The indigenous paraprofessional and involuntary civil commitment: A return to community values.

Abstract

Many community mental health centres in North America have on their staff paraprofcssionals who arc indigenous to the community. Sharing the same cultural background as the community, they can often bridge the wide cultural barriers which exist between the professional and the population served. Despite this, paraprofcssionals have traditionally held a relatively subservient role vis-a-vis their professional colleagues, with the more crucial, socially arbitrating decisions left to the professionals-specifically, the involuntary commitment of the potentially dangerous person. Because of their understanding of the community culture, paraprofessionals' involvement in civil commitment procedures would seem critical. The behavioural scientists' inability to predict dangerousness has been documented (Monahan, 1981). This lack of predictive accuracy is partially associated with a failure to incorporate contextual and situational variables (Bern & Funder, 1978;Mischel, 1973). Although medical-psychological training is adequate for assessing dispositional traits, the very nature of such training prohibits an emphasis on culturalcontextual variables (Keeney, 1979). The use of indigenous paraprofessionals in the commitment process would reduce this methodological lacuna, and would also attenuate the potential misuse of mental health facilities as agents of social control. The responsibility of arbitration would no longer entail the imposition of outside values against local ones; rather, local community values would become the judgemental criterion.This article is based on a major review paper submitted in partial fulfilment of the Ph.D. degree in psychology at York University. I wish to thank Irwin Silverman, David Bakan, Bruce Quarrington, and the anonymous reviewers for their comments on earlier drafts of this article.Requests for reprints should be sent to R.

The effects of legislative reform on civil commitment admission rates: A critical analysis

“…many individuals were being committed inappropriately, and little, if any, actual treatment was being administered, the reforms of this period sought to restrict the medical prerogative in civil commitment proceedings.' Most states and provinces have adopted a narrower criterion (Bagby, 1984;Kittrie, 1971;Schwitzgebel & Schwitzgebel, 1980), predicated in one form or another on the dangerousness criterion (Stone, 1975).…”

Contributions of Canadian applied psychological research to correctional and psychiatric institutions.

“…His results supported the notion that most patients are ignorant of the legal aspects of their hospitalization and do not desire legal counsel, and that improvements in the treatment of mental patients are unlikely to occur through changes in legal practice. In this connection, civil commitment procedures have been scrutinized and been determined to bear little relation to the legal criteria on which they are supposed to be based (Bagby, 1984;Page, 1981;Richert & Moyes, 1983). Stein and McNairn (1983) have studied the changing nature of diagnosis over the past twenty years in an inpatient setting for children.…”

Psychologists and privileged communication.

“…This state of affairs is particularly ironic; increasingly, the judiciary relies on the expertise of behavioural scientists to provide information to aid the courts' decision-making. Although it may not be in the best interests of psychologists to assert total discretion over the determination of privileged communication (e.g., Everstine et al, 1980), or for that matter, any other area where law and psychology interface (see, e.g., Bagby, 1984), psychologists do need to utilize their special skills as researchers to help shape legal policy.…”