Can a Forensic Psychiatrist achieve a 'Not guilty by reason of insanity' defence?
Although a psychiatric evaluation may not change a 'guilty,' or 'not guilty,' verdict, the severity of the charge and the length of sentencing can be very much depend on an expert testimony.
A clear well written expert psychiatric evaluation with or without testimony, by increasing a judge or jury's understanding of the individual, as well as mitigating factors leading to the individual breaking the law, an individual's risk to the community, and potential for rehabilitation back into the community, can lead to an individual being released on parole, or be granted a ' sentence served.' verdict.'
An example of where a psychiatrist evaluation may lead to a more lenient charge or sentence, is where an individual may have had an undiagnosed mental illness, where an individual had sought help but had been denied medical care, or where an individual's behaviour was caused by a side effect to certain prescription medication such as dopamine agonists.
Some Factors Determining the length of sentence, and whether a person receives a jail sentence can include :
-Whether an individual intended to commit a crime
-The presence of mental illness
-Vulnerability to coercion
-Vulnerability of Exploitation
-Presence of Medical illness and side effects to prescription medication
-External mitigating factors
Risk Assessment as to the individual's likeliness to reoffend, demonstration of internal and external protective factors which would prevent an individual from reoffending
Dangerousness and risk to the community - Demonstrating that an individual would not be a danger to the community of released.
Community Supports- demonstrating that an individual has adequate community supports to prevent relapse of mental illness or psychotic symptoms
What is the difference between a forensic psychiatrist and a Forensic Psychologist?
Forensic psychiatrists and forensic psychologists can both conduct clinical evaluations. However, a forensic psychiatrist is a medical doctor who has completed a psychiatry residency and is Board Certified in the field of Psychiatry and Neurology and may have completed a forensic psychiatry fellowship. A forensic psychiatrist can evaluate and also testify in court about social and biological aspects of mental illness or disorders.This includes genetic, developmental, endocrine, infectious, neoplastic, neurological , structural pharmacological and other causes of mental illness and changes in behavior. A forensic psychiatrist can recommend laboratory tests and medications if needed.
I am not allowed to see my children unsupervised will a Forensic Psychiatrist help?
Sometimes during divorce cases one spouse may be alienated from the children , or not allowed to see their children except with supervised visitation only. This is often the case when one parent suffers from mental illness, or is accused of suffering from mental illness.
Unless there is clear evidence to sustained abuse towards the children , alienation from one or more parents is almost always detrimental towards the children . Diagnosis of mental illness or substance use disorder in many cases should not be a reason to deny unsupervised visits.
A child custody evaluation or parenting evaluation should include :
1. Psychiatric evaluation with explanation of any psychiatric illness, and what efforts have been made to receive treatment so the individual can foster a relationship with their child.
2. Review of medical records, with explanation of past diagnosis , what treatment has been received and if symptoms have resolved. A prior history of mental illness is not usually a contraindication for child custody unless an individual has not received treatment or symptoms have not resolved. Past or current mental illness is not a contraindication to child custody, providing the parent is not abusive to the child, is not neglecting the child and is not behaving in ways to endanger the child.
3. Explanation of any substance abuse history, including how long the parent has been sobre, and what ongoing treatment has been received . Providing the parent is in remission and receiving treatment, a history of substance abuse is not a contraindication to child custody.
4. Collateral information , from the child if old enough, other older siblings, employers, housekeepers, friends, anyone else who is close to the individual, sees the individual closely on a regular basis, and can vouch that they have have not observed indicators of substance abuse, psychosis or erratic behavior. Collateral information is extremely important as it is common for the for former partner or opposing counsel to exaggerate symptoms, or fabricate information in order to build a case against an individual in order to obtain child custody.
5. Explanation of accusations and former judgements, when an motion is served to deny a parent of custody of a child, it usually involves some damming accusations . These accusations are often untrue, grossly exaggerated, or paint a very distorted picture, for example ' she went to the ER twice for a panic attack in 2010 , ' becomes ' she has a history of emotional instability with multiple psychiatric hospitalizations.' or he got into a bar fight in college in 2001, and the police were called, becomes ' he has a history of arrests for violent behavior.' It is important the an individual is allowed to tell their side of the story during the psychiatric evaluation as details can be lost during the court process.
7. Examination of any forensic psychiatric evaluations for clinical accuracy and evidence of bias. Psychiatric evaluations performed by experts hired by the opposing counsel can sometimes show signs of bias. Evidence of bias can include, writing the report based on testimony from the former spouse, while not performing a through psychiatric evaluation, not reviewing records, not collecting unbiased collateral, ignoring recommendations of other health care providers, omitting information that would place the individual in a positive light.
Legitimate reasons to deny joint custody and unsupervised visits may include :
1. History of excessive violence and sadistic behaviour towards the child. (this does not include spanking within the limits of the law in younger children).
2. Ongoing substance abuse and inconsistency with treatment (this does not include short relapses if mostly sobre).
3. Poor insight with regards to mental illness and non adherence to treatment (this does not include asking for a change of medication , reporting side effects to medication, or requesting a second opinion with regards to medication).
4. Refusal to participate in family therapy if relationship with children is stressed.
5. Consistent neglect of children.
6. Children report feeling safe and uncomfortable around the parent concerned.
7. The parent has endangered the child and shown gross neglect on more than one occasion, eg drinking and driving, not picking the child up from school, and other areas of poor judgement.
Even in the case of past neglect, or distressing behaviour due to mental illness, rather than wilful neglect or harm, strategies can be implemented to safely increase access to the child, as parental alienation is thought to be harmful to a child. The role of a forensic psychiatrist as well as evaluating risk would also be to solve problems and provide suggestions as to how to foster a relationship between children and parents.
What Are The Professional Ethics Expected From A Psychiatrist Expert Witness?
A forensic psychiatrist or psychiatrist expert witness must be able to differentiate the subjective from the objective, and put aside their personal feelings and bias.
A forensic psychiatrist or psychiatrist expert witness must act in the best interest of the client by presenting all relevant data that will assist the client in receiving a fair representation and not omit relevant information or cut corners.
Why does a Forensic Psychiatrist expected to be ethical as well as credible?
A forensic psychiatrist who says things which are not credible, not believable or obviously not true, is likely to harm a client because the whole testimony and report will lose credibility and recommendations are unlikely to be followed. A good psychiatrist expert witness will say things which are truthful, but clearly present all relevant data that would be helpful to the client, and should be considered during the legal process
Rather than saying things which are not credible, the best possible outcome for the client is usually achieved when an expert witness can back up their statements and opinions, by data, literature review, clinical interview, records review and previous experience.
