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The word “forensic” might make you think of shows like Criminal Minds or Law & Order, which both have to do with solving crimes and dealing with many types of perpetrators; "psychiatry” as a practice focuses on diagnosing and treating mental, emotional, and behavioral disorders. So, what happens when you put these words together? You get “forensic psychiatry,” which is “the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law, and with the flow of mentally disordered offenders along a continuum of social systems” [1]. Now, this does seem like a lot to unpack, but we can make it a bit simpler. The field of forensic psychiatry deals with issues “related to criminal prosecutions and the treatment of mentally ill offenders to many other fields of law and mental health policy” [1].
In penal cases, forensic psychiatrists determine whether an offender is fit to stand trial, is legally insane, or is a dangerous offender [1]. After an offender’s mental state has been determined by forensic psychiatrists, they will then be placed in an institution depending on their needs. Institutions can include: “hospitals for the criminally insane, mental hospitals for the civilly committed patients, penitentiary hospitals for mentally ill inmates, as well as hospital wings in local jails” [1]. In civil cases, “psychiatrists and other mental health specialists are often required to conduct assessments with a view to determining the presence of mental or emotional problems in one of the parties” [1]. There is such a huge spectrum of mental and emotional problems, and the same mental and emotional problems can affect different individuals in a variety of ways. So, in civil cases, “the issue at hand is a determination of capacity and competence to perform some function or the evaluation of autonomous decision-making by impaired persons” [1].
Now, a big ethical issue forensic psychiatrists face is their double role as clinicians and evaluators. “The most important issue for the forensic psychiatrist is to make sure that the person subject of the evaluation is not misled into believing that, because the psychiatrist is a medical doctor, the relationship to be unfolded is one of physician-patient, in which the doctor is expected to do the best for the patient and always to act to maximize the patient's benefit while reassuring the patient that privacy and confidentiality are protected” [1]. In fact, forensic psychiatrists must remain neutral and cannot promise confidentiality or privacy since all elements must be considered and presented to the court in the evaluation of individuals. “Because of this, forensic psychiatrists may even be implicated in the criminalization of mentally ill persons'' [1].
The field of forensic psychiatry requires expertise and patience in order for individuals to get evaluated as accurately as possible and placed in a facility that fits their needs.
References:
1. Arboleda-Flórez J. (2006). Forensic psychiatry: contemporary scope, challenges, and controversies. World Psychiatry: official journal of the World Psychiatric Association (WPA), 5(2), 87–91.
Contributors:
Author: Lauryn Agron
Editor: Chadwick Huynh
Health scientist: Chantelle Moore