Forensic psychiatry

Definition:

"a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.

Components and tasks of the forensic psychiater

• Has two parts: civil and criminal psychiatry
• Evaluation: Mental state opinion at the time of the crime, competency to stand trial
• Provides an assessment to the court about the mental status of the defendant in question → deals with various types of criminals: personality disorders, psychosis, malingering...
• Personality disorders are accountable for their actions → prison, psychotherapy
• Mental disorders are partially accountable to not accountable → treating: inpatient hospital (think of the woman with the baby)

Example:

A mother has killed her newborn baby. The forensic psychiatrist (usually just one in the CR) is going to evaluate her principally by interviewing her and presents his/her expert assessment to the court.

Possible questions that can be raised:

- Was the defendant aware, what he/she was doing?

- How was the mental status at the time of the crime? -> Psychosis, malingering, intoxication, serious mental disorder

- Proposed plan of action: Imprisonment, Hospitalization

"The mother was acutely intoxicated with amphetamines at the time of the crime. She experienced various types auditory and visual of hallucinations, together with persecutory delusions...."

Examples of mental disorders

• Paranoid schizophrenia → homicide
• Mania: Violence, reckless driving, inappropriate sexual behavior
• Personality disorders: Borderline, histrionic, antisocial personality disorder
• Postpartum psychosis: infanticide
• Somatic disorder: e.g. frontotemporal degeneration → sexual offenses
• Psychosis: Intoxication (e.g. methamphetamines), mental disorder (e.g. schizophrenia), somatic disease (e.g. hepatic encephalopathy)