The Liberal State and Its Mental Health Power



The Liberal State and Its Mental Health Power

An Interdisciplinary Conference

Open to Students, Faculty and the Community

April 25-26, 2003

Sheldon Lubar Commons (room 7200)

University of Wisconsin Law School

975 Bascom Mall

Madison, Wisconsin

Sponsored by

The Project for Law and the Humanities, Institute for Legal Studies

Frank J. Remington Center, University of Wisconsin Law School

Mendota Mental Health Institute, and State Bar of Wisconsin

With support from

The Evjue Foundation and Forest Pharmaceuticals

Near Final PROGRAM as of 3/31/03

Friday, April 25, 2003

7:45-8:15 Coffee and Registration

8:15-8:30 Welcome: Walter J. Dickey, Evjue-Bascom Professor of Law and Faculty Director, Frank J. Remington Center

Introduction: Leonard V. Kaplan, Mortimer M. Jackson Professor of Law; Co-Director, Project for Law and the Humanities

8:30-10:00 Session 1: Public Control of Deviant Behavior Recent breakthroughs in genetics and brain research are promising applications for all areas of medicine. There is no question that policy makers who are concerned with controlling deviant behavior will turn toward this new understanding for application in public control. What is the state of genetics and of brain research, and to what extent does any of this research have present application to preventive detention or any other aspect of public control?

Chair: Alan Weisbard Associate Professor of Law, Medical Ethics, Jewish Studies and Religious Studies, UW-Madison

Panel: Joseph P. Newman UW Professor of Psychology

"Information Processing Deficits in Psychopathic Offenders: Implications for Self-Regulation and Violence"

Pilar Ossorio Assistant Professor of Law and Medicine, UW-Madison

"Behavioral Genetics: How Antiquated Paradigms of ‘Being and Becoming’ Could Undermine Our Rights"

Lawrence Tancredi Psychiatrist, Lawyer, and Professor at NYU Medical School "The Biology of Choice"

10:00-10:15 Break

10:15-11:45 Session 2: Education Our education system is ever more deeply involved in interacting with the police and mental health power of the state. Zero tolerance as a policy in Wisconsin and elsewhere, after the tragedy of Columbine, has created greater awareness and tension toward what should be therapeutic or punitive with respect to student populations from kindergarten through high school. This panel will address mental health issues in the education system.

Chair: Michele Goodwin Director, Center for the Study of Race and Bioethics, DePaul University Law School

Panel: Lewis A. Leavitt Professor of Pediatrics, UW School of Medicine

Pediatrics

Guy Lord Psychiatrist and Assistant Clinical Professor, Medical College of Milwaukee

"Psychopharmacology in the Classroom"

Ruth Robarts Assistant Dean for Student and Academic Affairs, UW Law School

"Mental Health Categories in School Discipline and the Classroom: Observations of a School Board Member"

Francis K. Schrag Professor of Philosophy and Educational Policy, UW

"What do we owe children?"

11:45-1:15 Lunch Break

Lunch is provided for panelists in the Grainger Executive Dining Room (3275 Grainger Hall)

1:15-2:45 Session 3: State Correctional and Treatment Institutions In recent years policymakers have become more aware of the fact that significant numbers of those in the prison system suffer from major mental health problems, yet little has been done to take this fact into account toward a more enlightened set of dispositions. What constrains the obvious need for reform?

Chair: J. Arboleda-Flórez Professor and Head of Department of Psychiatry, Queens University

Panel: Michael Caldwell Senior Staff Psychologist, Mendota Juvenile Treatment Center and Lecturer, UW-Madison

"The Social Control of Adolescent Sexual Behavior"

Edward R. Garvey Garvey and Stoddard, S.C., Madison

"Representing the Mentally Ill in Wisconsin's Supermax Prison"

Michael Sullivan Former Secretary, Wisconsin Department of Corrections

A View from a Former Secretary of Corrections

Gregory Van Rybroek Chief Executive Officer, Mendota Mental Health Institute

"Treatment of High-Risk Violent Juveniles – An Alternative to Correctional Discipline"

2:45-3:00 Break

3:00-4:30 Session 4: Public and Private Provision of Benefits and Therapeutic Services We are at a moment in history where we know more about how to provide effective services to various and competing general populations for mental health expertise. We now have psycho-pharmacological interventions that provide potentially effective treatment where previously little treatment worked. Correspondingly, we have pathologized more and more behaviors and promised treatment for those behaviors. We still have little equity with respect to mental health service public and private, when compared to other medical dispositions. Cost and not therapeutic results seems more and more to dominate the public forum to the mutual dissatisfaction of all. This panel will address some of these issues.

Chair: Thomas E. Dixon, Jr. Director of Continuing Legal Education, State Bar of Wisconsin, and Lecturer, UW Law School

Panel: Carin Clauss Nathan P. Feinsinger Chair in Labor Law, UW Law School

"Mental Illness: Does It Have to Mean a Loss of Employment and Financial Independence?"

