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Policing the Intersection of Mental Health and the Law

Policing the Intersection of Mental Health and the Law

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Published by Douglas Page
Forensic psychiatry has little to do with blood, bones, or ballistics.
Forensic psychiatry has little to do with blood, bones, or ballistics.

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Published by: Douglas Page on Jun 13, 2009
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07/10/2010

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Forensic Magazine® | Articles | Forensic Psychiatry: Policing the Intersection of Mental Health and the Law
 
Forensic Psychiatry: Policing the Intersection of Mental Health and the Law
 
Douglas Page 
 
June/July 2008 
 
One realm of forensics has nothing to do with crime scene evidence like blood, bones, orballistics, but its intangible contributions are no less important to the flow of criminal and civiljustice.
Forensic psychiatry deals with matters of mental health. Its own health is robust.“Forensic psychiatry is booming,” said Timothy Allen, MD, director, Forensic Services, Department ofPsychiatry, University of Kentucky.Over 40 forensic psychiatry training programs currently exist at U.S. universities. The work of forensicpsychiatrists ranges from evaluating competency to stand trial, sentencing recommendations, andproviding expert opinions on mental health questions via written report, deposition, or courtroomtestimony.Of all the activities conducted by forensic psychiatrists, the most frequent pertain to a person’s mentalcompetency. Court ordered competency evaluations in some areas have doubled in the past fiveyears.In criminal cases, forensic psychiatrists evaluate a defendant’s competency to waive Miranda rights,competency to stand trial, and competency to waive legal representation. They also contribute to the jury’s decision as to whether the defendant is sent to prison or to a mental hospital. Once convicted,the forensic psychiatrist might assess the defendant’s competency to waive appeal or be executed.“Forensic psychiatrists play an important role because neither interrogations, nor trials, nor executionscan proceed if the person is not mentally competent,” said William Bernet, MD, director of ForensicServices in the Vanderbilt University School of Medicine.One of the biggest challenges in the field of forensic psychiatry is what to do with mentally illindividuals who are repeatedly found incompetent to stand trial and are released, but continue toreoffend. “Often, these individuals do not meet commitment criteria of being a danger to themselves or others,”
http://www.forensicmag.com/Article_Print.asp?pid=213 (1 of 3)6/12/2009 2:13:05 PM
 
Forensic Magazine® | Articles | Forensic Psychiatry: Policing the Intersection of Mental Health and the Law
Allen said.Some states have opened new forensic psychiatric hospital beds to accommodate non-violent,mentally ill defendants, but in others there is no such facility.One perceived weakness in forensic psychiatry is that mental health professionals often diametricallydisagree, sometimes over the same interview. Two experts, for instance, can view a videotapedinterview of a child disclosing sexual abuse and one will conclude the statement is spontaneous andauthentic while the other will see the disclosure as simply the product of coercive questioning.“Blatant disagreement over the same set of facts are embarrassing to the profession of forensicpsychiatry,” Bernet said. While no professional evaluation standards yet exist, that may be changing.Bernet predicts within the next five to ten years, professional organizations will publish standardizedprotocols for conducting forensic evaluations, as well as standardized methods for interpreting thedata.“We will also see more interdisciplinary cooperation among psychiatrists, other physicians,psychologists, basic scientists, and attorneys, including more interdisciplinary research, dayto- dayevaluations, and policy statements,” Bernet said.Other aspects of forensic psychiatry have progressed more rapidly. Charles L. Scott, MD, chief of theDivision of Psychiatry and the Law, University of California Davis Medical Center, believes the waypsychiatrists assess a defendant’s propensity toward violence has improved markedly.“Compared to 30 or 40 years ago, when interview evaluations relied more on clinician judgmentwithout much research to back it up, risk evaluations now are based much more on objectivemeasurements and known factors,” Scott said.
http://www.forensicmag.com/Article_Print.asp?pid=213 (2 of 3)6/12/2009 2:13:05 PM

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