly, from DSM to DSM-III-R, the introductory cautionary statement in the manual has warned against its use in the judicial context. The drafters of the DSM faced a choice and might have chosen to address in some greater detail those disordered behaviors that do have legal relevance in that they arise with some degree of regularity in the courts. The following essay examines this choice and its consequences.
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We evaluated the impact of the Texas limited privilege statute, enacted in 1979, through a questionnaire study of 121 lay persons, 79 patients receiving psychiatric outpatient treatment, and 84 psychiatrists. An almost equal percentage of lay persons and patients knew or guessed correctly that the statute existed (26% v 27%), but only 45% of the psychiatrists knew or guessed correctly that it had been enacted. Lay persons indicated that they might disclose more to a psychiatrist or psychologist if they had statutory protection, but only a few of the patients said they would have sought treatment earlier or would have disclosed more had they known of a privilege statute. Patients reported that they relied more heavily on their psychiatrists' ethics than on the statute to protect their privacy.
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