Kathleen Falk Dane County Executive

"Beyond Chapter 51: Meeting Community Mental Health Needs in Tough Financial Times"

David LeCount Mental Health Coordinator for Dane County Human Services

"Dane County, Wisconsin System Example: Laws and Legal Practices Impacting Upon an Adult Mental Health System"

Leonard I. Stein UW Professor of Medicine, Emeritus

"The Need for a Systems Approach to Mental Health Care"

4:30-4:45 Break

4:45-6:15 Session 5: Liberalism and Real Politik This panel will concern itself with the ways in which different kinds of people get directed into various institutional and communal dispositions with respect to the state’s police and/or mental health constitutional powers. We will generally consider discretion as it relates to policing decisions in the street, in the schools, in the prosecutor’s office.

Chair: Aviam Soifer Professor of Law and former dean, Boston College Law School: Dean designate, William S. Richardson School of Law, University of Hawai’i

Panel: Terry Carney Faculty of Law, and Director of Research, College of Humanities and Social Science, University of Sydney

"The Mental Health Service Crisis of Neoliberalism: An Antipodean Perspective"

S. Jan Brakel CEO and partner of the Isaac Ray Forensic Group

"Therapeutic Jurisprudence: the Empty Promise of a Superfluous Concept"

M. Dianne Greenley Attorney, Wisconsin Coalition for Advocacy and Lecturer, UW Law School

Mental Health Policy under the Liberal State in the U.S.

Stephen J. Morse Ferdinand Wakeman Hubbell Professor of Law, University of Pennsylvania School of Law and Professor of Psychology and Law in Psychiatry, University of Pennsylvania

"The Dangerous Demise of Desert-Disease Jurisprudence"

6:15 Closing remarks: Leonard V. Kaplan Mortimer M. Jackson Professor of Law

7:00-10:00 Reception for out of town guests

with buffet dinner for all conference participants

at the home of Len and Martha Kaplan

1410 Seminole Highway, Madison

Saturday, April 26, 2003

8:00-8:30 Coffee

8:30-10:00 Session 6: Cultural Representation of Pathology and Communal Response Culture, in the form of literature and cinema creates certain expectations about the ways in which the public understands mental status. This panel will address the changing nature of cultural representations toward understanding impacts on disposition, control and treatment of various classes of potentially targeted populations.

Chair: John Q. La Fond Edward A. Smith Missouri Chair in Law, the Constitution, and Society, The University of Missouri-Kansas City School of Law

Panel: Michele Goodwin Director, Center for the Study of Race and Bioethics, DePaul University Law School

"The ‘Feeble Woman’ and Reproductive Discrimination"

Richard C. Keller Assistant Professor of Medical History and the History of Science, UW-Madison

"The Limits of Citizenship: Historical Reflections on Race, Psychiatric Knowledge, and the State in France and the U.S."

Karl Shoemaker UW Departments of History and Law

"Furiosus Solo Furore Punitur: The Medieval Origins of the Supreme Court’s Prohibition on Executing the Insane"

Heather Stuart Associate Professor, Community Health and Epidemiology, and Psychiatry, Queen’s University "Mental Illness and Violence: An Overview"

10:00-10:15 Break

10:15-11:45 Session 7: From the Streets to the Courts: Criminal Process, Civil Commitment and Commitment of the Sexual Offender Two panels will consider question of civil commitment generally, and more particularly will explore the changing nature of the disposition of those who formerly were called sexual psychopaths. It will look specifically at current practices in Wisconsin, who falls within this category, the blend of penal and mental health institutions that address this population, and what seems to be the tendency to enlarge this population toward a more general theory of preventive detention. The panels also will address the relationship between civil commitment and community treatment and control; civil commitment and the criminal process.

Chair: Andrew Rutherford Professor and Dean of the Faculty of Law, University of Southampton

Panel: Krista Ralston Clinical Professor of Law and Director, Legal Defense Program, UW Law School

"The ‘Justice’ System: A View from the Street"

Pat Malloy Lieutenant, Madison Police Department and

Judy Schwaemle Dane County Deputy District Attorney

"When Mentally Ill People Get Caught up in the Criminal Justice System:

A View from Police and Prosecutor"

Thomas E. Dixon, Jr. Director of Continuing Legal Education, State Bar of Wisconsin, and Lecturer at UW-Madison

"Liberal to Libertarian and Back Again - The Pits and the Pendulum"

Stuart Schwartz Presiding Judge, Dane County Circuit Court, Division of Probate and Mental Health

"Mental Health Law in Transition: Then and Now"

11:45-1:15 Lunch Break

Lunch is provided for panelists in the Grainger Executive Dining Room (3275 Grainger Hall)

