MacArthur

Adjudicative Competence | Coercion | Treatment Competence

Violence: The MacArthur Community Violence Study
The MacArthur Violence Risk Assessment Study

February 2001 - Updated May 2004

Purpose and Origins

Although it is a relatively new field, mental health law has undergone major developments in the past decade, including landmark judicial decisions, dramatic legislative initiatives, and the publication of professional standards and guidelines in both criminal and civil law. All of these developments, however, have been predicated on plausible but untested assumptions about the mentally ill, their behavior, the service delivery system, and the law...and about how these elements affect one another. 

The goal of the Research Network on Mental Health and the Law is to build the empirical foundation for the next generation of mental health laws -- laws that will assure the rights and the safety of individuals and of society. The Network has two overriding mandates: to develop new knowledge about the relationships between mental health and the law, and to turn that understanding into improved tools and criteria for evaluating individuals and making decisions that affect their lives. 

The Network was created by the John D. and Catherine T. MacArthur Foundation with a grant to the University of Virginia in 1988. The Network is directed by John Monahan. Richard Bonnie is a member of the Network. The Network accepts no unsolicited proposals for funding. 

Major Program Elements

The Network involves experts from the fields of clinical, developmental, and social psychology; sociology; psychiatry; law; and mental health administration and policy. The Network members, in turn, communicate and interact continually with interested groups, including legal and mental health scholars and practitioners, national and state policy-makers, and groups such as former mental patients and their family members. 

The Network's studies are community- as well as clinic-based, and focus on pivotal issues facing the field of mental health law: the competence of mentally disordered people to make autonomous decisions in civil and in criminal law -- termed treatment competence and adjudicative competence, respectively; the violence risk that sometimes accompanies mental disorder; and the coercion that often characterizes interventions to redress incompetence or reduce risk. Several additional research topics, including mental disorder and work disability, were pursued in a more limited manner. 

  • Competence. In recent years, society has come to realize that mental disorder does not necessarily lead to incompetence. Even when it does, the ability to make some decisions regarding one's own treatment under civil law, or in the criminal process, may remain intact. But which disordered individuals are competent to make what kinds of decisions? The Network has developed conceptual frameworks and instruments for measuring the competence of mentally disordered individuals to understand information presented to them, appreciate its implications, and use this information to make rational decisions. 
  • Risk. Although assessing the risk of violence plays a central role in mental health law, our current state of knowledge provides an inadequate basis for making accurate assessments. The Network's research in this area is aimed at improving our ability to assess risk and, ultimately, at enhancing risk management. It includes a prospective, multi-site study of potential markers for increased risk of violence by released mental patients, with a comparison group of non-patients drawn from the same neighborhoods. 
  • Coercion. The state's use of its coercive power to assure that disordered people are hospitalized and treated has long been controversial in mental health law. The Network has focused not only on what is done to an individual (for example, the use of force or persuasion in involuntary hospitalization) but on the process by which the decision is reached and the action is chosen -- including the importance of the prospective patient's role in the process and his or her perception of its fairness. 

Last modified: Feb, 2001.