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Understanding the Role of a Forensic Psychiatrist

In court proceedings, when lawyers and judges have a case where a mental health question exists, they often rely on forensic psychiatrists to evaluate situations and answer questions particular to the legal system. He might be only one of a number of experts that a court has summoned for assistance. The court expects him to provide objective, professional commentary on information crucial to a legal case as it relates to mental health.

Q: Is a forensic psychiatrist a medical doctor?

A: Yes. A forensic psychiatrist has a medical degree, training as a psychiatrist, and education and experience in the practice of applying his knowledge to court cases. He might also run a private practice outside of the courtroom. Inside the courtroom, his job is not to offer therapeutic rehabilitation to people who are testifying; it is to draw on his expertise to supply the court with objective facts regarding mental health that will help judges, juries, and lawyers to make decisions integral to the outcome of the case.

Q: Do forensic psychiatrists take sides in legal cases?

A: Forensic psychiatrists who adhere to ethical codes are not supposed to take sides. Their job is to analyze data or evidence and to offer their professional opinion without bias toward either party. While lawyers and courts frequently ask forensic psychiatrists to consult on cases or to give strategic advice, they should not expect these experts to combine that advice, or advocacy, with specific testimony. The Hippocratic Oath and the Oath of Geneva provide standards for ethical behavior in this field. Forensic psychiatrists must also follow the state-mandated requirements of licensing agencies. Many are members of one or more professional organizations that speak to their respectability, such as the American Academy of Psychiatry and the Law or the American Psychiatric Association.

Q: What contributions do forensic psychiatrists make to civil and criminal cases?

A:  Forensic psychiatrists may determine people’s competency to stand trial and can assess for emotional and psychological stability. They can…

  • Evaluate whether someone is mentally equipped to waive Miranda rights, to confess, or to undergo a trial and a conviction;
  • evaluate someone’s competency to make decisions in disputes about wills, property, medical treatment, and child custody;
  • help to define how liable a product might be for causing illness and/or stress to a consumer;
  • analyze witnesses and their testimony to distinguish signs of authentic trauma from signs of false or exaggerated trauma;
  • assist in hearings that focus on negligence, discrimination, and sexual harassment at the workplace;
  • testify in cases about medical malpractice;
  • evaluate whether a defendant premeditated a crime or not, therefore influencing a judge’s or jury’s verdict;
  • evaluate if a person is Not Guilty by Reason of Insanity.

Q: What are some concerns that a legal client might raise about hiring a forensic psychiatrist, and how does a lawyer alleviate those concerns for his client?

A: A client might resent the additional cost of hiring a highly-qualified forensic psychiatrist, who will most likely charge by the hour. She might try to convince her lawyer to find an inexpensive alternative, placing her case at risk. She also might express anxiety about revealing emotionally sensitive information, solicited by a forensic psychiatrist, in the courtroom. A client could even argue that her own psychiatrist is a better option for bringing expertise to a case. However, she may not understand the consequences of exposing the details of her private relationship and therapeutic sessions with her psychiatrist. It would also prove difficult for her treating psychiatrist to avoid bias. A forensic psychiatrist offers specialized expertise and an objective evaluation, using multiple informational sources. He has garnered credibility and respect from the court through formal training and licensing. A client should realize that while she might choose not to hire a forensic psychiatrist, the opposing side might very well do so, giving themselves an advantage.

Q: What does a forensic evaluation include?

A: A forensic evaluation usually entails psychiatric interviews of the individual directly involved in the case; conversations with other relevant individuals; scrutiny of the verbal and non-verbal behaviors in these dialogues; a checking of consistency across interviews with multiple people; and a study of other collateral records. Often in cases, there is a medical-legal question that needs to be answered. Once a forensic psychiatrist has gathered his data, he writes a comprehensive report that addresses the medical-legal question.

Q: How much does a forensic psychiatrist charge for his services?

A: Conventionally, a forensic psychiatrist will charge anywhere from $400 to $800 per hour for his expertise. He might offer a free discussion or consultation to begin, but document review, report preparation, patient examination, travel time and distance, trial testimony and service cancellation will all require substantial per-hour or half-day/full-day fees. Some forensic psychiatrists might bill on a weekly or monthly basis; others will require deposits up front. No forensic psychiatrist who is operating under appropriate ethical guidelines should ask for, or accept, a contingency fee for his services.

Q: What does a forensic psychiatry report look like?

A: Whether a forensic psychiatry report makes it to trial or not, this report is a major component of a forensic psychiatrist’s work after he has interviewed and assessed an individual involved in a court case. A proper and effective report will include the following components:

    • The name of the individual who requested the evaluation
    • The questions that the report will answer
    • The informational sources on which the forensic psychiatrist is basing his evaluation
    • The guidelines and warnings made clear to the examinee at the start of the evaluation
    • The details of the information gathered by the evaluator, source by source
    • The evaluator’s observations of the examinee
    • The evaluator’s methods for reaching conclusions from those observations

A forensic psychiatrist should write his report in simple, straightforward language, remembering to avoid jargon particular to his field and therefore unfamiliar to the common reader. The prose should reflect the expert’s vast knowledge of psychiatry and the nuances of the legal system, as well as pay homage to the importance of truthfulness.