1:15-2:45 Session 8: From the Streets to the Courts: Criminal Process, Civil Commitment and Commitment of the Sexual Offender (continued from session 7)

Chair: Stewart Macaulay Malcolm Pitman Sharp and Theodore W. Brazeau Professor, UW Law School

Panel: John Q. La Fond Edward A. Smith Missouri Chair in Law, the Constitution, and Society, The University of Missouri-Kansas City School of Law

"Sexually Violent Predator Laws and the Liberal State: An Ominous Threat to Individual Liberty"

Nicholas G. Bokas Assistant State Public Defender, Criminal Division

"A Critical Examination of The Liberal State and Wisconsin's Civil Commitment Law for Sexually Violent Offenders"

Dennis M. Doren Evaluation Director, Sand Ridge Secure Treatment Center

"Assessments of Mental Conditions and Recidivism Risk for Sex Offender Civil Commitments"

David Thornton Medical Director, Sand Ridge Secure Treatment Center

"Prospects for the Effective Treatment of High-Risk Civilly Committed Sexual Offenders"

2:45-3:00 Break

3:00-4:15 Session 9: Guardianship and Competence This panel will address the complex set of issues concerning competency and guardianship. It will take into account issues ranging from competency to stand trial, to make wills, to manage one’s everyday living. The panel will address issues concerning those in the criminal justice system the civil commitment system, and the aged.

Chair: Terry Carney Faculty of Law, University of Sydney

Panel: Mark A. Frankel Lafollette Godfrey and Kahn; former Dane County circuit court judge

"The Power of a Guardian to Initiate Divorce Proceedings on behalf of an Incompetent Ward: An Exploration at the Boundaries of Substituted Judgment"

Robert Miller Professor of Psychiatry and Director of the Program for Forensic Psychiatry at the University of Colorado Health Sciences Center; Adjunct Professor of Law, University of Denver; Director of Research and Education, Institute for Forensic Psychiatry, Colorado Mental Health Institute at Pueblo

"Hospitalization of Criminal Defendants for Evaluation of Competency to Stand Trial or for Restoration of Competency: Clinical and Legal Issues"

Kenneth I. Robbins Clinical Associate Professor of Psychiatry

Evaluations

4:15-4:30 Break

4:30-6:00 Session 10: Treatment and Research After the deinstitutionalization movement, more emphasis has been placed on effective and responsible community treatment for those who were previously held in state mental health units. It is not clear that such treatment has always been effectively provided. Moreover, it is also clear that some people require more institutional care than is generally reported. What is the current balance between institutionalization and community disposition, and how properly rationalized is this balance?

Chair: Gregory Van Rybroek Chief Executive Officer, Mendota Mental Health Institute

Panel: Ronald J. Diamond Professor of Psychiatry, UW Medical School

"Power and Coercion in Mental Health Treatment"

Robert M. Factor Medical Director of Emergency Services, Mental Health Center of Dane County

"Paternalism and Involuntary Treatment: Can Involuntary Treatment Be Justified Ethically When Dangerousness Is Not Acute?"

Aleen Grabow Psychiatrist, GHC and private practice

"The Psychotherapeutic Alliance. . . An Anachronism?"

William Knoedler Psychiatrist for PACT in Madison and Green County, Wisconsin The PACT Model

6:00 Break

The reception, closing banquet, and final panel session will take place

at The University Club on the Library Mall

— * Advance registration is required for the dinner session —

6:30-7:00 Reception

7:00-8:00 Dinner

8:00 Welcome: Howard Erlanger Voss-Bascom Professor of Law, Professor of Sociology, and Director, Institute for Legal Studies

8:15-9:45 Session 11: Liberal State Perspectives on the Mental Health Power This panel will analyze the deepest institutional foundations of the mental health apparatus in the United States, Canada and United Kingdom. The theoretical tone of the panel will also integrate the various strands of analysis from the conference.

Chair: Leonard V. Kaplan Mortimer M. Jackson Professor of Law

Panel: J. Arboleda-Flórez Professor and Head of Department of Psychiatry, Hotel Dieu Hospital, Queens University

"Elements of Mental Health Reform"

Andrew Rutherford Professor and Dean of the Faculty of Law, University of Southampton

"Whatever happened to DSPDs?"

Andrew Siegel Assistant Scientist, Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins Univ. "Privacy, Identity, and the State"

Aviam Soifer Professor of Law and former dean, Boston College Law School: Dean designate, William S. Richardson School of Law, University of Hawai’i

"Ahistory Taking A History"

9:45 Closing Remarks: Leonard V. Kaplan

10:00 Adjourn

*Advance registration will be required for Saturday evening attendance; interested parties should register with Pam Hollenhorst at pshollen@wisc.edu. Please send a check for $35 made out to WLAA and mailed to Institute for Legal Studies, UW Law School, 975 Bascom Mall, Madison WI  53706-1399.

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