Forensic psychiatry is a subspecialty of psychiatry and is related to criminal and civil matters. It is a field that involves taking the help of psychiatrists in legal cases.
A forensic psychiatric evaluation involves conducting various tests to understand the mental capacity of the accused or defendant and providing opinions to the court regarding particular aspects of a case.
Various terms that are used include:
Competency to stand trial (CST)
CST is the evaluation of the mental capacity of defendants. It allows the defendant to take a stand against the accused, take the help of an attorney to solve their case, and understand the plea agreement.
- The psychiatrist tests the ability of the defendant to have a factual and rational understanding of allegations against themselves.
- The ability here implies the ability to understand the legal charges against them and the consequences of the legal proceedings.
- They should be able to convey the information to their attorney and should be able to understand their attorney’s words.
In criminal cases, forensic psychiatrists may be asked to provide their opinion on the competence of a person to make decisions throughout all the phases of criminal investigation, trial, and punishment.
In the United Kingdom, CST is referred to as “fitness to plead.”
Forensic psychiatrists are often taken as expert witnesses in both criminal and civil cases to provide their independent opinion.
Expert witnesses understand certain aspects of the case that are incomprehensible to the judge or jury. In most cases, they prepare a detailed report based on important concepts, approaches, and methods used in psychiatry.
Mental state opinion (MSO)
MSO gives the court an opinion, and not a verdict, regarding whether a defendant was able to understand what they were doing at the time of the crime. This word is known by various names in many states and has been rejected in some states. However, the opinion of the psychiatrist on the mental status of the defendant or accused affects the final verdict of the case.
Rules that come under MSO include:
- M'Naghten rules
- Durham rule
- ALI test
The psychiatrist can only opine that the criminal must have committed the crime under the influence of their mental illness, or they must not be aware of what they are doing because of their mental illness.
“Not guilty due to insanity” can be the judgment passed by the judge based on MSO. This means a criminal who has been proven to commit the crime may not be considered guilty on account of a mental illness (insanity). Insanity is a legal word and not a medical word.
What are the matters in which a psychiatrist forensic evaluation may play a role?
The role of forensic psychiatrists comes into the picture in matters such as:
- Care of prisoners
- Care of mentally ill people who have committed a crime
- Evaluation of several civil competencies such as:
- To make a will or contract
- To make decisions about one's person and property
- Juveniles delinquency (criminal behavior of a juvenile)
- Child custody
- Termination of parental rights
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"Ethics Guidelines | AAPL - American Academy of Psychiatry and the Law". Available at: www.aapl.org
Hoge SK. Competence to stand trial: An overview. Indian J Psychiatry. 2016;58(Suppl 2):S187-S190.
Gutheil, Thomas G. (2009). The Psychiatrist as Expert Witness (2nd ed.). American Psychiatric Publishing.
Simon, Robert and Liza Gold, ed. (2010). American Psychiatric Textbook of Forensic Psychiatry. American Psychiatric Publishing.
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